By Ujjwal Datta, D.P.M., FACFAS
The human foot has an amazingly complex anatomy, with 33 joints and a network of more than 100 tendons, muscles and ligaments. The heel bone is the largest of the 26 bones in the foot, and like all bones, it is subject to conditions that can affect its ability to perform its number one job — keeping us on our feet.
Heel pain can be extraordinarily disabling to sufferers. This pain has many causes but is generally the result of faulty biomechanics (walking gait abnormalities) that place too much stress on the heel bone and the soft tissues that attach to it. The stress may also result from injury or a bruise incurred while walking, running or jumping on hard surfaces; wearing poorly constructed footwear such as flip-flops, or being overweight. Common causes of heel pain include:
· Heel spurs – A bony growth on the underside of the heel bone
· Plantar Fasciitis – An inflammation of the band of fibrous connective tissue (fascia) running along the bottom (plantar surface) of the foot, from the heel to the ball of the foot
· Excessive Pronation – Pronation is the normal flexible motion and flattening of the arch of the foot that allows it to adapt to ground surfaces and absorb shock in the normal walking pattern. Excessive pronation—excessive inward motion—can create an abnormal amount of stretching and pulling on the ligaments and tendons attaching to the bottom back of the heel bone and can contribute to injury to the hip, knee and lower back.
· Achilles Tendinitis – Pain at the back of the heel, common among people who run and walk a lot and have tight tendons, leading to inflammation, pain and the possible growth of a bone spur on the back of the heel bone.
Other causes of heel pain include rheumatoid arthritis, bursitis, nerve entrapments, bone tumors, fractures, and rarely infections. If pain and other symptoms of inflammation — redness, swelling, heat — persist and limit normal daily activities, it is time to schedule an appointment with a board certified podiatrist.
A variety of steps can be taken to avoid heel pain. Most important is to wear shoes that fit well and have shock-absorbent soles, rigid shanks and supportive heel counters, wear proper shoes for each activity you undertake and make sure they are not too old. As with any exercise, warm up and stretch before and after your activities, pace yourself when you participate in athletics, don’t underestimate your body’s need for rest and good nutrition and make it a goal to lose weight if you have some extra pounds.
Many causes of heel pain can and are often treated conservatively by the podiatrist at his/her office. Only a relatively few cases of heel pain require more advanced treatments or surgery. If surgery is necessary, it may involve the release of the plantar fascia, removal of a spur, removal of a bursa, or removal of a nerve entrapment or other soft-tissue growth.
Remember to keep your feet healthy to enjoy an active summer!
Board certified foot and ankle surgeon Ujjwal Datta, D.P.M., is affiliated with Human Motion Institute at Raritan Bay Medical Center, a member of the Meridian Health family. The institute is a comprehensive musculoskeletal program dedicated to returning patients to normal activities quickly and safely under the guidance of a nurse navigator. Dr. Datta is also certified in extra corporal shock wave therapy; an innovative, non-invasive treatment modality to treat patients suffering from chronic heel and arch pain. He specializes in extra osseous talo tarsal stabilization, a surgical procedure to correct over pronation, heel pain, and flat feet. For an appointment, call 855-5-MOTION. For more information, visit www.gardenstatepodiatrist.com.
