When most people experience heel pain the first thought that comes to mind is plantar fasciitis, which is an inflammation of the plantar fascia. Pain occurs at the inside/bottom of the foot/heel from where the plantar fascia starts.
Classic signs of plantar fasciitis:
1. Pain at the heel
2. Morning pain and stiffness, the first few steps out of bed may be the worst
3. Point tenderness at the heel
4. Increased pain with prolonged standing or walking
It is important to note that people get plantar fasciitis for different reasons. A person may have excessive pronation, where their arch drops or they have “flat feet”. In this case, the person needs support and strength in their foot and ankle to decrease stress and load to the plantar fascia. A person may have a stiff foot, in which case stretching would be important to improve mobility in the foot and ankle, which can help decrease stress to the plantar fascia.
There are also other causes of heel pain unrelated to plantar fasciitis. Heel pain can be caused by a stiff heel joint which becomes inflamed and painful with standing and walking; the same types of activities that aggravate plantar fasciitis and can present similarly. Heel pain may also be related to tightness of the intrinsic muscles of the foot. Heel pain could also be due to some good old fashion tight calves. There are two muscles in the calf: the gastroc and the soleus. Pain can be referred to the heel if either or both muscles are tight.
So what should I do if I get Heel Pain?
There are a few things you can try at home to deal with heel pain. First, ice the area. Try icing every day for 20 minutes for one week to help decrease the inflammation and help reduce pain. Massage the bottom of the foot. Loosening up the bottom of the foot can help decrease the stress those structures place on the heel. Stretch your foot, cross one leg over the other and pull your toes back to feel a stretch in the bottom of your foot, hold this for 30 seconds and repeat a few times a day. Stretch your calves, holding for 20 seconds and repeat several times throughout the day. Also, try changing your footwear. Wear something supportive such as a sneaker to decrease stress to the heel. Check out this video to help instruct you on how to do these exercises.