Heel Pain & Injury
What Causes Heel Pain?
Heel pain is a prevalent foot complaint and may involve injury to the bone, fat pad, ligaments, tendons or muscles.
Common Causes of Heel Pain
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.
More info: Plantar Fasciitis
Plantar fasciitis can develop into a heel spur (calcaneal spur) when your fascia healing is delayed and bone is laid down in response to excessive load through the injured soft tissue. Heel spurs are often related to flat feet or pes planus.
The attachment of your Achilles tendon can cause Achilles heel issues onto your heel. This can be due to tendonitis or a related Achilles tendinopathy. While not necessarily painful, a ruptured Achilles tendon causes functional limitation such as an inability to rise on your toes, walk or run.
Peroneal tendonitis is a common lateral heel condition due to altered foot biomechanics or hind-foot control issues. Medially (inside your heel), another tendinopathy known as tibialis posterior tendinopathy can cause heel pain.
More info: Retrocalcaneal bursitis
Posterior Impingement Syndrome
Heel pain can also be associated with posterior impingement syndrome conditions, common in dancers or athletes who need to plant their foot, e.g. cricket fast bowlers. It can also occur in any athlete with a relatively unstable ankle, e.g. poorly rehabilitated sprained ankle.
More info: Posterior Impingement Syndrome
Your heel pain can arise from osteoarthritis affecting the subtalar joint or talocrural (ankle) joint.
More info: Heel Arthritis
Bone injuries such as fractures can occur from a trauma such as a fall from a height onto your heel. Athletes, especially runners and landing sports, can also suffer overload fractures known as a calcaneal stress fracture.
More info: Stress Fracture
Children’s Heel Pain
Sever’s disease is a ubiquitous source of children’s heel pain. Sever’s is related to overactivity and overloading of the calcaneal growth plate.
More info: Sever’s disease.
It is important to have you thoroughly assessed to ensure an accurate diagnosis and subsequent treatment. Heel pain can also be referred to by a pinched nerve in your lower back, e.g. 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, e.g. 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
Some of the many causes of heel pain can include:
- Abnormal walking style (such as rolling the feet inwards)
- Ill-fitting shoes, e.g. narrow toe, worn-out shoes
- Standing, running or jumping on hard surfaces
- Recent changes in an exercise programme
- Heel trauma, e.g. stress fractures
- Bursitis (inflammation of a bursa)
- Health disorders, including diabetes and arthritis.
Common Heel Pain & Injury Conditions
Traumatic Ankle Ligament Injuries
- Achilles Tendon Rupture
- Achilles Tendinopathy
- FHL Tendinopathy
- Peroneal Tendinopathy
- Tibialis Posterior Tendinopathy
- Ankle Fracture (Broken Ankle)
- Stress Fracture
- Stress Fracture Feet
- Severs Disease
- Heel Spur
- Shin Splints
Soft Tissue Inflammation
Common Treatments For Foot Pain
With accurate assessment and early treatment, most foot pain responds extremely quickly to physiotherapy allowing you to quickly resume pain-free and normal activities of daily living.
Please ask your physiotherapist for their professional treatment advice.
- Early Injury Treatment
- Avoid the HARM Factors
- Walking Boot
- Brace or Support
- Electrotherapy & Local Modalities
Subacute Treatment Options
- Acupuncture and Dry Needling
- Joint Mobilisation Techniques
- Physiotherapy Instrument Mobilisation (PIM)
Other Treatment Options
- Active Foot Posture Correction Exercises
- Strength Exercises
- Stretching Exercises
- Closed Kinetic Chain Exercises
- Gait Analysis
- Running Analysis
- Video Analysis
- Biomechanical Analysis
- Agility & Sport-Specific Exercises