Heel Pain

When most people present to their family physician with heel pain, they are often told to stop their ambulatory activities (walking, running) and rest. This may indeed, for a short time, help reduce the heel pain. However once a person resumes his/her normal level of activity the heel pain will almost always recur.

Most heel pain is due to a continuous pulling of a ligamentous tissue, called the plantar fascia, located on the bottom of the foot. This tissue is oftentimes severely stretched and strained due to excessive joint motion and flattening of the feet that occurs while walking and/or running on hard surfaces. This joint motion is called pronation. The condition that develops in the heel is called plantar fasciitis and oftentimes will lead to the formation of a heel spur. “Itis” at the end of a word means inflammation and this is an inflammation of the plantar fascia. The most effective type of treatment for this condition is not to stop all activity, but to control excess joint motion, or pronation in the foot, which is actually responsible for causing the problem. This can be most easily accomplished by fabricating a custom molded shoe insert, called a foot orthotic device.

The orthotic device places the feet and legs in their most ideal or neutral position, thereby reducing the pressure on the plantar fascial tissue. A proper foot orthotic device also may reduce stress and strain on the tendons, ligament muscles, bones and joints of the entire lower extremity (foot, ankle, knee, hip and low back.)

Approximately 90% of all people with heel pain, including runners and other athletes, will experience almost complete resolution of their heel pain when a proper orthotic device is fabricated and used. For those people who do not respond to orthotic therapy, additional forms of treatment including therapeutic injections, physical therapy, and anti-inflammatory medications may be required. It should also be mentioned that approximately 5% of all heel pain is due to metabolic conditions including arthritis, gout, diabetes, and certain gastrointestinal disorders.

It should be re-emphasized that the majority of people that do have heel pain, do not need to stop their athletic activity, provided that adequate treatment is rendered.