GET A HANDLE ON YOUR HEEL PAIN GUIDE

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1 GET A HANDLE ON YOUR HEEL PAIN GUIDE American Podiatric Medical Association

2 Take a Moment to Focus in on Your Feet. Does one (or even both) of your heels hurt? If so, you aren t alone. A study by the American Podiatric Medical Association (APMA) has found that nearly 40 percent of all Americans have suffered from heel pain at some point in their lives. So what causes heel pain? Furthermore, what are the best ways to fix this problem that can drastically impact your quality of life? Can heel pain be prevented entirely? Determining the cause of heel pain is not always a simple answer, but early treatment is vital. Educating yourself about the main causes of heel pain, as well as the best ways that you and your podiatrist can treat and prevent this common foot condition, will help keep your feet healthy and pain-free. 1

3 Achilles tendon Plantar Fasciitis WHAT Is CAUsING MY HEEL PAIN? What are some common causes of heel pain? The number one cause of heel pain is a condition called plantar fasciitis. It is often characterized by pain on the bottom of the heel when you take your first steps in the morning, but can also last all day long with pain often progressing the longer the condition remains untreated. In addition, other common causes of heel pain include tendinitis, stress fractures, neuritis, bursitis, tarsal tunnel syndrome, arthritis, and fat pad thinning. What can cause Plantar Fasciitis specifically? What is Causing My Heel Pain? Inflammation Plantar fascia Plantar fasciitis can be caused by a number of factors, including weight gain, worn-out shoes, walking barefoot, increasing exercise, and walking on hard surfaces without proper support. Any of these factors, in combination with how your feet function mechanically, can cause plantar fasciitis. 2 3

4 What is Causing My Heel Pain? What are my possible treatment options if I ve already been diagnosed with heel pain? Once your podiatrist examines your feet and determines the cause of your pain, you may be treated immediately with options such as custom orthotics, steroid injections, prescription medications, physical therapy, and immobilization. Depending on your response to treatment, your pain may require more advanced treatments or surgery. Talk to your podiatrist about what avenue of treatment is best for you. Is there anything I can do on my own to relieve heel pain? Absolutely! There are several steps you can take to help relieve many types of heel pain, as well as prevent the condition before it starts. For more information, (see page 9, Ways To Avoid Heel Pain ). What is Causing My Heel Pain? My podiatrist told me that my feet roll inward too much while walking, calling it pronation. How can pronation contribute to heel pain? Excessive pronation can create an abnormal amount of stretching and pulling on the ligaments and tendons that attach to the bottom back of the heel bone. It can also contribute to problems of the hip, knee and lower back. 4 5

5 A Closer Look A Closer Look at Plantar Fasciitis The primary cause of heel pain, plantar fasciitis is an inflammation of the tissue band (fascia) connecting the heel bone to the base of the toes. This pain is generally centered under the heel, and can be caused by (but not limited to) activities that include: wearing improper footwear, excessive weight, walking barefoot and/or walking barefoot on hard surfaces, and an increase in exercise. While many heel pain sufferers often assume their heel pain is caused by a heel spur on the heel bone (commonly referred to as heel spur syndrome ), heel spurs have been proven to not be the cause of heel pain. Plantar fasciitis is often successfully treated with custom orthotics prescribed by a podiatrist, injections, prescription medications, physical therapy and immobilization. The longer plantar fasciitis goes untreated, the more difficult it is to find relief, so above all, visit a podiatrist at the first sign of heel pain. Sometimes heel pain can be aggravated due to the type of footwear worn. However, relieving the pain can be as simple as changing the type of shoes you wear! In a recent American Podiatric Medical Association survey, 45 percent of Americans attribute heel pain to wearing FOOTWEAR AND HEEL PAIN uncomfortable or ill-fitting shoes. Shoes that fail to give adequate support to the foot can increase strain on the largest ligament of the foot, known as the plantar fascia, resulting in inflammation, heel pain and possible injury. This inflammation to the plantar fascia is called plantar fasciitis one of the most common causes of heel pain. An APMA survey found that 45 percent of Americans Well-Heeled Footwear Advice to Help Avoid Pain attribute their heel pain to wearing uncomfortable or illfitting shoes. What types of footwear are best bets for avoiding heel pain? Replace shoes with excessive or Sometimes Footwear Type heel pain can be aggravated Problem due to the type of footwear worn. However, Solution relieving the pain can be as simple as changing the type of shoes you wear! In a recent American Podiatric Medical Association survey, 45 percent of Americans attribute heel pain to wearing uncomfortable or ill-fitting shoes. Shoes that fail to give adequate support uneven to the foot wear can on soles and heels. Athletic increase Shoe strain on the largest Heel ligament pain can of occur the foot, while known wearing as the plantar fascia, Replace resulting shoes every in miles. inflammation, heel pain and athletic possible shoes especially injury. This inflammation if the to the plantar To test fascia the is support called of the heel, plantar fasciitis one of the shoe most has common a worn causes heel or sole, of heel or pain. press the sides and make sure they does not provide enough support. do not collapse. Footwear Type Problem Make sure Solution the shoe doesn t bend too Replace easily shoes in the with middle. excessive or Ballet Flat This popular style of shoe can uneven Use an over-the-counter wear on soles and insert heels. to cause plantar fasciitis, Achilles Athletic Shoe Heel pain can occur while wearing provide Replace support. shoes every miles. tendon strain and an overall feeling athletic shoes especially if the Don t To test walk the long support distances of the heel, in these of tiredness in the feet and legs. shoes. shoe has a worn heel or sole, or press the sides and make sure they does not provide enough support. do not collapse. Slides or Mules Ballet Flat This type of shoe can cause plantar fasciitis This popular and Achilles style of shoe tendon can strain. cause plantar fasciitis, Achilles tendon strain and an overall feeling of tiredness in the feet and legs. Select Make sure a shoe the that shoe allows doesn t some bend bend too easily at the in ball the of middle. the foot. Avoid Use an wearing over-the-counter this type of insert shoe to for long provide periods support. of time. Refrain Don t walk from long wearing distances this shoe in these if you shoes. experience heel pain. Surprisingly, this easy-to-wear Select flip-flops made of natural Select a shoe that allows some Flip-Flop shoe can lead to plantar fasciitis materials such as soft, supple Slides or Mules This type of shoe can cause plantar bend at the ball of the foot. and Achilles tendon strain. Daily leather. The heel of your foot should fasciitis and Achilles tendon strain. Avoid wearing this type of shoe for wear of flip-flops can also cause not hang over the edge. long periods of time. calluses in the heel area. Look for styles with a built-in arch. Refrain from wearing this shoe if you experience heel pain. This type of sneaker may cause Make sure the sneakers have laces Fashion Sneaker plantar fasciitis due to the flexible and the soles don t twist. Surprisingly, sole and the lack this easy-to-wear of arch and heel Select Don t wear flip-flops this shoe made for of exercise; natural it Flip-Flop shoe support. can lead to plantar fasciitis and Achilles tendon strain. Daily wear of flip-flops can also cause materials is not intended such as for soft, athletic supple activities. leather. The heel of your foot should not hang over the edge. Foot pain is not calluses normal! in With the early heel detection, area. heel pain can be Look treated for with styles non-invasive with a built-in arch. treatment options. It typically is more difficult to successfully treat heel pain the longer it is left untreated. This If type you of experience sneaker may heel cause pain, see a podiatrist Make right sure away. the sneakers have laces Fashion Sneaker plantar fasciitis due to the flexible and the soles don t twist. Visit sole and the lack to of find arch an and APMA heel member podiatrist Don t in wear your this area. shoe for exercise; it support. is not intended for athletic activities. Footwear and Heel Pain Foot pain is not normal! With early Sponsored detection, by heel pain can be treated with non-invasive treatment options. It typically is more difficult to successfully treat heel pain the longer it is left untreated. If you experience heel pain, see a podiatrist right away. 6 7

6 sports and Heel Pain Get a Jump on Heel Pain & Sports sports AND HEEL PAIN Sports activities are an exciting and healthy part of life. Sometimes, sports that include jarring starts and stops, or sports that are performed on uneven surfaces, can lead to heel pain. The American Podiatric Medical Association (APMA) in cooperation with the American Academy of Podiatric Sports Medicine (AAPSM) offer five sports most likely to contribute to heel pain and steps you can take to prevent it from occurring. Participating in sports that include jarring starts and Get a Jump on Heel Pain & Sports stops, or sports performed on uneven surfaces, can quickly lead to heel pain. The chart below outlines several Sport popular sporting Problem activities and tips to avoid Solution heel pain during each: Sports activities are an exciting and healthy part of life. Sometimes, sports that include jarring starts and stops, or sports that are performed on uneven surfaces, can lead to heel pain. The American Podiatric Medical Association (APMA) in cooperation with the American Academy of Podiatric Sports Medicine (AAPSM) offer five sports most likely to contribute to heel pain and steps you can take to prevent it from occurring. Choose the correct shoe for running, short or long distances, Pain in the arch and bottom of the this can prevent most pain. Running heel can be caused by both short Try over-the-counter insoles, they Sport and long distance Problem running. can sometimes help Solution to relieve pain by providing cushion and shock Pain in the arch and bottom of the absorption. Choose the correct Custom shoe orthotics for help running, many runners. short or long distances, this Replace can prevent worn shoes most every pain Running Walking & Hiking heel can be caused by both short and long distance running. Walking and hiking may irritate a Haglund s deformity, which is a bump on the back of the heel miles. Try over-the-counter insoles, they can Wearing sometimes shoes or help boots to relieve with stiff pain by heel providing counters cushion can irritate and the shock heel absorption. bone, especially Custom on steep orthotics uphills. help many Selecting runners. a shoe with a lower or bone where the Achilles tendon attaches. It can become larger or softer Replace heel worn counter shoes may every relieve miles. pain. inflamed over time. Walking and hiking may irritate a Haglund s deformity, which is a Wearing Using heel shoes lifts and or boots custom with orthotics stiff heel can reposition counters can the heel irritate and the reduce heel bone, irritation. especially on steep uphills. Walking & Hiking bump on the back of the heel bone Acute where or traumatic the Achilles pain in tendon the attaches. arch of the It foot can and become bottom larger of the or Selecting Focus stretching a shoe with the Achilles a lower or softer tendon heel both counter before may and after relieve pain. activity. Kickboxing & Aerobics inflamed heel can over develop time. due to the high impact of these activities. Using Consult heel a podiatrist lifts and custom immediately orthotics if can sudden reposition heel, arch the heel or ankle and pain reduce is irritation. experienced. Acute or traumatic pain in the arch Tennis of may the foot cause and pain bottom on the of the Increase Focus stretching the at Achilles the first signs of tendon heel pain. both before Include and stretching after the hamstrings. activity. Kickboxing Tennis & Aerobics heel outer can sides develop of the due heel to due the to high impact body positioning of these activities. during play. Using Consult insoles a podiatrist and custom immediately molded if orthotic sudden devices heel, arch available or ankle from pain a is podiatric experienced. physician can help. Increase stretching at the first signs of heel pain. Include stretching the High-top shoes can help to keep the Tennis may cause pain on the hamstrings. Basketball, as well as other foot stable. Tennis outer sides of the heel due to Using insoles and custom molded jarring sports, can cause stress Stretch the entire leg and foot body positioning during play. orthotic devices available from a Basketball fractures and pain on the bottom, before playing. podiatric physician can help. back and sides of the heel. Heel lifts and custom foot orthoses can prevent pain or provide relief. High-top shoes can help to keep the Basketball, as well as other foot stable. jarring sports, can cause stress Stretch the entire leg and foot To find an APMA member podiatrist in your area, visit Basketball fractures and pain on the bottom, before playing. back and sides of the heel. Heel lifts and custom foot orthoses can prevent pain or provide relief. WAYs TO AVOID HEEL PAIN Heel pain, if detected early, can usually be treated with conservative options. However, the longer you wait to have heel pain addressed by a podiatrist, the more difficult it is to successfully treat. Looking for the best ways to avoid heel pain altogether? Consider the following: Always: Wear supportive shoes Avoid walking barefoot Stretch your feet well prior to exercising Ice your heel if pain is felt If heel pain persists, always schedule an appointment with a podiatrist for evaluation to avoid complications in treatment. 8 9 Ways to Avoid Heel Pain

7 HEEL PAIN TREATMENT OPTIONS HEEL PAIN TREATMENT OPTIONS Treatment Options Medical Treatments: Commonly prescribed treatments for heel pain include: custom orthotic insoles night splints non-steroidal, anti-inflammatory medication Additionally, podiatric medicine is on the cutting-edge of technology when it comes to both diagnosing and treating heel pain. Whether through the use of radio frequency technology, shockwave therapy or another form of treatment, technology for heel pain treatment is evolving everyday. Discuss treatment options that are right for you with your doctor. Over-the-Counter (OTC) treatment options: Insoles OTC insole products, such as those made by Spenco and Pedag USA, can often provide some relief by stabilizing the foot and helping to correct overpronation. Heel Supports Supports such as those made by Spenco and Sorbothane are specifically designed to cup the heel using gel supports. Treatment Options 10 11

8 A FINAL WORD ON HEEL PAIN Final Word While many Americans take their feet for granted, always focusing in on your foot health can ensure that you never lose a step to heel pain. Remember, if detected early, chances are high that your heel pain can be treated successfully. To get more information on heel pain, visit the APMA s Web site, apma.org. There, you ll learn about other specific kinds of heel pain, the latest advances in heel pain treatment technology and much more! While heel pain may be common, remember... foot pain of any kind is never considered normal. If you experience any discomfort in your heels or other areas of the foot or lower leg, see a podiatrist. Podiatrists Keep America Walking. 12

9 American Podiatric Medical Association 9312 Old Georgetown Road Bethesda, MD FootCare

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