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Foot problems - heel pain

Theheelisapaddedcushionoffattytissuethatholdsitsshapedespitethepressureofbody weightandmovement.Itservestoprotectthestructuresofthefoot,includingtheheelbone, musclesandligaments.Heelpainisacommonfootcomplaint. Some groups are at increased risk Anyonecansufferfromheelpain,butcertaingroupsseemtobeatincreasedrisk,including: Middleagedmenandwomen Physicallyactivepeople Peoplewhoareveryoverweightorobese Peoplewhoareontheirfeetforlongperiodsoftime Childrenagedbetweeneightand13years Womenduringpregnancy.

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Common causes Someofthemanycausesofheelpaincaninclude: Abnormalwalkingstyle(suchasrollingthefeetinwards) Obesity Ill-fittingshoes Standing,runningorjumpingonhardsurfaces Injurytotheheel,suchasstressfractures Bursitis(inflammationofabursa-bursaearesmallsacsthatcontainfluidtolubricate movingparts,suchasjointsandmuscles) Neuroma(nervegrowth) Certaindisorders,includingdiabetesandarthritis.

Complications of heel pain Complicationsofheelpaincaninclude: Plantarfasciitis Heelspur.

Plantar fasciitis Theplantarfasciaisabandofconnectivetissuethatrunsalongthesolefromtheheeltotheball ofthefoot.Oneofitsmainrolesistokeepthebonesandjointsinposition.Bruisingor overstretchingthisligamentcancauseinflammationandheelpain.Acommoncauseisflatfeet, becausetheligamentisforcedtooverstretchasthefootspreadsoutandthearchflattens.The painmaybeworsefirstthinginthemorningorafterrest.Inmanycases,plantarfasciitisis associatedwithheelspur.Theplantarfasciatearsandbleedsattheheeland,overtime,these injuriescalcifyandformabonygrowth. Heel spur Anabnormalwalkingstyle,suchasrollingthefeetinwards,canplaceextrastrainontheplantar fascia.Chronicinflammationmaydevelopand,overtime,leadtoabonygrowthorspur.Thespur canonlybeseenonX-ray,butitspresenceisoftenflaggedbyatenderpatchattheheelonthe soleofthefoot.Youmayhaveheelspurswithoutrealisingit-itisestimatedthataboutonein10 Australianshaveheelspurswithoutanysymptoms.Thespuritselfdoesnotcausethepain,but painmaybeassociatedwithinflammationinthearea. Severs disease

Footproblems-heelpain

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Seversdiseaseisthemostcommoncauseofheelpaininchildrenagedeightto16.Severs diseaseresultsfromstressplacedonthegrowthplateoftheheelbone.Anexcessiveamountof runningorjumpingcausesinflammationtothegrowthplate,whichresultsinpain.Rest,iceand heelliftsareusuallyprescribed. Diagnosis methods Dependingonthecondition,thecauseofheelpainisdiagnosedusinganumberoftests,including: Medicalhistory. Physicalexamination,includingexaminationofjointsandmusclesofthefootandleg. X-rays.

Treatment options Dependingontheunderlyingcause,treatmentcaninclude: Restfromactivitiesthatstresstheheel(suchasrunningandjumping). Icepacks. Regularfootmassage,concentratingonthearchofthefoot. Professionalstrapping. Asplintwornatnight. Flexibilityexercises. Ultrasoundtherapy. Anti-inflammatorydrugs. Investigationofthepersonspostureandwalkingstyle,tocheckandcorrectimbalances andgaitabnormalitiesthatmaycontributetothepain. Shoeinserts(orthoses)tohelpsupportthefoot. Insomecases,surgerymayberecommendedtotreatconditionsincludingneuroma, bursitisandheelspurs.

Prevention strategies Youcanreducetheriskofheelpaininmanyways,including: Wearshoesthatfityouproperlywithafirmfastening,e.g.laces. Chooseshoeswithshock-absorbentsolesandsupportiveheels. Repairorthrowoutanyshoesthathavewornheels. Alwayswarmupandcooldownwhenexercisingorplayingsport-includeplentyofslow, sustainedstretches. Ifnecessary,yourpodiatristwillshowyouhowtotapeorstrapyourfeettohelpsupport themusclesandligaments. Shoeinserts(orthoses)professionallyfittedbyyourpodiatristcanhelpsupportyourfeetin thelongterm.

Where to get help Podiatrist AustralianPodiatryAssociationVic-tofindapodiatristinyourlocalareacallTel.(03) 98665906orwebsite Yourdoctor

Things to remember

Theheelisapaddedcushionoffattytissuethatholdsitsshapedespitethepressureof bodyweightandmovement. Commoncausesofheelpainincludeobesity,ill-fittingshoes,runningandjumpingonhard surfaces,abnormalwalkingstyle,injuriesandcertaindiseases. Plantarfasciitisisinflammationoftheligamentthatrunsthelengthofthefoot,commonly causedbyoverstretching.Itresultsinpainundertheheel,particularlyafterrest. Aheelspurisabonygrowththatisnotusuallypainfultothetouch. Seversdiseaseiscausedbystressonthegrowthplateintheheelbone.

This page has been produced in consultation with, and approved by:

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AustralianPodiatryAssociation(Vic)

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Footproblems-heelpain

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