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Lets heal heel pain

heel pain

Heel pain can be very distressing and can stop you enjoying life or taking part in active pursuits. Here are some recommended at home tips from us and lets heal heel pain.

What can you do to help yourself

  1. Footwear review/change – wear footwear that is suited for the activity you are doing and be mindful to choose footwear that supports the length, breadth and form of the foot. Footwear that has inbuild support under the arch is good and with fastenings that can be adjusted such as laces. 
  2. Icing the heel 3 times a day can be beneficial as an analgesic. Although most heel conditions are not due to inflammatory causes so icing is used as a therapy to reduce swelling.
  3. Wearing an orthotic with a supportive heel cup and supportive heel cushion may be beneficial.
  4. Simple stretching programmes – calf muscles and the big toe complex.
  5. Taping the heel.
  6. Modify activity to reduce load onto heel or change to non weight bearing activities – cycling/swimming.
  7. Weight loss.

Not easing? Lets get professional help and lets heal heel pain.

What is a podiatrist?

A podiatrist is an expert in the lower limb, especially the foot and ankle. They are degree trained and can diagnose, treat and improve pain, form and function.

A podiatrist is to feet what a dentist is to teeth

What can a podiatrist do for heel pain

Podiatrists can clinically diagnose the structures involved with the heel pain, and if necessary facilitate further diagnostic tests.

They can build a treatment plan with patients which would typically involve taping, stretching and strengthening exercises, orthotics, shockwave therapy, steroid injection therapy, night splints.

Make Your Appointment Today

To book an appointment with Zest Podiatry & Physio please book online or contact us direct for further details.

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What is heel pain?

Are you or someone you know suffering with heel pain? Scared to take that first step in the morning or has it stopped you from enjoying walking and sports.

If you have heel pain you are in the company of many people who have foot pain, accounting for many visits to healthcare professionals – including podiatrists, physios and GPs. It is the most common foot disorder encountered by podiatrists (college of podiatry).

Who gets heel pain

Young children can get heel pain especially those who are active and sporty. Adults who enjoy running and high impact sports can get heel pain. Adults whose occupations require them to be on their feet for long periods are susceptible. As we age, the soft tissue within the heel can degenerate leading to heel pain.

What is the structure within the heel that can be injured

The heel consists of bone (calcaneus) and soft tissue structures that attach to the bone including tendons, fascia, ligament.

The foot is a key structure for walking and running and whilst it is very well designed to withstand such load, it can suffer from over -use, overload or degeneration. 

Causes of heel pain or injury

Degeneration of the soft tissue is the most common cause and in particular, Plantar heel Pain syndrome PHPS (commonly known as Plantar Fasciitis) especially amongst runners and those who stand for long periods at work.

Are you a runner?

PHPS is a degenerative condition rather than an inflammatory condition, and affects 10% of the population and 15% of all foot related complaints being seen by medical staff. 10% of all runners experience plantar pain and most common in those who run long distances.

Some of the common conditions include

  • PHPS
  • Baxter’s Nerve
  • Heel spur
  • Tarsal Tunnel Syndrome
  • Fat Pad Contusion
  • Distal Tear
  • Tibialis Posterior Dysfunction

How can we help

Treatment from a podiatrist will be tailor-made for each patient but likely to include advice, taping, stretching and strengthening exercises, orthotics, shockwave therapy, steroid injection therapy, night splints.

Make Your Appointment Today

To book an appointment with Zest Podiatry & Physio please book online or contact us direct for further details.

Online Booking   Contact us

Sever’s disease/Calcaneal apophysitis

Calcaneal apophysitis

This condition is also known after doctor who first identified it in 1912 It was called Sever’s disease which does sound rather scary. It is the most common cause of heel pain in children. Podiatrists regularly treat these common injuries when they affect a foot or ankle, at Zest we would recommend our MSK lead.

Symptoms of calcaneal apophysitis

In all growing children there are areas on the bone that are made up of special cells from which the bone will grow. These are called your growth plates or apophysis. The growth plate on the back of the heel bone (calcaneus) is situated where the Achilles tendon connects to it. Bones in children tend to grow quite quickly in comparison to other structures particularly tendons.

As parents can testify when their child goes through a growth spurt can be very quickly over a few weeks. These growth spurts are most prevalent between the ages of 9 and 11 which is the most common time to get calcaneal apophysitis and at the start of a new sporting season.

The shin bone (tibia) starts to grow but unfortunately the Achilles tendon, which does not have as good blood supply as the bone, cannot grow or stretch at the same rate. This means that the Achilles tendon becomes tighter and as they move it pulls with more and more force on the growth plate at the back of the heel bone causing the growth plate to become irritated.

Treatment

If left calcaneal apophysitis will eventually get better by itself within 2 to 4 weeks. But it can become very painful and last longer in which case your podiatrist can help. If the child is not in too much pain they can continue with their activities and use ice regularly on the area to relieve pain. In some cases, a heel raise, or orthosis will help and often stretches are used to help settle the condition more quickly.

The most important thing is to keep the child is comfortable as possible while this condition resolves. We often recommend daily use of trainers or walking shoes until the pain settles. Recurrence of calcaneal apophysitis is not uncommon with each growth spurt but should this occur your podiatrist will tell you how to deal with it. This same sort of condition occurs in other areas of the foot such as at the base of the fifth metatarsal where it is known as Iselin’s disease.

Achilles Tendinitis Post

achilles tendonitis

The Achilles tendon is the tendon that connects the calf muscles to the back of the heel bone. It is a key tendon in providing movement and power on walking. On occasions it can become irritated or thickened as a result of trauma or overuse, causing Achilles Tendinitis. Often changes in heel height of shoes, from high to low, can also create this irritation. During this irritation the Achilles tendon becomes thickened, stiff and painful, particularly on movement after sitting.

It is important to keep the tissues of the tendon moving so rest id not usually recommended unless in high levels of pain. Your podiatrist will be able to examine the area to determine if there is any tearing of the tendon a period of rest or possibly surgery may be required. This can be done using ultrasound imaging that is available in the clinic

Achilles Tendinitis treatment

Once the integrity of the tendon has been determined the podiatrist can then start you on your treatment plan.

This will usually involve stretches and strengthening of the tendon and the calf muscles themselves. In order to help you with this your podiatrist may recommend that we use orthoses to help distribute the stress and strain through the tendon evenly or occasionally strapping to allow you to continue to be active.

In cases of extreme inflammation may be indicated to perform injection therapy. This usually involves a period of immobilisation cast boot.

Given that the Achilles tendon does not have a great blood supply compared to muscles it can take some time to fully recover from injury.

Plantar fasciitis

plantar fasciitis

We use the term Plantar fasciitis to describe a type heel pain. Which results from the deterioration of your plantar fascia. However, today we prefer to call it plantar heel pain syndrome or plantar fasciopathy.

Plantar fasciitis symptoms.

Plantar fasciitis is characterised either firstly by initial step pain or secondly by a pain on weight-bearing after rest. It is a very common condition, for instance around 10% of the population will suffer at some point in their lives.

The pain is usually felt anywhere along the bottom of the foot is typically located underneath the heel. As mentioned previously it is worse first thing in the morning or after long periods of rest once the foot starts moving the pain normally decreases. Plantar fasciitis can occur in people of any age but is usually in adults.

Causes

It is usually as a result of a sudden change in the loading of the heel and its associated structures this can be due to:

  • changes in activity
  • poor footwear
  • sports injury
  • imbalance in the muscles of the legs or hips
  • tight calf muscles

Often other structures than just the plantar fascia can be involved such as the nerves or tendons around the inside of the ankle. Furthermore this can often give subtle changes to the type of pain felt in the heel. Your podiatrist will ask you about this during consultation.

Treatments

The specialist podiatrist here at Zest Podiatry will then have a look at the thickness of the plantar fascia and the integrity of the structures around the area using a diagnostic ultrasound imaging. If this confirms the diagnosis of plantar fasciitis then treatment options can be discussed.

These plantar fasciitis treatment options could include:

The Zest team here will take you through the pros and cons of each treatment option so you can make decision that is right for you.

Why shockwave?

shockwave

Extracorporeal shockwave therapy (ECSWT)

Shockwave therapy is used in the treatment of heel pain and tendon injuries.

The latest research in shockwave reveals it to be as effective for plantar fasciitis as a corticosteroid injection and is very helpful for achilles tendonitis. Its use is supported by the National Institute of Clinical Health and Excellence (NICE).

At Zest we use the best machine on the market the ‘Swiss Dolarclast’. The Swiss Dolarcast is the same type that is used in the NICE research. The machine sends waves of pressure into the tissue encouraging it to heal.

Why does it work?

The machine sends shockwaves from a compressor into a special probe. The probe sends the waves into the damaged area. The waves encourage the damaged tissue to heal at a quicker rate than is normally would.

Does it hurt?

Shockwave is a non-invasive treatment so no skin is broken or damaged. It can be a bit tender during the treatment but this eases in a few seconds.

You can return to normal activity immediately as there is no damage to the area,. We may encourage you to rest and have a cup of tea after.

How many sessions will I need?

We recommend 3 shockwave sessions, a week apart. This gives you the best chance for resolution of pain. Occasionally further sessions are required, although not common we can accommodate this.

How will I know it is better?

Your pain should be gone or much less. But we will have a look with an Ultrasound scanner to see how well the damage tissue is healing.

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