Heel Pain

Inside Your Heel

Your heel is the back part of your foot. A band of tissue called the plantar fascia connects the heel bone to the bones in the ball of your foot. Nerves run from the heel up the inside of your ankle and into your leg. These nerves send pain messages from your foot to your brain in response to pain.

When Your Heel Hurts

When you feel pain in the bottom of your heel, the plantar fascia is most likely inflamed. Overuse or excess body weight can cause the tissue to tear or pull away from the bone. The tissue then becomes inflamed and painful. Sometimes the inflamed plantar fascia also irritates a nerve, causing even more discomfort.

What Causes Heel Pain?

Wearing shoes with poor cushioning can irritate the tissue in your heel (plantar fascia). Being overweight or standing for long periods of time can also irritate the surrounding tissue. Running, walking, tennis, and other sports that put stress on the heels can cause tiny tears in the tissue. If your lower leg muscles are tight, this is more likely to develop.

Symptoms

You may feel pain on the bottom, or the inside edge of your heel. The pain may be sharp when you get out of bed, or when standing up after sitting for a while. You may also feel a dull ache in your heel after you've been standing on a hard surface. Running can also produce pain. If a nerve is irritated, you may feel a burning sensation or shooting pain in your heel.

Diagnosis and Treatment

Your foot specialist will examine your foot and ask about your pain level. Be sure to show him/her exactly where your heel hurts. To treat your pain, you may need to make changes in your activities, or change the type of shoes that you wear. You may also need to exercise and stretch the tissue. The tissue can take up to 6 months or more to fully recover. In some extreme cases, your specialist may suggest surgery to release the plantar fascia.

Activities

To give the tissue time to heal, avoid doing things that cause strain or pain. This may include standing or walking for extended periods and running activities.

Foot Stretches

• Lie on your back with your legs straight
• Stretch your toes toward you. Or put a towel around the ball of your foot and pull it toward you
• Hold for 10 to 20 seconds, relax
• Repeat 10 times

Heel Stretch

• Stand with the ball of the painful foot on the edge of a step. Hold on to the railing
• Slowly drop the heel down until you feel a stretch in the back of your calf
• Hold for 30 seconds. Repeat 4 times a day

Shoes

Purchase shoes that have a good amount of cushioning in the soles and heels. Replace athletic shoes proactively, before the cushioning in the heels wear out.

Shoe Inserts

To add shock absorption to the heel, consider the use of a heel cup, or cushioned pad in your shoe. Your foot specialist may prescribe a custom foot orthotic for more specialized correction.

Contrast Baths

To reduce inflammation, soak your foot in warm water for 30 seconds, then soak it in cool water for 30 seconds. repeat this process going back and forth for 5 minutes. This should be done 3 to 4 times a day. You may also hold an ice pack on the heel for up to 5 minutes, 3 to 4 times a day. Always ensure that you begin this process and end the process with cold water to minimize inflammation.

Medication

Your Foot Specialist may suggest on oral anti-inflammatory medicine, such as ibuprofen, to reduce the inflammation. If you still experience heel pain after changing your shoes and doing heel stretches for several months, your Foot Specialist may inject cortisone into the tissue.

Preventing Future Problems

To prevent future heel pain, wear supportive shoes with well-cushioned heels. Perform regular exercises, such as the ones outlined below, to stretch the plantar fascia and the muscles in the lower leg.

 Calf Stretch

• Stand with one foot an arm's length away from a tree or wall. Place the other foot about 12″ behind. Put both hands on the tree or wall for support
• Keeping both heels on the ground, bend the knee on the leg closest to the tree or wall. Lean forward, keeping the back leg straight. Hold this stretch for 15 to 20 seconds
• Now bend both knees. Hold for 15 to 20 seconds. Then relax
• Repeat this process 10 times, then switch sides.