Heel Disorders & Injuries * Foot Doctor * Plantar Fasciitis * Archilles Tendinitis * Podiatrists Alabama

Heel Disorders & Injuries
Heel problems are common and can be painful. Often, they result from too much stress on your heel bone and the tissues that surround it. That stress can come from:
Injuries
Bruises that you get walking, running or jumping
Wearing shoes that don't fit or aren't made well
Being overweightLack of flexibility
These can lead to tendonitis, bursitis and fasciitis, which are all types of inflammation of the tissues that surround your heel. Over time the stress can cause bone spurs and deformities. Certain diseases, such as rheumatoid arthritis and gout, can also lead to heel problems. Treatments for heel problems might include rest, medicines, exercises, taping and special shoes. Surgery is rarely needed.

Heel Pain/Plantar Fasciitis
Causes

Most frequently heel pain is not the result of any single injury, such as a fall or twist, but rather the result of repetitive or excessive heel pounding.

Plantar fasciitis is inflammation of the thick connective tissue on the sole of your foot that attaches to your heel. The pain is usually felt at the bottom of your heel and is often worse in the morning because of stiffness that occurs overnight. The following increase your risk of developing this painful problem:
Shoes with poor arch support or soft soles
Quick turns that put stress on your foot
Tight calf musclesChange in activitiesChange in shoe type
Repetitive pounding on your feet from long-distance running, especially running downhill or on uneven surfaces
Pronation -- landing on the outside of your foot and rolling inward when walking or running; to know if you pronate, check the soles of your shoes to see if they are worn along the outer edge

Bone spurs in the heel can accompany plantar fasciitis, but are generally not the source of the pain. If you treat the plantar fasciitis appropriately, the bone spur is likely to no longer bother you.

Heel bursitis (inflammation of the back of the heel) can be caused by landing hard or awkwardly on the heel, or by pressure from shoes.

Home Care
Rest as much as possible for at least a week.
Apply ice to the painful area. Do this at least twice a day for 10 to 15 minutes, more often in the first couple of days.
Take acetaminophen for pain or ibuprofen for pain and inflammation.
Wear proper-fitting shoes.
A heel cup, felt pads in the heel area, or an orthotic device may help.
Night splints can stretch the injured fascia and allow it to heal.
Achilles Tendonitis
Achilles tendonitis is inflammation, irritation, and swelling of the Achilles tendon (the tendon that connects the muscles of the calf to the heel).

Causes

There are two large muscles in the calf, the gastrocnemius, and soleus. These muscles generate the power for pushing off with the foot or going up on the toes. The large Achilles tendon connects these muscles to the heel.

These are important muscles for walking. This tendon can become inflamed, most commonly as a result of overuse or arthritis, although inflammation can also be associated with trauma and infection.

Tendonitis due to overuse is most common in younger individuals and can occur in walkers, runners, or other athletes, especially in sports like basketball that involve jumping. Jumping places a large amount of stress on the Achilles tendon.

Tendonitis from arthritis is more common in the middle aged and elderly population.

Symptoms

Symptoms usually include pain in the heel when walking or running. The tendon is usually painful to touch and the skin over the tendon may be swollen and warm.

Exams and Tests

The doctor will perform a physical exam and look for tenderness along the tendon and for pain in the area of the tendon when you stand on your toes.

Imaging studies can also be helpful. X-rays can help diagnose arthritis and an MRI or in office diagnostic ultrasound will show inflammation in the tendon.

Treatment

Treatment usually involves:
Ice
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen
Rest
Physical therapyOrthotic therapy with heel post
You should limit any activities that make the symptoms worse.

Occasionally, a cast, brace, or boot may be used to keep the heel still and allow the swelling to go down.

If these treatments fail to improve symptoms, surgery may be needed to remove inflamed tissue and abnormal areas of the tendon.

Outlook (Prognosis)

Conservative therapy usually helps improve symptoms. However, symptoms may return if activities that cause the pain are not limited, or if the strength and flexibility of the tendon is not maintained.

Surgery, if needed, has been shown to be very effective in improving pain symptoms.

Possible Complications

Achilles tendonitis may make you more likely to have an Achilles rupture. This condition usually causes a sharp pain, like someone hit you in the back of the heel with a stick. Surgical repair is necessary, but difficult because the tendon is not normal.

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