The foot is one of the most overlooked parts of the human body. It may look simple but it’s actually not. Our foot and ankle are made up of 26 bones, 33 joints, and over 100 tendons. The largest bone on our foot is the heel. The heel which is located on the bottom rear part of our foot is responsible for our foot’s movements and steps. It also acts as a shock absorber and stabilizer of our foot whether we are standing on flat ground or uneven surface.
Heel disorders can give a person difficulty in walking, running, standing, and performing various activities. According to the American Academy of Orthopedic Surgeons, about 2 million people each year seek treatment for sharp, stabbing, sometimes burning pain in the heel or arch of their foot.
The Structure Of The Heel Bone
There are seven bones called tarsals that made up the part of the ankle and foot. They are the calcaneus and talus (hind foot) and the cuboid, navicular, medial, middle, and lateral cuneiforms (mid foot).
The largest of all these 7 tarsals is the calcaneus, which is the load-bearing bone within the heel of the foot. The heel bone is also connected to the Achilles tendon, which attaches the calf and the muscles to the heel.
Symptoms of Heel Pain
Heel pain usually occurs under the heel or on the side part of it. The pain can range from mild to disabling. If you overuse and injure your foot, you may experience soreness and sharp pain in the heel and arch area. This pain can increase for months, affecting your mobility and quality of life.
Symptoms of heel pain include:
- Inability to put weight on the heel or walk
- Numbness or a tingling sensation in your foot
- Your heel is stiff and swollen
- Sudden sharp pain
- Difficulty in walking
- Pain in the calf when standing tiptoes
6 Causes of Heel Pain
There are several causes of why heel pain occurs. It can be from injury, inappropriate footwear, being overweight, exercising too much, or a result of a medical condition. It also doesn’t mean that if you have heel pain, you have a heel spur. If you are experiencing pain in your heels, it’s best to seek help from a medical professional to get proper aid.
Here’s a word from orthopaedic foot and ankle surgeon Alan Davis, MD:
”A heel spur can be an incidental finding on an X-ray. You can have one even if you don’t have heel pain,” Dr. Davis says. “When we’re treating people, we don’t focus on the spur because often the spur doesn’t have to go away for the pain to resolve,” says orthopedic foot and ankle surgeon Alan Davis, MD.Source: Clevelandclinic.org
Now, let us discuss the common causes of heel pain to better understand the condition of our foot.
1. Plantar Fasciitis
One of the most common causes of heel pain is plantar fasciitis. It is the inflammation of the plantar fascia, a thick fibrous band that runs from the heel bone to the tip of the foot. If you exert too much force or weight on your foot, your plantar fascia can stretch too far, causing its soft tissue fibers to become inflamed.
You’ll then experience a stabbing pain that normally decreases as you move. However, it haunts you again after a long period of sitting or standing. This annoying pain is commonly experienced by runners, overweight people, and workers with heavy work demands. Our foot bears the weight of our body. Improper foot mechanics and wearing shoes that lack adequate support has a significant impact on our foot structure. A high- arched or overly flat foot has a higher risk of developing plantar fasciitis.
2. Heel Spurs
A heel spur is an abnormal growth of calcium deposit on the underside of the heel bone. When your plantar fascia and foot muscles consistently receive strain and pressure, inflammation occurs. The repeated tearing of muscles and ligaments stress the heel bone and nerves of the heel.
This condition is usually examined in an X-ray, and the heel spur can be seen extending forward as much as half-inch. If you have frequent bursts of physical activity or you spend most of your day on one foot, it can aggravate the problem.
3. Achilles Tendonitis
You probably heard “Achilles heel” from Greek mythology. No matter how strong we are, we still have a vulnerability. This is true to our feet. The Achilles tendon is the strongest and largest tendon in the human body. The reason why you are able to walk, run, and jump is because your Achilles tendon connects your calf muscles to the heel bone.
If this tendon receives repetitive pressure and high tension, it results in tears that cannot heal or repair properly. Running, basketball, football, and activities that require strong
push-off lead to Achilles tendonitis. When left untreated, the tendon weakens and becomes painful and can even lead to arthritis. If you are involved in sports, try to avoid jumping and running explosively. Wear shoes that provide foot comfort and heel support.
4. Calcaneal Bursitis
Located at the back of our heel is the bursa, a fluid-filled sac that connects and cushions the bones and tendons, allowing them to move easily. Bursitis refers to the inflammation of the bursa, which is often characterized by a bruise-pain at the back of the heel.
Since the bursa surrounds the areas where skin, bones, tendons, and muscle tissues meet, inflammation can result in baggy swelling and intense pain. Too much rubbing or friction against the skin over the Achilles tendon can injure and inflict trauma to the bursa. As a result, the heel can become very swollen and red and the pain intensifies following physical activity. This can give you discomfort in fitting and wearing shoes.
Engaging in high-impact sports, doing repetitive calf contraction activities, and wearing ill-fitting shoes such as high heels can trigger bursitis. Choose your footwear wisely like the ones that have soft padding at the heel. Stretching exercises are also important as they can increase the range of motion of your heel and foot and strengthen your muscles.
5. Sever’s Disease
Sever’s disease is the most common cause of heel pain for kids and teenage athletes, aging from 8 to 15. Also known as calcaneal apophysitis, Sever’s disease is a result of bone injury due to repetitive stress on the Achilles tendon. When the growth plate in the lower back of the heel becomes overstretched, it leads to inflammation and pain.
The heel area is not very flexible and is susceptible to injury. This is why kids at a young age should avoid excessive amounts of running and jumping activities as constant stress can damage the growth plate of the heel bone. Since the body is still maturing, it’s better to control the kid’s engagement in high-intensity physical activities. As we get older, the back of our heel hardens and gets stronger. Strenuous activities at a young age will force the young heel to bear the tension, increasing the risk of injury and heel disorders.
6. Certain Foot Disorders
Aside from the things listed above, there are some medical conditions that can trigger heel pain.
“An overwhelming majority of diabetic individuals—almost 90% by some counts—are overweight for their respective body structures. Excess weight is a well-known risk for heel pain, and especially plantar fasciitis (which is already the most common source of heel pain for adults)”.Source: Capitaldistrictpodiatry.com
Excessive weight brings additional pressure to the heel bone and muscle tissues. This is why adults should maintain a balanced diet and a healthy weight. Inflammatory arthritis can also affect your feet and ankles. Osteoarthritis can grow in and around the joint of the foot, causing a small lump, and making it swollen and painful.
Same with rheumatoid arthritis which attacks your immune system and causes long-term damage to the joints in your feet and ankles. As a result, you will experience a stiff, hot, swollen feeling.
Who is at increased risk of Heel Pain?
Anyone can suffer heel pain. The most important thing is you should not overuse your foot muscles, joints, and tendon. The severity of the pain is directly related to the tension and load that your heel bears. In order to manage the pain, doing activities in moderation is key.
Although all of us can experience heel pain from time to time, there are certain groups of people who are at greater risk. They are:
- Women during pregnancy
- Athletes and physically active people
- Overweight and obese individuals
- Children between 8 and 15 years
- People with certain medical conditions
- People with walking gait issues
Heel pain is a common condition that many people are suffering yet most of us don’t take it seriously and just shrug it off, assuming that the pain will go away. Whether the pain is disabling or manageable, you need to take action and seek professional help. If you or someone you know is experiencing heel pain, you should be concerned about it.
When left untreated, heel pain does not only affect your foot but can also lead to back pain, blood pressure, and other complications. You can consult your doctor to run a physical examination of your foot.
There are also foot orthotics available online that can help improve your body alignment and foot health.
Next Article: Can your shoes cause plantar fasciitis?