Every time you take a step, one of your heels has to support the whole weight of your body. As you move, the load is equal to 20 times your own body weight. The load is softened by a pillow of fat under the heel and a large sinew or ligament (the fibrous tissue that joins muscle and bone together) under the sole of the foot. This sinew is called the plantar fascia and it pulls the heel bone forward (in opposition to the Achilles tendon, which pulls it backwards). If an athlete does not warm up properly or a person with a sedentary job exercises heavily during the weekends, they might overload the muscles of the calf or strain the Achilles tendon, which joins these muscles to the heel bone. When overloaded the tendon becomes tight and painfully inflamed, which places extra strain on the plantar fascia and muscles in the soles of the foot. The strained plantar fascia becomes inflamed and may even develop tiny cracks. This is known as plantar fasciitis. Every time you sit down, sleep or otherwise rest your legs, the muscles of the sole of the foot will contract in an attempt to protect the damaged sinew. The pain in the heel will then no longer be felt. But when you get up again and put weight on the foot, the foot and ankle may feel stiff (because of the inflammation) and the pain will return either at the back of the heel or on the soles of the feet. When you start to move, the plantar fascia may crack even more causing a vicious cycle of damage and pain. Inflammation at the point where the Achilles tendon (at the back of the heel) or the plantar fascia (under the heel) join the heel bone (a bone known as the Calcaneum) stimulates cells that form bone to deposit bone in this area, eventually leading to the build up of a bony prominence on the heel bone called a calcaneal spur. But it's not the spur itself that causes the pain. The spur is a sign of chronic inflammation in the connective tissues, which is the result of a prolonged overload. It should also be pointed out that heel spurs can occur on their own, without plantar fasciitis or pain, or may be linked to some types of arthritis (inflammation of the joints). And plantar fasciitis or Achilles tendonitis don't necessarily lead to spur formation.
Plantar fasciitis: It is the most common cause of heel pain. In this condition, the pain is more severe in the morning but becomes less painful as the day continues. It occurs due to tiny tears in the plantar fascia.The plantar faschia is a tissue band that connects the bottom of the heel bones to the ball of the foot and is involved in walking and running, giving spring to the step. If left untreated, the symptoms usually worsen and can lead to problems with the knee and hip and can cause back pain due to difficulty walking. Those who frequently stand or walk throughout the day or those who run are most likely to develop plantar fasciitis.
Both heel pain and heel spurs are frequently associated with an inflammation of the long band of tissue that connects the heel and the ball of the foot. The inflammation of this arch area is called plantar fasciitis. The inflammation maybe aggravated by shoes that lack appropriate support and by the chronic irritation that sometimes accompanies an athletic lifestyle. Achilles Tendinopathy, Pain and inflammation of the tendon at the back of the heel that connects the calf muscle to the foot. Sever?s, Often found in children between the ages of 8 - 13 years and is an inflammation of the calcaneal epiphyseal plate (growth plate) in the back of the heel. Bursitis, An inflamed bursa is a small irritated sack of fluid at the back of the heel. Other types of heel pain include soft tissue growths, Haglunds deformity (bone enlargement at the back of the heel), bruises or stress fractures and possible nerve entrapment.
In most cases, your GP or a podiatrist (a specialist in foot problems and foot care) should be able to diagnose the cause of your heel pain by asking about your symptoms and medical history, examining your heel and foot.
Non Surgical Treatment
Treatment for heel pain usually involves using a combination of techniques, such as stretches and painkillers, to relieve pain and speed up recovery. Most cases of heel pain get better within 12 months. Surgery may be recommended as a last resort if your symptoms don't improve after this time. Only 1 in 20 people with heel pain will need surgery. Whenever possible, rest the affected foot by not walking long distances and standing for long periods. However, you should regularly stretch your feet and calves using exercises such as those described. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can be used to help relieve pain. Some people also find applying an ice pack to the affected heel for 5-10 minutes can help relieve pain and inflammation. However, do not apply an ice pack directly to your skin. Instead, wrap it in a towel. If you do not have an ice pack, you can use a packet of frozen vegetables. Exercises designed to stretch both your calf muscles and your plantar fascia (the band of tissue that runs under the sole of your foot) should help relieve pain and improve flexibility in the affected foot. A number of stretching exercises are described below. It's usually recommended that you do the exercises on both legs, even if only one of your heels is affected by pain. This will improve your balance and stability, and help relieve heel pain. Keep a long towel beside your bed. Before you get out of bed in the morning, loop the towel around your foot and use it to pull your toes towards your body, while keeping your knee straight. Repeat three times on each foot. Place both hands on a wall at shoulder height, with one of your feet in front of the other. The front foot should be about 30cm (12 inches) away from the wall. With your front knee bent and your back leg straight, lean towards the wall until you feel a tightening in the calf muscles of your back leg. Then relax. Repeat this exercise 10 times before switching legs and repeating the cycle. You should practise wall stretches twice a day. Stand on a step of your stairs facing upstairs, using your banister for support. Your feet should be slightly apart, with your heels hanging off the back of the step. Lower your heels until you feel a tightening in your calves. Hold this position for about 40 seconds, before raising your heels back to the starting position. Repeat this procedure six times, at least twice a day. Sit on a chair, with your knees bent at right angles. Turn your feet sideways so your heels are touching and your toes are pointing in opposite directions. Lift the toes of the affected foot upwards, while keeping the heel firmly on the floor. You should feel your calf muscles and Achilles tendon (the band of tissue that connects your heel bone to your calf muscle) tighten. Hold this position for several seconds and then relax. Repeat this procedure 10 times, five to six times a day. While seated, roll the arch of your foot (the curved bottom part of the foot between your toes and heel) over a round object, such as a rolling pin, tennis ball or drinks can. Some people find that using a chilled can from their fridge has the added benefit of helping to relieve pain. Move your foot and ankle in all directions over the object for several minutes. Repeat the exercise twice a day. Your GP or podiatrist may advise you to change your footwear. You should avoid wearing flat-soled shoes, because they will not provide your heel with support and could make your heel pain worse. Ideally, you should wear shoes that cushion your heels and provide a good level of support to the arches of your feet. For women wearing high heels, and for men wearing heeled boots or brogues, can provide short- to medium-term pain relief, as they help reduce pressure on the heels. However, these types of shoes may not be suitable in the long term, because they can lead to further episodes of heel pain. Your GP or podiatrist can advise on footwear. Orthoses are insoles that fit inside your shoe to support your foot and help your heel recover. You can buy orthoses off-the-shelf from sports shops and larger pharmacies. Alternatively, your podiatrist should be able to recommend a supplier. If your pain does not respond to treatment and keeps recurring, or if you have an abnormal foot shape or structure, custom-made orthoses are available. These are specifically made to fit the shape of your feet. However, there is currently no evidence to suggest that custom-made orthoses are more effective than those bought off-the-shelf. An alternative to using orthoses is to have your heel strapped with sports strapping (zinc oxide) tape, which helps relieve pressure on your heel. Your GP or podiatrist can teach you how to apply the tape yourself. In some cases, night splints can also be useful. Most people sleep with their toes pointing down, which means tissue inside the heel is squeezed together. Night splints, which look like boots, are designed to keep your toes and feet pointing up while you are asleep. This will stretch both your Achilles tendon and your plantar fascia, which should help speed up your recovery time. Night splints are usually only available from specialist shops and online retailers. Again, your podiatrist should be able to recommend a supplier. If treatment hasn't helped relieve your painful symptoms, your GP may recommend corticosteroid injections. Corticosteroids are a type of medication that have a powerful anti-inflammatory effect. They have to be used sparingly because overuse can cause serious side effects, such as weight gain and high blood pressure (hypertension). As a result, it is usually recommended that no more than three corticosteroid injections are given within a year in any part of the body. Before having a corticosteroid injection, a local anaesthetic may be used to numb your foot so you don't feel any pain.
With the advancements in technology and treatments, if you do need to have surgery for the heel, it is very minimal incision that?s done. And the nice thing is your recovery period is short and you should be able to bear weight right after the surgery. This means you can get back to your weekly routine in just a few weeks. Recovery is a lot different than it used to be and a lot of it is because of doing a minimal incision and decreasing trauma to soft tissues, as well as even the bone. So if you need surgery, then your recovery period is pretty quick.
heel spur shoes
Wear properly fitting shoes. Place insoles or inserts in your shoes to help control abnormal foot motion. Maintain a healthy weight. Exercise and do foot stretches as they have been shown to decrease the incidence of heel pain.