Heel pain is one of the most common reasons people seek help at the Epping Podiatry Centre. The most common cause of heel pain is plantar fasciitis, sometimes referred to as "heel spurs", which occurs under the heel. But there are other structures around the heel that can cause pain.
Plantar Fasciitis
Plantar fasciitis (or plantar heel pain) occurs when there is inflammation and degeneration of the plantar fascia where it attaches to the heel bone. The plantar fascia is a ligament that connects the toes to the heel. Its function is to provide support when propelling forward. Often a heel spur is found on x-ray, but this is just an association, and the spur itself is usually painless.
The risk factors for developing plantar fasciitis include increased activity, being overweight, middle-aged or older and standing more ("stand up desks").
The typical symptom of from plantar fasciitis is sharp pain under the heel. It commonly occurs pain on rising, either getting out of bed in the morning or up from sitting. Pain can occur with activity and may limit your walking.
There are many treatments available for plantar fasciitis. There is evidence for stretching, foot orthoses and taping.
Achilles Tendinopathy
The Achilles tendon is the largest and strongest tendon in the human body. It connects the calf muscles (gastrocnemius and soleus) to the heel and allows the muscles to pull up on the heel. This pull is what allows you to go up on your toes. This motion is needed for the leg to push off when walking or running.
There are many structures associated with the Achilles tendon, including bursae and fat pads. The tendon does not have a good blood supply, and this combined with high tensile forces and age-related degeneration makes it vulnerable to injury.
Treatment options for Achilles tendinopathy, include strengthening exercises, footwear modification and orthoses.