Heel Pain

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Definition

Heel pain is a common condition in which weight bearing on the heel causes extreme discomfort.

Cause

There are two different categories of heel pain. The first is caused by over-use repetitive stress which refers to a soreness resulting from too much impact on a specific area of the foot. This condition, often referred to as "heel pain syndrome," can be caused by shoes with heels that are too low, a thinned out fat pad in the heel area, or from a sudden increase in activity.

Plantar fasciitis, a very common diagnosis of heel pain, is usually caused from a biomechancial problem such as over-pronation (flatfeet). The plantar fascia is a broad band of fibrous tissue that runs along the bottom surface of the foot, from the heel through the midfoot and into the forefoot. Over-pronation can cause the plantar fascia to be excessively stretched and inflamed, resulting in pain in the heel and arch areas of the foot. Often heel pain will be most intense first thing in the morning or after a prolonged period of rest. The pain will gradually subside as the day progresses.

Treatment and Prevention

To properly treat heel pain, you must absorb shock, provide cushioning and elevate the heel to transfer pressure. This can be accomplished with a heel cup, visco heel cradle, or a custom heel orthotic designed with materials that will absorb shock and shear forces.

When the condition is pronation related (usually plantar fasciitis),an orthotic with medial posting and good arch support will control the pronation and prevent the inflammation of the plantar fascia.

Footwear selection is also an important criteria when treating heel pain. Shoes with a firm heel counter, good arch support, and appropriate heel height are the ideal choice.

If the problem persists, consult your foot doctor.

To relieve the excessive pressure that leads to callus formation,weight should be redistributed equally with the use of an orthotic. Aneffective orthotic transfers pressure away from the "hot spots" or highpressured areas to allow the callus to heal. The orthotic should bemade with materials that absorb shock and shear (friction) forces.Women should also steer away from wearing high-heeled shoes.

As always, surgery should be the very last resort. If the problem persists, consult your foot doctor.