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  • Writer's pictureDr. Joel Spring

Hidden Causes of Heel Pain


If your heels hurt, it's difficult to do a lot of things. It's hard to walk, wear shoes, run, jump, stand, etc..

There are many things that can cause your heel pain. Things that you do regularly without even thinking twice. This post is not meant to have you stop doing those things but, maybe, change the way you are doing them.

Also, this post is not meant to be diagnostic. It will address things that cause heel pain, not the conditions of heel pain.


Heel Pain


For this post, heel pain will be referred to as any pain in the heel region of your foot. This includes the bottom, side, and behind.

Many things that cause heel pain can lead to different clinical diagnoses; plantar fasciitis, bone spurs, Achilles' tendinitis, etc..

As you read further, you will learn about the things that cause these different issues. If you find that you fit into one of these "risk" categories, you may want to try to alter the way you are doing it as opposed to stopping all together.


Causes of Heel Pain


This will be broken down into activities, health issues, footwear, and biomechanics.


Activities


  1. Any increase in activity compared to your normal amount: Each of us has a "normal" level of activity. When we increase it we can irritate some of the soft tissues and/or bones in the heel. For example, if you usually walk about 8-10,000 steps per day, but up it to 15-20,000 steps per day that is a large increase compared to "normal" for you.

  2. Plyometrics: Plyometrics usually refers to jumping activities. If you are at the beginning of a training session, sometimes doing plyometrics first, before a proper warm up, can exacerbate the tissues in and around your heel.

  3. Running: Running is notorious for causing heel pain and there are various reasons for it to cause your heel issue(s); The way your land on your feet with each step, the amount of steps you take (See reason 1), your cadence (rate of stride), or your step length.

  4. Hiking: Depending on where you live, there may be hiking seasons. The first hike of the season may need to be short as your body adapts to both your fitness level, amount of impact, grade of the climb, and footwear.

  5. Cycling: Riding a bike seems easy and is about as low impact as you can get, but your muscles can tighten up leading to sprains and strains.

  6. New Workouts: Any time you start a new workout program your body will need an adjustment period. Going all out on your first day of something (depending on your fitness level) can have detrimental effects to your heel area.


Health Issues


  1. Diabetes: Diabetes can cause something called Diabetic Neuropathy. This decreases your feeling and awareness of what is happening to your feet. Due to this, there can be issues that you may not be aware of before they become super painful and distracting.

  2. Peripheral Neuropathy: Similar to Diabetic Neuropathy but without the diagnosis of Diabetes. The research is not sure what causes this, but it affects the lives of many people.

  3. Organs: Issues with your heart, kidneys, and/or liver can lead to swollen feet and pain in the heel.

  4. Blood Clots: Known medically as Deep Vein Thrombosis (DVT), blood clots in your legs can cause your feet to be painful and in the heel area. Look for signs of redness and pain to the touch.


Footwear


  1. High Heels: This is a huge culprit in pain in the back of the heel and on the bottom of the heel itself. One way to reduce this cause is to limit the amount of time you spend in heels (take them off when you are sitting).

  2. Poor Fitting Shoes: Not all shoes are meant for all feet. Your foot is different than my foot, so finding a shoe that fits you is important. I would suggest going to a quality shoe store and trying on a bunch of styles that you like in order to find the one that is most comfortable for you.

  3. Not Being Barefoot Enough: This one is probably catching you off-guard. Your feet are designed to support you and hold you up without shoes!! It is important that you spend some time without shoes on to build up the muscles and ligaments of the foot so they can do their job!

  4. Stiff Shoes: Each of your feet is going to require a different amount of stiffness to feel good on your feet. But for most, if not all, of you there is such a thing as too stiff. Men's dress shoes tend to be very flat, stiff, and hard. These can lead to heel pain and other foot issues.


Biomechanics


  1. Stepping too hard: If you walk and people know you are coming, it is not a weight issue, it is a weight distribution and control issue. Practice walking softly around your house without making a noise. As you get used to it, it will become more natural.

  2. Straight Leg Landing: In both running and jumping, your body is designed for the muscles to take up the impact. If you keep your ankles and knees stiff on a landing, the bones absorb the impact.

  3. Foot Position: When your feet don't walk using the tripod shape (heel, big toe, little toe) the extra stress will be absorbed by the bones, muscles, tendons, and ligaments around the heel.

  4. Stiff and Weak Hips: Your hips control most of your movement, when they don't move that movement needs to come from somewhere else. Since the ankle is a mobile joint, it often will come from your ankle. Teaching your hips how to move can resolve your heel pain.

Bonus


  1. Low Back Issues: Your low back is home to all of the nerves of your legs and feet. An issue there can present as pain, numbness, or tingling anywhere in the foot or leg.

  2. Stepping on a Sharp Object: This one is obvious and sometimes unavoidable. I'm going to assume you aren't stepping on sharp rocks or nails on purpose, but it can cause you to have heel pain so I included it here.


What You Can Do About It


For most of these issues, just changing how you do things or how often you do them can result in tons of relief. For some, you may need to see someone to either rule in or rule out the actual cause.


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