The Center for Podiatric Care and Sports Medicine

Do You Have Heel Pain? How to Identify the Three Most Common Causes

Posted by on Wednesday, November 7th, 2012

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Your heel hurts, and it’s not getting better. In fact, it’s getting worse, and you’re starting to walk with a weird rolling step in an attempt to keep weight off your foot. When you google “my heel hurts” or “heel pain,” though, you come up with about a million answers. So let’s help clear things up for you by comparing three common  heel pain-causing injuries.

Plantar Fasciitis This is by far one of the most common foot injuries. Actually, it’s not even really a heel injury–plantar fasciitis is a strain on the plantar fascia, the thick band of tissue that connects your heel to your forefoot. Pain from tiny tears in the plantar fascia causes pain that radiates to your heel; if left untreated, heel spurs, or bony outgrowths, can develop on your heel, making the pain worse.

You know you have plantar fasciitis if… You feel pain in your heel on “first steps,” such as when you get up in the morning or stand up after sitting for a long time.

Stress Fractures/Heel fractures Let’s talk about two types of heel fractures. A broken heel, or calcaneal fracture, is simply a broken heel bone. It’s caused by a traumatic event, such as a high impact collision or fall from a considerable height. If you have a broken heel, chances are good that you have other injuries, too–probably lots of them. Stress fractures, on the other hand, are overuse injuries that come from doing things that regularly put a lot of pressure on your heel, such as running, if you’re a heel striking runner (see this video if you’re not sure what heel striking looks like and read this article if you’re not sure if heel striking is bad or good) , or jumping, as you would in basketball or dancing. After a while tiny cracks can develop in your heel bone, causing pain.

You know you have a heel fracture if…Well, it’s really clear when you have one of these–if you’ve just been involved in a serious accident or collision and have heel pain and can’t put any weight on it you probably have a heel fracture. You probably also have a myriad of other problems.

You know you have a stress fracture if… You’re relatively pain free in the morning, but pain gets worse throughout the day, especially when you do activities where you use your heel a lot.

Heel Bruise Also known as a stone bruise or “policeman’s heel,” a heel bruise comes from repeated pounding on your heel (think a police officer walking a beat in ye olde cop days, soldiers marching during training, ultramarathoners, really intense marching bands). The fat pad on your heel is supposed to protect it from this kind of pressure, but constant stress on the heel can cause the fat pad to be pushed to the side of your heel, leaving less padding to cushion each step. In time, the thinly protected heel becomes bruised and painful.

You know you have a heel bruise if… the pain is there with each step, but is noticeably located on the outside corner of your heel.

To get an accurate diagnosis for any of these conditions,  you should see a podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900). The exception is the heel fracture, in which case you’re probably going to be in an ER.

Treatment for all of these (again, heel fracture excepted) will start with rest from activities that put stress on your heel. You can also take anti-inflammatories such as ibuprofen or aspirin to bring down swelling. Icing will also help the pain–try filling a water bottle, freezing it, then using it as a roller under your painful foot.

Your podiatrist will probably recommend heel cups or insoles that can provide extra cushioning for your heels. You can get these in a drugstore, or your podiatrist can make custom fit ones that are more durable. There are exercises you can do to help with a variety of heel ailments. You can even give yourself a heel massage to alleviate pain.

Think you have a better handle on your mystery heel pain now? If you’re in doubt, or pain, don’t ignore it, go see your podiatrist!

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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.