Heel Pain (Heel Pain)

Heel pain and heel pain can make it difficult to walk or stand on your feet. Do you particularly hurt the morning or will the pain go through the day?

Heel pain and heel pain may be due to several possible diagnoses and causes. However, it is important to mention that plantar fascitis and heel spur are among the most common causes of heel pain. Both diagnoses are usually caused by a gradual overload over an extended period of time, which causes the tendon plate below the foot to be damaged.

BONUSES: Scroll below for to watch two training videos with good exercises which can help you relieve pain in your heels. 

VIDEO: 6 Exercises against Plantar Fascitt

The plantar fascia is the tendon plate under your foot - this attaches to the heel and can cause characteristic pain in the front of the heel. These six exercises can increase the blood circulation to your feet, strengthen your arches, and relieve your heel. Click below to watch the training video.

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VIDEO: 5 Mini-Band Exercises for Stronger Ass

Did you know that the seat muscles and hips play a key role in the shock absorption when walking or running? Lack of or reduced strength in the hips or seat could lead to more of the shock load ending up in the heel - instead of being cushioned in the hips and seat.

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Also read: 4 Exercises against Plantar Fascitt

Also read: This You Should Know About Heel Trace

Self-help: What can I do even against pain?

Self-massage (eg with trigger point ball) as you roll under the foot and regular stretching of the foot blade can stimulate increased blood circulation against dysfunctional tissue and thus help to speed up healing and pain relief. This should be combined with training of the foot blades, thighs and hips to reduce the strain on the foot.

1. General exercise, specific exercise, stretching and activity are recommended, but stay within the pain limit. Two walks a day of 20-40 minutes make good for the body and aching muscles.

2. Trigger point / massage balls we strongly recommend - they come in different sizes so you can hit well even on all parts of the body. There is no better self help than this! We recommend the following (click the image below) - which is a complete set of 5 trigger point / massage balls in different sizes:

3. Training: Specific training with training tricks of various opponents (such as this complete set of 6 knits of different resistance) can help you train strength and function. Knit training often involves more specific training, which in turn can lead to more effective injury prevention and pain reduction.

4. Pain Relief - Cooling: Biofreeze is a natural product that can relieve pain by cooling the area gently. Cooling is especially recommended when the pain is very severe. When they have calmed down then heat treatment is recommended - it is therefore advisable to have both cooling and heating available.

5. Pain Relief - Heating: Warming up tight muscles can increase blood circulation and reduce pain. We recommend the following reusable hot / cold gasket (click here to read more about it) - which can be used both for cooling (can be frozen) and for heating (can be heated in the microwave).

Recommended products for pain relief in pain

Biofreeze (Cold / cryotherapy)

Possible Causes and Diagnoses of Heel Pain

In the list below you will see a collection of different causes and diagnoses that can hurt your heels.

Achilles bursitis (Achilles tendon mucosa) (can hurt the back of the heel)

Osteoarthritis (the pain depends on which joints are affected)

Inflammation of the heel

Bursitis / mucosal inflammation

Diabetic neuropathy

Fat Pad Inflammation (typically causes pain in the fat pad under the heel)

arthritis

The deformity of Haglund (can cause pain on the underside of the foot blade, at the very back of the heel and at the back of the heel)

Heel spurs (causes pain in the underside of the foot blade, usually just in front of the heel)

Heel infection

Peripheral neuropathy

Plantar fascite (causes pain in the foot leaf, along the plantar fascia from the protrusion of the heel)

Flat foot / pes planus (not synonymous with pain but may be a contributing cause)

Psoriatic arthritis

Sinus tarsi syndrome (causes characteristic pain on the outside of the foot between the heel and the talus)

Tarsal tunnel syndrome aka Tarsal tunnel syndrome (usually causes quite intense pain on the inside of the foot, heel)

tendinitis

Tendinosis

Gout (most commonly found in the first metatarsus joint, on the big toe)

Quadratus plantae myalgia (muscular dysfunction causing pain in and in front of the heel)

rheumatism (the pain depends on which joints are affected)

However, we want to remind you that plantar fascitis, heel spur and tense foot muscle are among the most common causes of heel pain.

Do you want faster healing and further prevention of heel pain?

This compression sock is specially designed to provide pressure to the correct points in heel problems such as heel spurs and plantar fasciitis. Compression socks can contribute to increased blood circulation and increased healing in those who are affected by reduced function in the feet - when the condition is improved, they can also have a preventive effect and ensure that the condition does not recur.

Click the image above to learn more about these socks.

Imaging Diagnosis of Heel Pain

The vast majority of causes and diagnoses that provide the basis for heel pain can be detected without imaging diagnostic. But if the pain does not respond to conservative treatment or that there has been trauma before the pain occurred.

Various imaging examinations may include X-ray, CT, MRI or diagnostic ultrasound. Of these, an MRI examination is especially relevant to detect any damage to the tendon plate in front of the heel or the heel bone itself.

X-ray of the heel and foot

In the image above you see an X-ray that visualizes the entire foot and ankle. Calcaneus is also known as the heel bone.

MR image of plantar fascia in the heel

An MRI examination does not contain radioactive radiation - unlike CT and X-rays. The study uses magnetism to give a clear picture of both soft tissue and bone tissue in the foot.

In this MRI examination image we see a distinct thickening of the plantar fascia under the foot leaf at the front of the heel. Such an MRI examination can also reveal if there is any type of tearing or similar in the plantar fascia (tendon plate).

CT examination of the heel

A CT image shows much the same as an MRI scan - but without magnetic radio waves. A CT scan utilizes X-rays and is suitable for those with operated implants, pacemakers and implanted metal.

Diagnostic ultrasound of the foot blade and heel (plantar fascia)

To the left we see a clearly thickened plantar fascia for comparison with a normal plantar fascia in the right part of the image. This is the diagnosis we call plantar fasciitis.

Treatment of Heel pain

The treatment and treatment methods used to relieve and reduce your heel pain depend on the clinical history and suspected diagnosis. Here is a list of treatment techniques that are often used to improve heel pain and heel diagnoses - such as plantar fasciitis.

Due to public education and certification requirements, we recommend that you receive treatment from a publicly licensed clinician. The three professions that hold this protected public approval are chiropractor, physiotherapist and manual therapist - and this approval acts as a quality protection.

Physiotherapy and Heel pain

A physiotherapist can examine and process tight muscles and dysfunctional tendons. The physiotherapist will work towards the pain-sensitive soft tissue and try to break down the damaged tissue. The therapist will also instruct you in home exercises.

Modern Chiropractic

A modern chiropractor investigates and processes diagnoses in muscles, tendons, nerves and joints. They also hold the longest education in health professions working with muscles and joints (6 years of university education including one year in tournament service). Most modern chiropractors are also trained and trained in pressure wave therapy (shock wave therapy).

Shockwave Therapy

This treatment breaks down the damage tissue by shock waves. The treatment method was first developed by the medical profession in Switzerland, but has since found its way into many multidisciplinary clinics. Pressure wave treatment is considered the gold standard in the treatment of both heel spurs and plantar fascitis.

Clinically proven effect on the relief of heel pain in plantar fasciitis

A recent meta-study (Brantingham et al. 2012) showed that manipulation of plantar fascia and metatarsalgia gave symptomatic relief.

Using this in conjunction with pressure wave therapy will give an even better effect, based on research. Indeed, Gerdesmeyer et al (2008) demonstrated that pressure wave therapy provides a significant statistically significant improvement when it comes to pain reduction, functional improvement, and quality of life after only 3 treatments in patients with chronic plantar fascia.

Pressure wave therapy should only be performed by a publicly licensed clinician (chiropractor or physiotherapist). 

Read more: Pressure Wave Therapy - Something for Your Heel Pain?

Exercises and Training for Heel Pain

At the beginning of the article, we showed you two great exercise videos with exercises that can help you cushion your heel pain and give you better foot function. Have you seen them already? If not, we recommend you take a look. Scroll up to see the exercises.

Try these: - 4 exercises for heel pain and plantar fasciitis

Next page: 6 Early Signs of Osteoarthritis

Click on the image above to proceed to the next page.

References:

1. NHI - Norwegian Health Informatics.
2. Brantingham, JW. Manipulative therapy for lower extremity conditions: update of a literature review. J Manipulative Physiol Ther. 2012 Feb;35(2):127-66. doi: 10.1016/j.jmpt.2012.01.001.
3. Gerdesmeyer, L. Radial extracorporeal shock wave therapy is safe and effective in the treatment of chronic recalcitrant plantar fasciitis: results of a confirmatory randomized placebo-controlled multicenter study. Am J Sports Med. 2008 Nov; 36 (11): 2100-9. doi: 10.1177 / 0363546508324176. Epub 2008 Oct 1.

Frequently asked questions about heel pain

Below you will see various questions and inquiries we have received regarding heel pain.

Acute sore heel after exercise - what do you think is the diagnosis?

Sudden pain in the heel and under the foot leaf can be caused by damage to the plantar fascia - if it occurred, for example, after a very large increase in the amount of exercise, then there may also have been a partial tearing of this in the attachment on the heel bone.

It can also be due to damage to the heel pad itself. This can be examined with an imaging examination in the form of an MRI examination.

Fortunately, the most common cause of such acute heel pain is overload of the foot muscles and tendons - which with the right amount of rest, preferably the use of compression clothing and any treatment will pass when the overloaded, damaged tissue has healed itself.

Questions with the same answer: 'Why did I suddenly get a sore heel after training?', 'What can the diagnosis be in acute heel pain after training?'

Are there tendons and tissue on the heel?

Yes, the heel also has a number of tendons and other tissue structures. Among other things, the plantar fascia that attaches to the front of the heel bone (calcaneus) is considered a shock-absorbing tendon - if this is damaged or overloaded, it can lead to the diagnosis. plantar fasciitis with or without associated heel spurs.

The fat pad under the heel contains, hence the name, larger amounts of adipose tissue. We also have a number of soft tissue structures, ligaments and muscle attachments that attach around or in the heel.

Has pain in heel. What could be the cause of my heel pain?

There may be many causes and diagnoses that are to blame if you experience pain in the heel. Some examples are plantar fasciitis or muscular overload. You can see a more comprehensive list of diagnoses at the top of this article.

Questions with the same answer: 'Why do I have heel pain?', 'Why did I get heel pain?'

Has been hurting on the heel after wearing long running shoes. Can it have a connection?

Sneakers are not as shock absorbing and cushioning as sneakers. This is because, naturally, the spikes under the shoe are often made of hard material (for example, hard plastic, blend steel or the like). It is not necessarily the sneakers themselves that have hurt you, but their lack of cushioning and shock absorption.

Has pain in the back of the heel. What could be the reason for pain in the back of the heel?

Some of the most common causes of back pain are Haglund's heel, Achilles tendon dysfunction or tendon injury - or dysfunction / myalgia in the calf muscles (eg both soleus and gastrocnemius can cause or contribute to discomfort and pain in the back of the heel).

How to train your heel to withstand more strain?

To increase the capacity of the heel and the sole of the foot, one must focus on training strength in the soles of the feet, thighs and hips - studies have shown that hip training is among the most injury-preventing when it comes to preventing heel pain and heel problems. We recommend checking out the exercises we showed in the videos earlier in the article.

Here you will find some good examples of hip exercises which can relieve foot, heel, knee and thigh. It is also recommended to use compression noise (as shown earlier in the article) if you want to increase natural healing and blood circulation towards the injured area.

Intense pain in the heel. What can these symptoms be?

This depends on the presentation and other symptoms you have, but some of the most common causes of intense pain in the heel are plantar fasciitis, heel spurs, muscle dysfunction, tendon injury or fat pad inflammation.

Can heel pain come from the back?

Heel pain can come from the back in the form of sciatica irritation or nerve compression. Radiation, ile and / or numbness in the leg and heel may cause nerve root nausea called S1 (this is located at the lower back).

Prolonged pain on the side of the heel. What can this symptom point to in relation to diagnosis?

Here it depends on where on the heel of your heel your pain is located. If they sit on the outside, there may be muscle dysfunction (for example, muscular peroneus), tarsal tunnel syndrome or sciatica - there may also be damage to tendons or ligaments.

Pain on the inside of the heel may in turn indicate damage to the tendons or ligaments, but one of the most common is otherwise muscular dysfunction in the leg muscles. (eg musculus tibialis anterior) - referenced nerve pain from local or distal irritations may also occur.

Questions with the same answer: 'Why do you have chronic pain on the side of the heel? '

Pain in both the heel and the Achilles. What diagnosis could this be?

In case of pain on the back of the heel and in the Achilles tendon itself, we suspect that you have one of - or a combination of - Haglund's heel, Achilles tendinosis / tendinitis (tendonitis) og / eller retrocalcaneal bursitis (mucosal inflammation in the heel-and-Achilles attachment).

Questions with the same answer: Have pain both in the Achilles tendon and on the back of the heel - what can this be symptomatic of? '

Pain under the heel and the full cushion. What can this come from?

Pain during healing itself and helplessness may be due to several different diagnoses, but the three most common are plantar fasciitis, heel spur, and fat pad inflammation. It can also be due to tight muscles and dysfunctional foot muscles - so-called heel myosia or heel myalgia.

Questions with the same answer: 'Why do you get pain under the heel?', 'What is the diagnosis of pain under the heel?'

Painful to walk and walk on the heel. What could be the reason for that?

In case of pain when you step on the heel - especially if it occurs in the morning and the pain goes from the front edge of the heel and out into the sole of the foot - is often due to plantar fasciitis, heel spurs, muscular dysfunction (for tight foot muscles) or fat pads. It may also be due to injuries or tightening of ligaments and tendons in the ankle.

Questions with the same answer: 'Why does it hurt to believe in the heel?'

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