Search
Heel pain treatment
The heel has the function of a shock-absorbing cushion. The heel bone is the largest bone in the foot. Under the calcaneus is shock-absorbing fascia that acts as a resilient cushion. When you walk or run, you land on the heel, which then distributes the pressure to reduce the load on the joints upwards, in the ankle, knee, hip and back.
Underneath the arch is a broad and strong fascia, the plantar fascia. It extends from each toe bone and attaches to the heel bone. It is designed to provide a resilient arch that also helps to absorb shock. Around the attachments of the plantar fascia are small fluid-filled bursae to protect the tendon at the bones.
From the calf muscles, the Achilles tendon extends down and attaches to the heel bone.
Causes of heel pain
The cause of heel pain can be trauma but in the vast majority of cases it is caused by some form of overload, which in turn is most often caused by a misalignment due to an asymmetrical posture. Often the core musculature and hip flexors are involved. The function of shock absorption and pressure equalization is then not optimal. If one foot, or part of the foot, is loaded more than the other, joints and fascia structures, such as the plantar fascia and Achilles tendon, are overloaded. Dumb shoes with poor cushioning can also cause overloading of the different parts of the foot, such as the heel pad, Achilles tendon and plantar fascia.
Overloading means increased pressure and this creates a constriction with reduced flow and glide. This puts extra strain and stress on tendon attachments, which can then become inflamed. Depending on where the overload occurs, the pain can come from different parts of the heel
Heel pain during overload
If the plantar fascia is overloaded, it can become irritated and there is inflammation, usually at the heel bone attachment, plantar fasciitis. Due to the overload, a small calcification can then form at the tendon attachment, a strengthening of the tendon, which is visible as a small nabb on X-ray, therefore it is often called heel spur. The pain is under the heel, usually towards the inside but can also extend forward along the arch. It also hurts more in the morning, right when you start walking on your foot.
If the Achilles tendon is overloaded at the attachment to the heel bone, small tears can occur and become an inflammation that causes pain from the back of the heel, this can be called false heel spur. (In the worst case, a total tendon rupture, but most often it is an Achilles tendon rupture). The tendon can be sore, swollen and feel stiff all the way up to the calf.
Pain from the back of the heel can also be caused by an inflammation of the bursa at the attachment of the Achilles tendon to the heel bone. Overloading of the Achilles tendon and bursa can also give rise to Haglund’s heel.
An overloaded heel pad can cause Achilles syndrome, it can also be caused by a trauma to the heel. Repeated blows to the heel such as hard landings from a high height, hard shoes, hard flooring can create problems with the heel pad.
Trauma can also result in a fracture of the heel bone.
Heel pain during pregnancy
The hormonal changes of pregnancy alter the structure and properties of the fascia. It becomes softer and less stable. The change in weight during pregnancy also puts more strain on the feet, for example. Any type of oblique loading also causes greater problems because of this. The stress on the plantar fascia, Achilles tendon, heel pad, etc. is therefore greater during pregnancy.
What is heel pain a symptom of?
Heel pain is usually completely harmless and in most cases is due to an overload of various structures around the foot due to a non-optimal function and balance of the body’s joints and soft tissues. So most often, heel pain is a symptom of a non-functional load, a misalignment of fascia structures, muscles, bones and joints. The most common is plantar fasciitis, which can eventually cause a heel spur. Heel spurs cause symptoms such as sharp pain under the heel, often towards the inside and especially in the morning when taking the first steps.
See more under cause.
Why do you get heel pain?
An uneven load of the body with overloading of certain parts can damage structures in the heel. Poor shoes with poor cushioning or that do not provide enough support can also cause overloading of the structures of the foot, usually the plantar fascia, which then causes plantar fasciitis and ultimately heel spurs. Prolonged standing or running on hard surfaces, especially with poor footwear and when exercising too hard in relation to how you are trained.
Excess weight also overloads the structures of the foot as well as other joints and structures in the body.
Poorly fitting shoes can also cause blisters on the heel and irritate the Achilles tendon.
When and where should I seek treatment for heel pain?
It is a good idea to seek treatment as soon as possible before the problems get worse and before new problems are created due to compensations. Fascia clinics can help improve posture and balance and reduce problems in the heel.
How is heel pain treated?
The treatment aims to improve the function and balance of the whole body, relieving the foot and heel. At the same time, the treatment provides relaxation for tense muscles and creates a better flow in the fascia and lymphatic system. This allows the fascia and muscles to glide better and creates less resistance and provides a better balance in the body.
Heel pain – What can I do myself?
Stretching the arch, toes and Achilles tendon is good and relatively easy to do daily. Taping the foot and heel provides better stability. Foot gymnastics with circles and toe gymnastics are effective exercises for the feet and fascia.
Make sure to wear good shock-absorbing shoes, try to go barefoot a lot.
Exercises for heel pain
Stretch the plantar fascia (arch), toes and Achilles tendon daily. It helps to keep the tendons elastic and strong. Foot gymnastics with circles and toe gymnastics is an effective training of the feet and fascia.
Heel pain – frequently asked questions
Why do I get heel pain after running?
It is usually the Achilles tendon that hurts after running because it has been overworked. You may have run more than you are trained for or used bad shoes.
You should have your posture, body weight and symmetry checked at a Fascia Clinic as a functional imbalance is probably the primary cause.
Why do I have heel pain in the morning?
If the pain is under the heel, you probably have an inflammation of the plantar fascia, plantar fasciitis. It may also have caused a heel spur.
If the pain is at the back of the heel, it could be an inflamed Achilles tendon or Achilles tendon bursa.
You should have your posture, body weight and symmetry checked at a Fascia Clinic as a functional imbalance is probably the primary cause.
