Heel pain happens.
Unwelcome aches and pains greet you with the first steps of the day. They flare up after more than a few minutes of walking. They make daily tasks more difficult, and they make old favorite hobbies (hiking, sports, etc.) difficult to even contemplate.
Heel pain is, in fact, one of the most frequent symptoms and complaints among our patients when they first walk (or hobble) into our office.
But that doesn’t make it normal.
Common, maybe. But never normal.
Fortunately, we do have some good news for you. Heel pain is almost always diagnosable, manageable, and treatable using conservative methods—regardless of your age or activity level. We are very confident we can help you, and make your life a whole lot better.
But before we can help, we need to figure out what’s causing the pain.
What Conditions Cause Heel Pain?
A lot of times, when people come in for treatment, they use the term “heel spurs” to describe their pain. That’s possible, but heel spurs are actually not especially likely.
Most likely, the cause is plantar fasciitis, the diagnosis in roughly 4 out of 5 heel pain cases.
Time for a quick anatomy lesson.
The plantar fascia is a long, thick ligament that runs across all along the bottom of the foot and attaches the heel bone to the metatarsal bones near the base of the toes. It serves to support the arch and provide shock absorption for the foot, flexing like a bowstring with each step.
However, put too much force and pressure on the plantar fascia over a long enough period of time, and the fibers can get irritated and inflamed. Usually the pain is right underneath the heel, or a little in front of it.
Plantar fasciitis pain is usually worst immediately after a period of rest—particularly the first few steps of the morning. That said, it is also prone to flare up after prolonged standing, or after (though not usually during) exercise.
All that being said, while plantar fasciitis might be the problem 4 out of 5 times, that still means it’s something else about 20% of the time. Other possible diagnoses include tendinitis, pinched nerves, arthritis, and bony deformities—including the infamous heel spurs. (Truthfully, heel spurs are not usually painful in and of themselves, but they can be under certain circumstances).
What Could Be Contributing to My Heel Pain?
Now, a diagnosis is an important first step—it gives a name to your pain, and helps us determine the best way to treat it.
But probably for your purposes, a more salient question is, “Why did I get plantar fasciitis (or whatever the diagnosis may be) in the first place?”
That one is a little trickier.
We don’t always know the precise reason why heel pain occurs. Often, there are a mix of factors involved. However, we can isolate several common risk factors:
Here’s an unfortunate truth: every foot is unique, but not every foot handles the wear and tear of modern living equally well. Our ancestors weren’t accustomed to hard, flat surfaces everywhere!
As a result, the natural shape of your feet may not be especially well equipped to support your weight and activity over the course of a long day without wearing down. And among those structural deficiencies, flat feet are by far the most common.
Unfortunately, surgery is the only way to repair or restructure a flat arch. If your pain is serious, this may be your best option. However, we’ll do our best to accommodate you with conservative treatment options when possible, including new shoes, custom insoles, stretching exercises, and medications.
A good pair of shoes fits your feet just right. They’re naturally curved to give your arch extra support, while spongy midsoles dampen the impact forces of each step better than your feet can alone.
Unfortunately, many of us are wearing shoes that are the wrong size, or were built for fashion rather than health and ergonomics. Bad shoes make your feet work even harder than normal, and shift excessive weight and pressure to places that can’t take the strain for very long.
Occupations and Hobbies
Many of us have to be on our feet all day to make a living—teachers, construction workers, salespeople, cashiers, etc. In terms of your long-term health, that’s probably better than spending nine hours sitting at a desk. But it also increases your risk of heel pain.
The same goes for those with active hobbies outside working hours, like running, hiking, or other high-impact sports. Running puts significantly more force on feet than just standing or walking; jumping even more than that.
Don’t get us wrong—we’re not saying you should stop being active! You just may need to make some accommodations. That might include a rubber mat at your workstation, or a new pair of shoes, or regular breaks, or more stretching, or cross-training in some low-impact athletic disciplines. We’re happy to help make recommendations when we see you in person.
This one is simple mathematics. The heavier you are, the greater the force placed on your plantar fascia and your heels every step you take, and every second you stand.
And as we said, the effective force of a footstep is actually greater than your weight itself. There are impact forces to consider. So when you’re just walking, your foot might have to absorb 1.5 times your body weight. When you run, it’s more like 3-4 times.
That adds up quick. But it also means that even losing 10-15 pounds can have a large impact on how long your feet can hold up.
Here’s a risk factor that you can’t do much about. Or can you?
It’s true that you can’t beat Father Time. And it’s also true that, as we age, ligaments such as the plantar fascia tend to naturally lose strength and flexibility. At the same time, the thick pad of fat that cushions the underside of the heel itself tends to thin out.
In other words, it’s not altogether surprising that heel pain tends to be especially common in middle aged adults—a time in life where the body isn’t quite as durable as it used to be, but activity levels remain relatively high.
On the other hand, like any other risk factor this can be managed. While you can’t make yourself literally younger, focusing on staying healthy and fit makes a difference at any age.
Whatever the Cause, We Can Help
Dr. Bruce Scudday and his team pride themselves on providing sound diagnoses and offering the highest quality podiatric care with integrity, honesty, and efficiency.
Whatever might be causing your heel pain—both the diagnosis itself, as well as the underlying factors—we will get to the bottom of it and help you fix it as quickly and simply as possible. The vast majority of the time, this can be done without requiring surgery.
To schedule your appointment with our team, call the office closest to your location:
Curie Drive: (915) 533-5151
George Dieter Drive: (915) 856-3331