The heel is prone to many types of injuries. The Mayo Clinic, for instance, lists several. This is a shame, because, despite frequently being overlooked, they are essential for performing most sports. When they hurt, your practice routine is overthrown. Getting back to that routine means finding the source of the heel pain and how to treat it.
Here are 5 types of injuries a heel can sustain and some ways to treat those injuries.
This is the easiest to deal with. It is a deep bruise to the fat pad of the heel that makes it feel like you have a pebble in your shoe. These bruises can come from stepping on something hard or simply landing hard on the heel. Overtraining, hard surfaces or worn-out shoes can also trigger these pains, and there are sometimes underlying structural problems with the foot that causes them to be particularly susceptible to stone bruises.
The bruise responds well to icing the area for 10 to 15 minutes and resting the heel. Taking an over-the-counter pain medication will take the edge off until the pain dissipates completely. The best cure is to put cushioning inner soles in your shoes and to get new shoes that provide padding. If the pain persists after the change in shoes, it may be a more serious problem that requires a doctor’s attention.
This is one of the most common sources of pain in heels. It is when the thick band of tissues that connect the heel bone to the toes, called the plantar fascia, gets irritated or inflamed. This causes sharp, sudden pains in the bottom of the foot and heel when a person first gets up in the morning and after exercise. The pain may decrease with motion, but get worse after sitting or standing for a long time.
Runners, dancers and jumpers are prone to plantar fasciitis. So are people who are overweight or wear ill-fitting shoes. Flat feet, high arches and abnormal gait are also factors. The direct cause of the pain isn’t always clear, but anything that repeatedly stretches and tears the tendons on the bottom of the foot can trigger it.
Heel and foot muscle stretches can help ease the pain. Particularly, heel cord stretches are recommended by the American Academy of Podiatric Sports Medicine for treating the pain at home. A tape system such as the PF tape Plantar Fasciitis Pain Relief System can provide support and cushioning for the afflicted foot. Letting the foot rest will give the tendons time to recuperate, too. This is one of those pains that should be treated because people who ignore it often change their posture and gait to accommodate the pain, and that can lead to stress on other body parts.
The Achilles tendon is the band of tissue that connects calf muscles at the back of the lower leg to your heel bone. When these tissues are overused, such as when a runner increases the intensity of their workout suddenly or when people start playing intense sports on the weekends, they can get inflamed. This causes pain in the lower leg and right above the heel. It will start out as mild aches right after exercising those tendons, and you may feel stiffness or tenderness in the morning that gets better with gentle movement.
It is possible for severe cases to lead the Achilles tendons to tear, and this may require surgery. Surgery may also be in order if you have tried to manage the pain for several months without any result.
For pain from overuse, physical therapy is helpful. A physical therapist might recommend ‘eccentric’ strengthening, which is an exercise where someone raises a weight and then slowly lets it down, for persistent Achilles pain. For temporary pain, the therapist would probably recommend other stretches and exercises. Another way to ease the pain is to use shoe inserts that raise the heel slightly and relieves the strain on the tendons.
The heel bone can crack from a high-impact injury, such as a fall. Tiny fractures can also develop from overuse, such as when a person runs for a long distance often. People in high-impact sports have a higher risk of such fractures, especially if they use poor equipment or don’t use the proper technique.
A fracture in the heel will cause pain when it is being moved and may not be able to take any weight. Other signs of a fracture are swelling, tenderness and bruising around the heel.
The usual treatments are putting the heel in a cast or splint and wearing pads around the heel. Fractures vary in size, though, and some may require surgery. Someone with a fractured heel bone will have to keep pressure off the heel, and will probably use crutches to get around for a few months while the bone mends. Physical therapy can help relieve some of the pain and stiffness once the bone is mended.
Spurs are abnormal growths on the sides of bones, officially called osteophytes. Often they form where bones meet, but not always. One place these growths can start is on the bottom of a person’s heel. Normally, they begin on the front of the heel and point towards the arch of the foot. The main cause of bone spurs is osteoarthritis, but there are other reasons that they develop. Runners can get them, and so can anyone with an unusual posture or a tendency to wear ill-fitting shoes. About half the people with plantar fasciitis have bone spurs on their heels. A person with flat feet or high arches can be particularly prone to them.
Pain from spurs can be treated by using custom-made orthotic inserts or a cutout heel pad that accommodates the growths. Physical therapy and over-the-counter pain relievers will also relieve the pain. If the spur is limiting your range of motion or pinching the nerves in the heels, a doctor may recommend surgery to remove it.
The fluid-filled sac at the back of the heel bone, at the bottom of the Achilles tendon, is called the retrocalcaneal bursa. This can become inflamed from sudden impacts or repeated stress. For instance, starting a very rigorous workout schedule can get irritate it. When this happens, the back of the heel will feel warm and turn red, and the heel will hurt when walking or running. It may feel even worse when you stand on your toes.
There are a few ways of dealing with this painful condition. Icing the back of the heel several times a day will reduce the inflammation, and taking over-the-counter non-steroidal pain relievers can do the same. Another way of treating bursitis of the heel is to use heel wedges that will take away some of the stress from the heel.
Physical therapy that focuses on strengthening your ankle will help the bursa heal and prevent it from returning. If none of these work, you might get injections of small amounts of steroid medicine in the bursa to cure it.
Bursitis of the heel sometimes comes with Achilles tendonitis, in which case the doctors may want to have the ankle in a cast for several weeks to give the entire area a rest.
Heel pain puts a cramp in any athlete’s routine. Tapes and shoe inserts can alleviate many types of heel problems, so if you need some relief for your heel, check out some of our other blogs.