Heel Pain & Heel Spurs Sydney
What is heel pain?
Heel pain one of is the most common conditions we treat and can be caused by many different conditions. It can occur in people of all ages and fitness levels and may be acute or chronic in nature.
What are heel spurs?
Very often a heel spur is associated with or spoken about as the same injury as plantar fasciitis. A heel spur is a boney growth under the heel bone at the attachment of the “arch muscle”. For a heel spur to develop, the underlying cause has to have been present for many years. Biomechanical anomalies with the foot are often the base cause but the presence of a spur does not indicate the severity of your heel pain and often the worst cases of plantar fasciitis have no spur formation.
What exactly causes heel pain in the morning?
The plantar fascia is a strong ligament that runs the length of your foot from the heel bone to the toes. Although it is strong, it is not very elastic, so repeated movements, such as running, can overstretch it and partially tear or pull it away from the heel bone. The plantar fascia can also overstretch or tear at the arch.
Usually, the symptoms begin gradually, but after several weeks, the pain gets worse and does not diminish. Generally, there is no swelling or bruising in the area. However, you may feel tenderness when you apply deep pressure to the heel pad or the arch.
Plantar fasciitis and many other heel conditions are caused by damage to the tissue that connects into the heel or mid foot. This damage causes inflammation.
When you walk around during the day, the act of walking with muscles contracting and pressure from the ground pressing on the heel acts like a massage and prevents inflammation from building up in the heel. But if you lay down at night or sit down for a while during the day, you stop doing those actions that prevent the build-up of inflammation. The inflammation builds up and then when you go to stand up again, you have a sharp pain in your heel due to the extra inflammatory fluid in the area. You then walk around for a few minutes, the inflammatory fluid is pumped out of the area and you feel better – at least for a while.
In normal functioning of the heel, the plantar fascia acts as a shock absorber and support mechanism for the arch of the foot. During gait, or movement, the plantar fascia acts like a spring which winds and unwinds to conserve energy and provide propulsion. Tension increases while the foot is on the ground to store the energy and is then released during toe-off to help with acceleration.
Plantar fasciitis literally means inflammation of the plantar fascia, but most cases are more degenerative changes rather than inflammatory ones. A new term being used to accurately describe the condition is plantar fasciosis. In most cases the pain is on the under surface of the foot at the junction of the plantar fascia and the heel bone know as the calcaneus. The condition accounts for about 10% of runner related injuries and is twice as predominant in women than in men. Because of this high incidence in runners, micro trauma from repeated stress is believed to be the primary base cause.
Plantar fasciitis may go away on its own, with rest, but it may take several months or longer to resolve completely. There is treatment to help you recover faster. Book online today in one of our clinics in Bondi Junction, St Ives or Barangaroo.
symptoms of heel pain
Heel Pain has a number of symptoms that include:
- Sharp, stabbing pain on the bottom or side of the heel or in the arch of the foot.
- Pain that is worse in the morning or after any period of inactivity. As you begin to move around, the pain level usually improves.
- Pain that gets worse after a prolonged period of standing, walking, or running.
- Pain that can last for several weeks or months and can range from mild to severe.
screening and diagnosis
We usually diagnose heel pain by asking you about your symptoms and physically examining your foot. At the footinjuryclinic we have state of the art video gait analysis and pressure fluoroscopes which we use in aiding our diagnosis. We may order an imaging study, such as an X-ray, if we suspect that your symptoms may be caused by another condition, such as a stress fracture, but this is rare. If you’re suffering from heel pain, St Ives, Bondi Junction and Barangaroo clinics are here to help you.
who gets heel pain
There are a number of factors that can increase the likelihood that you will develop heel pain including:
- Excess weight
- Specific sports activities
Activities that put significant pressure on your foot and require it to stretch repeatedly increase your risk. These activities include running, walking long distances, jumping, tennis, beach running and aerobics. - Age
Middle-aged people, between 40 and 60 years old are more likely to develop plantar fasciitis. - Abnormal foot mechanics
Flat feet or high arches can affect the way that pressure is distributed across your foot ,placing additional stress on the plantar fascia. - Tight Achilles tendon and excessive flattening of your feet (pronation)
The Achilles tendon links the calf muscle to the back of the heel. A tight calf muscle and Achilles tendon can cause your foot to flatten further, placing additional stress on the plantar fascia. - Standing all day
Standing or walking on hard floors for a long time increases the load on your plantar fascia. - Inadequate footwear
Excessively flat shoes that do not support your arch leave the plantar fascia unprotected. A shoe with a medium heel can heighten the arch and decrease stress on the plantar fascia. - Sudden change in activity
Beginning an exercise program , such as high-impact aerobics, after a period of inactivity can overload the structures in your foot. Similarly, changing your running surface from grass to road can affect your plantar fascia.
prevention of heel pain
There are a number of things you can do to protect your feet and prevent injury to your plantar fascia:
- Wear supportive shoes
We recommend running shoes or “pro” walking shoes. It’s a good idea to wear these when you are running or walking a long distance or when you will be on your feet for an extended period of time. - Wear shoes with slightly higher heels
A moderate heel can shorten the arch, reduce stress on the plantar fascia, and lead to a reduction of pain. At the footinjuryclinic we recommend a ladies heel of around 2.5cm. - Do not walk barefoot
Even at home when suffering from plantar fasciitis. - Lose weight
Talk to your personal doctor, trainer or dietician. - Stretch
It is important to warm up before you exercise. Stretching your calf muscles will help protect your Achilles tendon, which in turn will ensure that your feet land correctly during walking and running.
heel pain treatment
It may take 3 to 12 months for your plantar fascia to heal completely. We recommend using a number of treatment approaches simultaneously, home and medical. It is important that you continue treatment until you have been pain-free for at least 3 months. Book now at one of our clinics located in Bondi Junction, St Ives and Barangaroo to start your heel pain treatment plan.
- Rest
Rest your foot for 2 to 6 weeks. Stand, walk, or run less. - Change your activities
While your foot is resting, try exercise that does not stretch your arch, like swimming or cycling. - Choose footwear that supports your foot
Shoes and devices that support your foot can help protect your plantar fascia and allow it to heal. We recommend a combination of the following footwear and devices:
– Supportive shoes
Wear shoes with good arch and heel support. A higher heel may also help. Avoid standing or walking barefoot or in unsupportive shoes like slippers or sandals.
– Arch supports
Wearing arch supports inside your shoes reduces strain on the plantar fascia. We recommend the Orthema EVA molded orthoses.
– Use over-the-counter pain relievers
Over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs), such as Ibuprofen or Volatren can help manage your pain or discomfort. OTC NSAIDs are effective pain relievers that can be used if you have no health conditions that prevent you from taking them. Even though you do not need a prescription for OTC NSAIDs, you should be careful to consult the package so that you take the correct dose.Be aware that OTC NSAIDs can interact with other medicines you may be taking and cause problems for people with various medical conditions. These medications can help reduce the pain while your plantar fascia is healing. If they do not seem to be helping, do not continue taking them.
If you have a complex medical condition, are pregnant or trying to get pregnant, or have been taking OTC NSAIDs and they do not relieve your symptoms, please let us know so that we can recommend an alternative. Anti-inflammatory medication (if tolerated) and natural substances such as arnica may help reduce your pain and swelling. However, it is best to avoid anti-inflammatory drugs during the initial 48 to 72 hours when they may encourage additional bleeding. Most people can tolerate paracetamol as a pain reducing medication. - ice your foot
Massage the painful area with ice for 2 to 10 minutes , several times a day. A frozen water bottle can provide you with a ice foot roller that can simultaneously provide you with some gentle plantar fascia massage. - stretch
Stretch your calf muscles and Achilles tendon. It’s important to stretch before and after you exercise. We recommend that you warm up a little and then stretch at the beginning of your exercise program, if possible. footinjuryclinic recommended stretches FIC Stretches. - strapping/taping
Low Dye taping for the feet that can be performed by your podiatrist and taught to self application. - nonsurgical medical treatments
If the home treatment methods do not completely resolve your symptoms , we may recommend additional treatments that may include:
– Custom orthotic insoles
We recommend custom orthotic inserts that are made specifically for your foot. We use Orthema CAD/CAM digital technology in order to create these inserts.– Physiotherapy– Cortisone injections
We may recommend a cortisone injection to reduce inflammation and accompanying pain. Cortisone is a steroid that mimics natural hormones that reduce inflammation.
Is heel pain slowing you down? Come in and see how we can help get you pain free.
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