Heel Pain

Achilles Tendonitis

The Achilles tendon is the large tendon connecting the two major calf muscles to the heel bone. This is one of the more common sites of overuse injury seen in athletes. Achilles tendonitis is inflammation in the large tendon that is attached to the heel bone (calcaneus). It results in specific, localized pain in the back of the heel, which is aggravated by physical activity, especially running. Inflammation in the bursae (“bursitis”) adjacent to the tendon can cause similar symptoms. Injuries to other nearby tendons may also occur. Treatment often includes custom made orthotics, supportive footwear, laser therapy, and stretching.

Heel Spur

Heel spur is technically a bone formation at the bottom of the heel where the plantar fascia attaches to the heel bone. If this finding is present with pain overlying the area of the spur, the patient is said to have “heel spur syndrome”. Since the plantar fascia connects to the heel, it is clear why “plantar fasciitis” and “heel spur” are often used interchangeably.

Spending a great deal of time on your feet can increase the likelihood of developing these conditions. Being overweight can aggravate the condition. Overstressing the area by walking, running, or jumping, especially on hard surfaces, and activities such as aerobics, stair-climbing, hiking, volleyball, basketball, and tennis, often can lead to plantar fasciitis. A heel spur is present (on x-ray) inonly about half of all patients.

Plantar Fasciitis

Plantar fasciitis and heel spur are terms that refer to conditions that are associated with pain and inflammation of the heel, bottom of the foot, and arch. Many healthcare professionals use the terms interchangeably but they are not technically the same. These conditions may or may not co-exist.

“Plantar” means bottom of the foot. Fascia is a band or sheet of fibrous tissue that lies beneath the skin and separates muscles or other structures from the surrounding tissue.

The plantar fascia is found on the sole of the foot and passess from the heel bone (calcaneus) to the bases of the toes. It is a band that helps support the arch of the foot. If you pull your big toe and foot up toward your head, you will feel this band tighten. The plantar fascia must withstand a great amount of tension. It often withstands two to four times the body’s weight during activity or exercise. Plantar fasciitis is inflammation at the attachment of the fascia at or around the heel and arch. Treatment often includes custom made orthotics, laser therapy, and stretching.