Heel Pain & Injury
What Causes Heel Pain?
Heel pain is a prevalent foot complaint and may involve bone, fat pad, ligaments, tendons or muscles.
Common Causes of Heel Pain
The most common cause of heel pain is plantar fasciitis, 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 delayed fascia healing and bone is laid down due 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, and 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.
Bursitis is another source of heel pain, and it can cause pain between your Achilles tendon and heel.
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 calcaneal stress fractures.
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 essential 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. Neural-origin pain such as sciatica and sural nerve pathologies 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.
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
FAQs about Heel Pain & Injury
Acute Injury Signs
Acute Injury Management.
Here are some warning signs that you have an injury. While some injuries are immediately evident, others can creep up slowly and progressively get worse. If you don't pay attention to both types of injuries, chronic problems can develop.
For detailed information on specific injuries, check out the injury by body part section.
Don't Ignore these Injury Warning Signs
Joint pain, particularly in the knee, ankle, elbow, and wrist joints, should never be ignored. Because these joints are not covered by muscle, pain here is rarely of muscular origin. Joint pain that lasts more than 48 hours requires a professional diagnosis.
If you can elicit pain at a specific point in a bone, muscle, or joint, you may have a significant injury by pressing your finger into it. If the same spot on the other side of the body does not produce the same pain, you should probably see your health professional.
Nearly all sports or musculoskeletal injuries cause swelling. Swelling is usually quite obvious and can be seen, but occasionally you may feel as though something is swollen or "full" even though it looks normal. Swelling usually goes along with pain, redness and heat.
Reduced Range of Motion
If the swelling isn't obvious, you can usually find it by checking for a reduced range of motion in a joint. If there is significant swelling within a joint, you will lose range of motion. Compare one side of the body with the other to identify major differences. If there are any, you probably have an injury that needs attention.
Compare sides for weakness by performing the same task. One way to tell is to lift the same weight with the right and left sides and look at the result. Or try to place body weight on one leg and then the other. A difference in your ability to support your weight is another suggestion of an injury that requires attention.
Immediate Injury Treatment: Step-by-Step Guidelines
- Stop the activity immediately.
- Wrap the injured part in a compression bandage.
- Apply ice to the injured part (use a bag of crushed ice or a bag of frozen vegetables).
- Elevate the injured part to reduce swelling.
- Consult your health practitioner for a proper diagnosis of any serious injury.
- Rehabilitate your injury under professional guidance.
- Seek a second opinion if you are not improving.