Hello and welcome to the first episode in this series about sports podiatry. We’ll be focusing on conditions that affect athletes, and today we’ll be focusing more specifically on heel pain, the treatments and symptoms. We generally find there are different conditions that can affect the bottom of the heel, compared to the back of the heel. In this video, we will look to address these separately.
Pain at the bottom of the heel can be caused by a variety of reasons. However, the most common cause in the adult population is plantar fasciitis. Plantar fasciitis is inflammation of the thick band of tissue running from your heel to your big toe, called the plantar fascia.
Symptoms of plantar fasciitis include pain that is usually well-localized in the bottom of the heel. The pain can extend into the arch or into the ankle, however, is most-commonly reported at the bottom of the heel. The pain is usually worst on the first step and usually eases up after a few steps. The pain is also sometimes also worsened into the afternoon and into the evening.
If your pain is worse at nighttime or if you feel like it’s painful when you’re in bed or with your feet up, there can be an entrapment of your nerve called your Baxter’s nerve. This is usually due to a biomechanical abnormality in the foot and often is a result of the nerve that runs near the plantar fascia, becoming entrapped and inflamed.
Symptoms are slightly different with Baxter’s nerve entrapment, and often include burning, numbness and shooting and tingling pain. Treatments of plantar fasciitis, or pain at the bottom of the heel, can include orthotics or shoe inserts, footwear education, dry needling with acupuncture needles, steroid injections, or surgery.
A common cause of pain in the back of the heel is Achilles tendinopathy. Your Achilles tendon is your strongest and largest tendon in your body, and it becomes an issue when there’s inflammation or degeneration in the actual tendon. With Achilles tendinopathy, it is most common in runners or extremely active people.
Achilles tendinopathy is often reported as a persistent pain at the back of the heel. It’s usually persistently painful throughout the entirety of the day, and usually gets worst with high level of activity. Usually Achilles tendinopathy can be painful into the mid-portion of the Achilles tendon, which is between the calf muscle and the heel, which is between the calf muscle and the heel, where the Achilles tendon inserts into the actual calcaneus itself.
As these locations of pain are slightly different conditions, often this should guide treatment around Achilles tendinopathy as well. Treatments for Achilles tendinopathy and plantar fasciitis are often very similar. Treatments for Achilles tendinopathy still include healing, shoe inserts, or orthotics, dry needling, and a comprehensive stretching and strengthening regime.
Treating heel pain is very important, because having heel pain can affect your general activity levels and your health and well-being. We have provided some general advice and information in today’s video, and if you would like some more, specifically tailored information, advice, and treatments, we would love for you to book online on our website.