Heel Pain

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Article by John Miller

Heel Pain?

heel pain

Heel pain is a very common foot complaint and may involve injury to the bone, fat pad, ligaments, tendons or muscles. 

The most common cause of heel pain is plantar fasciitis. This is a condition where your main arch ligament (fascia) becomes inflamed and causes pain.  

What is a Heel Spur?

This can develop into a heel spur (calcaneal spur) over time when your fascia healing is delayed and bone is laid down in response to excessive through the injured soft tissue. 

Heel spurs are often related to flat feet.


Achilles Heel / Back of Heel

Achilles heel issues can be caused by the attachment of your Achilles tendon onto your heel. This can be due to tendonitis or a related Achilles tendinopathy.

Bursitis is another source of heel pain. In particular, retrocalcaneal bursitis is common.

Heel pain can also be associated with conditions such as posterior impingement syndrome, which is common in dancers or athletes who need to plant their foot eg cricket fast bowlers. It can also occur in any athlete with a relatively unstable ankle eg poorly rehabilitated sprained ankle.

Likewise, peroneal tendonitis is a common lateral heel condition that is due to altered foot biomechanics or hind-foot control issues.

Sever's Disease

Sever's disease is a very common source of children's heel pain. Sever's is related to overactivity and overloading of the calcaneal growth plate. More info: Sever's disease.

Referred Sources

It is important to have you in thoroughly assessed to ensure an accurate diagnosis and subsequent treatment. Heel pain can also be referred by a pinched nerve in your lower back eg sciatica. This can be tricky to diagnose and requires the professional opinion of an experienced spinal health care practitioner such as your physiotherapist.

Who Suffers Heel Pain?

Anyone can suffer from heel pain, but certain groups seem to be at increased risk, including:

  • Middle-aged men and women
  • Active people eg running sports
  • People who are very overweight 
  • Children aged between 8 and 13 years
  • Pregnant women
  • People who stand for long periods of time.

Common Sources of Heel Pain

  • Achilles Tendon Rupture
  • Achilles Tendonitis / Tendinitis
  • Cramps
  • Fibromyalgia
  • Heel Spur
  • High Ankle Sprain
  • Muscle Strain (Muscle Pain)
  • Overuse Injuries
  • Peroneal Tendonitis
  • Pes Planus - Flat Feet
  • Pinched Nerve
  • Plantar Fasciitis
  • Posterior Ankle Impingement
  • Psoriatic Arthritis
  • Retrocalcaneal Bursitis
  • Rheumatoid Arthritis
  • Severs Disease
  • Shin Splints
  • Sprained Ankle
  • Stress Fracture Feet
  • Tarsal Tunnel Syndrome
  • Common Causes of Heel Pain?

    Some of the many causes of heel pain can include:

    • Abnormal walking style (such as rolling the feet inwards)
    • Obesity
    • Ill-fitting shoes eg narrow toe, worn out shoes
    • Standing, running or jumping on hard surfaces
    • Recent changes in exercise programme
    • Heel trauma eg. stress fractures 
    • Bursitis (inflammation of a bursa) 
    • Health disorders, including diabetes and arthritis.

    Heel Pain Treatment

    Most heel pain is caused by a combination of poor biomechanics, or muscle weakness or tightness. The good news is that heel pain can be effectively managed once the cause is identified. 

    Most heel pain can be successfully treated via:

    If you feel that your footwear or sports training schedule are potentially causing your heel pain, then we recommend that you seek the advice of a sports physiotherapist, podiatrist or trained footwear specialist (not just a shop assistant) to see if your shoe is a match for your foot; or discuss your training regime to see if you are doing too much.

    Heel pain and injury are extremely common. With accurate assessment and early treatment, most heel pain injuries respond extremely quickly to physiotherapy allowing you to quickly resume pain-free and normal activities of daily living.

    Please ask you physiotherapist for their professional treatment advice.

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    Heel Injuries

    Heel Pain Treatment Options

  • Early Injury Treatment
  • Avoid the HARM Factors
  • What to do after a Muscle Strain or Ligament Sprain?
  • Acupuncture and Dry Needling
  • Sub-Acute Soft Tissue Injury Treatment
  • Closed Kinetic Chain Exercises
  • Active Foot Posture Correction Exercises
  • Gait Analysis
  • Biomechanical Analysis
  • Balance Enhancement Exercises
  • Proprioception & Balance Exercises
  • Agility & Sport-Specific Exercises
  • Medications?
  • Heel Cups
  • Orthotics
  • Soft Tissue Massage
  • Walking Boot
  • Brace or Support
  • Electrotherapy & Local Modalities
  • Heat Packs
  • Joint Mobilisation Techniques
  • Kinesiology Tape
  • Neurodynamics
  • Physiotherapy Instrument Mobilisation (PIM)
  • Prehabilitation
  • Running Analysis
  • Strength Exercises
  • Stretching Exercises
  • Supportive Taping & Strapping
  • TENS Machine
  • Video Analysis
  • FAQs about Heel Pain

  • Common Physiotherapy Treatment Techniques
  • What is Pain?
  • Physiotherapy & Exercise
  • How Does Kinesiology Tape Reduce Swelling?
  • Barefoot Running: Your MUST READ Guide to the Pro's and Con's.
  • Heat Packs. Why does heat feel so good?
  • Running Recovery: 6 Helpful Tips
  • Sports Injury? What to do? When?
  • What are Common Adolescent / Children Leg Injuries?
  • What are Growing Pains?
  • What are the Early Warning Signs of an Injury?
  • What is a TENS Machine?
  • What is Chronic Pain?
  • What is Musculoskeletal Physiotherapy?
  • What is Nerve Pain?
  • What is Sports Physiotherapy?
  • What to expect when you visit PhysioWorks?
  • What's the Benefit of Stretching Exercises?
  • Call PhysioWorks Book Online

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    Last updated 10-May-2016 12:00 PM

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