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Foot and Ankle Associates
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Richmond/Rosenberg Podiatry Tackles Heel Pain

Welcome to the Heel Pain Center at Foot & Ankle Associates.  Heel Pain is one of the most common complaints seen by podiatrists.  Heel pain is generally the result of faulty biomechanics (walking gait abnormalities) that place too much stress on the heel bone and the soft tissues that attach to it. The stress may also result from injury, or a bruise incurred while walking, running, or jumping on hard surfaces; wearing poorly constructed footwear; or being overweight.

 

In our pursuit of healthy bodies, pain can be an enemy. In some instances, however, it is of biological benefit. Pain that occurs right after an injury or early in an illness may play a protective role, often warning us about the damage we've suffered.

 

The heel bone is the largest of the 26 bones in the human foot, which also has 33 joints and a network of more than 100 tendons, muscles, and ligaments. Like all bones, it is subject to outside influences that can affect its integrity and its ability to keep us on our feet. Heel pain, sometimes disabling, can occur in the front, back, or bottom of the heel.

 

Plantar Fasciitis

Both heel pain and heel spurs are frequently associated with an inflammation of the band of fibrous connective tissue (fascia) running along the bottom (plantar surface) of the foot, from the heel to the ball of the foot. The inflammation is called plantar fasciitis. It is common among athletes who run and jump a lot, and it can be quite painful.

 

The condition occurs when the plantar fascia is strained over time beyond its normal extension, causing the soft tissue fibers of the fascia to tear or stretch at points along its length; this leads to inflammation, pain, and possibly the growth of a bone spur where it attaches to the heel bone.  The inflammation may be aggravated by shoes that lack appropriate support, especially in the arch area, and by the chronic irritation that sometimes accompanies an athletic lifestyle.

 

Resting provides only temporary relief. When you resume walking, particularly after a night's sleep, you may experience a sudden elongation of the fascia band, which stretches and pulls on the heel. As you walk, the heel pain may lessen or even disappear, but that may be just a false sense of relief. The pain often returns after prolonged rest or extensive walking.

 

Children’s Heel Pain

Heel pain can also occur in children, most commonly between ages 8 and 13, as they become increasingly active in sports activity in and out of school. This physical activity, particularly jumping, inflames the growth centers of the heels; the more active the child, the more likely the condition will occur. When the bones mature, the problems disappear and are not likely to recur. If heel pain occurs in this age group they could be experiencing the effects of Sever's Disease and podiatric care is necessary to protect the growing bone and to provide pain relief. Other good news is that heel spurs do not often develop in children.
 

Prevention

  • Shoes - select shoes that fit well in the front, back and sides!
  • Ensure shoes have shock-absorbent soles, rigid shanks, and supportive heel counters.
  • Wear the proper shoes for each activity.
  • Do not wear shoes with excessive wear on heels or soles.
  • Warm up and do stretching exercises before and after running.
  • Listen to your body's need for rest and good nutrition.
  • If obese, lose weight
 

Treatment

Early treatment might involve oral or injectable anti-inflammatory medication, exercise and shoe recommendations, taping or strapping, or use of shoe inserts or orthotic devices. Taping or strapping supports the foot, placing stressed muscles and tendons in a physiologically restful state. Physical therapy may be used in conjunction with such treatments.
 

A functional orthotic device may be prescribed for correcting biomechanical imbalance, controlling excessive pronation, and supporting of the ligaments and tendons attaching to the heel bone. It will effectively treat the majority of heel and arch pain without the need for surgery.
 

Only a relatively few cases of heel pain require more advanced treatments or surgery. If surgery is necessary, it may involve the release of the plantar fascia, removal of a spur, removal of a bursa, or removal of a neuroma or other soft-tissue growth.

 

Heel Pain Tips

  • If you have experienced painful heels try wearing your shoes around your house in the evening. Don't wear slippers or socks or go barefoot. You may also try gentle calf stretches for 20 to 30 seconds on each leg. This is best done barefoot, leaning forward towards a wall with one foot forward and one foot back.
  • If the pain persists longer than one month, you should visit a podiatrist for evaluation and treatment. Your feet should not hurt, and professional podiatric care may be required to help relieve your discomfort.
  • If you have not exercised in a long time, consult your podiatric physician before starting a new exercise program.
  • Begin an exercise program slowly. Don't go too far or too fast.
  • Purchase and maintain good shoes and replace them regularly.
  • Stretch each foot and achilles tendon before and after exercise.
  • Avoid uneven walking surfaces or stepping on rocks as much as possible.
  • Avoid going barefoot on hard surfaces.
  • Vary the incline on a treadmill during exercise. Nobody walks uphill all the time.
  • If it hurts, stop. Don't try to "work through the pain."
     

Non-invasive treatment for stubborn and persistent heel pain


Additional options may be availabe to help you avoid surgery for heel pain cases For cases of plantar fasciitis that do not react to our typical treatments such as:

 

Laser Therapy

Laser Therapy, or "photobiomodulation", is the use of specific wavelengths of light (red and near-infrared) to create therapeutic effects. These effects include improved healing time, pain reduction, increased circulation and decreased swelling. Laser Therapy has been widely utilized in Europe by physical therapists, nurses and doctors as far back as the 1970's. Now, after FDA clearance in 2002, Laser Therapy is being used extensively in the United States. Laser Therapy is proven to biostimulate tissue repair and growth. The Laser accelerates wound healing and decreases inflammation, pain, and scar tissue formation. In the management of chronic pain Class IV Laser Therapy can provide dramatic results, is non-addictive and virtually free of side effects.  Click on the video below to view the benefits of laser therapy.

 

During Laser Therapy the infrared laser light interacts with tissues at the cellular level and metabolic activity increases within the cell, improving the transport of nutrients across the cell membrane. This initiates the production of cellular energy (ATP) that leads to a cascade of beneficial effects, increasing cellular function and health.  During each painless treatment laser energy increases circulation, drawing water, oxygen, and nutrients to the damaged area. This creates an optimal healing environment that reduces inflammation, swelling, muscle spasms, stiffness, and pain. As the injured area returns to normal, function is restored and pain is relieved.
 

Benefits to the patient include:

  • Improves and promotes healing
  • Reduces pain and spasm
  • Increases joint flexibility
  • Reduces symptoms of osteoarthritis
  • Improves peripheral microcirculation
  • Detoxifies and eliminates trigger points
  • Advanced pain relief
  • More info on Laser Therapy