From Award Winning Podiatrist
2018 Australian Allied Health Award Winner
2019 National Industry Awards Judge
HEEL PAIN: THE DIFFERENT SOURCES
Managing Heel Pain in 2022: Everything you have been doing wrong and why you're not pain free yet.
Can’t quite figure out what is causing that pesky pain around your heel area? You’re not alone!
Heel pain and its many different forms are some of the most common injuries we see in the clinic.
For many people it’s a pain that comes and goes and something they put up with until they’ve just had too much… If you’re reading this I’m assuming you’re sick of it too!
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The first thing to consider when finding out your type of heel pain is the important structures that surround your heel and the things that can become irritated.
Through the back of the heel we have our Achilles tendon which connects our three calf muscles into the back of our feet. This structure is a strong fibrous band which assists us with being bouncy and powerful through our foot and ankle.
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This Tendon is encased by a “sheath” which uses a lubricating fluid to protect the tendon and allow it to glide smoothly back and forth.
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Right down near where the tendon attaches onto the bone we have a couple of Bursae which are like little fluid filled cushions which help to reduce friction between different moving parts. These are some of the key things we are looking at and assessing through the back of the heel.
Now onto the underside or “plantar” side of the heel. We have a number of our intrinsic foot muscles attaching into the underside of the heel.
On top of these muscles the Plantar Fascia has some strong attachments across the plantar heel surface.
Again this area also has bursae present to help with the movement between different parts of the foot. Superficial to all this and just below the skin we have our heel fat pad which is designed as our naturally occurring cushioning.
In addition to these key areas we also need to look at things like the integrity of the heel bone and check to see if there is any nerve irritation to ensure that we have looked at all possible sources of heel pain.
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Most Common Sources of Heel Pain
So having looked at all these types of heel pain hundreds of times, what is the most common source of pain? We’ve listed our 3 most common types of heel pain below:
Mid Portion Achilles Tendinopathy
As the name describes this is felt in the middle of the Achilles Tendon, usually a couple of centimetres above the heel bone. Most people describe this pain as something they feel when first begin to exercise or walk, but the pain eases or fades slightly as they warm up.
Plantar Fasciitis (aka Fasciopathy)
Your Plantar Fascia is a thick band of tissue which runs from your toes to your heel on the underside of your foot. When it becomes overloaded and painful it can usually be felt as heel pain when first getting out of bed or when first walking after sitting for a long period of time.
Achilles Tenosynovitis
This condition refers to inflammation of the sheath that surrounds the Achilles tendon, which usually impacts the tendon’s ability to glide smoothly up and down. This pain usually increases with intensity of movement and can at times feel like tendon is "catching".
How do we manage these injuries?
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Each of these injuries are managed differently, but the first and most important thing is moving through a range of testing to find the contributing factors which have lead to the injury occurring. This is usually done by looking at the way your body is moving as well as testing the strength and mobility of the surrounding muscles and joints.
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Once we have found the causes behind the injury we can then begin with developing management tailored specifically to you.
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Early stages we look at deloading the injured area with a combination of strapping, taping and padding. Once we have used this to break the pain cycle we dive into working on the areas of strength and mobility which might be lacking. Combine these movement strategies with some gait retraining, footwear advice and short term offloading and we have a path to success!
If you are struggling with ongoing heel pain and not sure what to do, we are offering 20 FREE Initial Assessments with our Heel Pain Guru, Angus McSweyn. He only has a limited number of spots available, so jump in quick.
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What you need to do:
Click the "BOOK ONLINE" button below
Select your preferred location at either our Geelong or Torquay clinic
Book in to see Angus McSweyn and use promo code "FREEHEEL"
