Whats The Deal With Heel Pain: The 101

heel pain 101

Some of the most nagging pain is heel pain. It is one of those pains which you know that you are going to have to face day in and day out.

The unfortunate thing about it that many orthotics don't work- or the pain goes for a while but soon enough, back it comes.

So what gives.

heel pain origins

Well we must look at that picture up above there. That will tell us what is going on.

The Gastrocnemius muscle- your calf muscle, is a powerful muscle and attached to that muscle is the tendon Achilles. This tendon attaches into the back of the heel and slightly underneath.

The plantar fascia is a length of tissue coming from the base of the heel and then splays into the toes.

These are the main mechanisms in creating heel pain.

What I have found is that true heel pain in itself is usually caused by tight gastrocs over a long period of time.

The tightness pulls upon the heel and the fascia then gets pulled away from the heel creating a very painful heel. And it is the position of that pain, directly under the heel- nowhere else, which is a good indication of tight calf muscles.

Some people even have a slightly large bump behind their heel which is a sign of a tight calf over many years. The Achilles insertion has pulled on the bone for so long the bone increases in size- this also makes the Achilles tendon slightly less effective.

What you find is that as the day goes on the heel gets better. Usually because the pain chemicals do not have a chance to stay put- they are constantly being moved around and pushed out of the way. When you stop walking then they have time to collect and build up and don't relieve until you get going.

So many health professionals believe that you have heel pain caused by Plantar Fasciitis. In a way you do, but it is not caused really by the fascia itself, it is secondary to the gastroc muscle.

So they give you an orthotic and really it works, but not as good as you expect.

How do we treat heel pain?

Heel pain can be treated by a few ways. You need:

1. Exercises.

heel pain stretch

The left leg is straight, and the right one is bent.

Bend the right leg until you can feel tightness, no pain, in the back of the other leg. Hold it for 10 seconds...don't bounce. Release. Do it again 10 more times. Then swap legs and start again.You dont bounce and never do it to pain.

This should be done twice a day everyday for a week. You should feel less pain after the week. A professional clinician should show you how. I can not because my interpretation could be very different to yours and that will not help anyone.

A similar gastroc exercise is in the video below:

2. Shoes.

Make sure that your shoes are not heeled. If they are try and reduce the heel. If you have a heel, it makes the calf muscle shorter, so doing exercises will be a waste of time. Flip flops just don't work. Also, make sure then is enough cushioning around that heel. If you feel inside the shoe, press on the heel area and it is hard, then there is your problem.

3. Orthotics.

Sometimes the body has altered itself to compensate for the tight calf and you might need an orthotic to rebalance the problem. Then over time you can ween yourself of it. Also some orthotics can be created to have a heel raise included- this helps your calf whilst you are exercising and trying to lengthen it.

Ultimately, we are not super Olympic athletes

So we shouldn't act like one. The stretching is going to take time, the pain is going to subside over time, especially if you are not doing the work.

Also there is a point where if you have had the pain for some time then it might take a little bit of time for that issue to clear up.

Initially if you have heel pain that:

  • is sore first thing in the morning
  • reduces after a couple of steps
  • then starts to build up in pain as the day goes on.

Then that is usually acute pain.

If it started off like the above points and then lasts through the morning and then through the day, then that is chronic pain.

Once chronic pain sets in then other therapies need to be used, like medication, steroid injections or other devices applied to the foot.

Go to the main orthotics page, or the plantar fascia HQ.