Heel Pain

March 01, 2010 Posted by Dr.Murray

A very common complaint presented by patients to their podiatrist is that of heel pain. It is caused by a variety of conditions but this blog will discuss heel pain due to plantar fasciitis. Plantar fasciitis is the most common condition associated with heel pain, especially in athletes, dancers and individuals within the ages of 40-60. It causes a mild discomfort to an aggressive form of pain in the plantar aspect of the foot- in the area of the heel.

The plantar fascia ligament, illustrated in the picture below, runs between the calcaneus (heel bone) and the base of the toes and is defined as a strong connective tissue that helps in forming the arch of the foot. A person’s biomechanics, such as being flatfoot or having high arches can create a pressure on this tissue. Incorrect shoes or even physical activity as well as diabetes or arthritis can also impact this fascia. A surplus of exercise and physical activity, including excessive running and jumping can result in loss of elasticity and compliance overtime second to micro injuries. At the same time, individuals with inflammatory types of arthritis can unfortunately develop inflammation within the tendons consequently resulting in the same condition. While being overweight is a significant contraindication, walking or exercising in improper shoes can cause impairment in weight distribution considerably increasing the pressure on the plantar fascia. When overload occurs, microtears in the tissue present themselves, and the plantar fascia becomes inflamed, typically in its central band, resulting in what is known as heel pain.
Symptoms include:
Pain in the heel
Stabbing, burning, aching pain
Pain worse in the morning when stepping out of bed
Diminishing pain as the tissue “warms up”
Intensity of pain increases over a period of months.
Stay tuned for next week’s blog when we discuss ways to prevent, manage and treat plantar fasciitis.

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