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Causes of Pain in the Back of the Heel (and Helpful Exercises)

Triangle Region / 08 May 2020

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by EmergeOrtho
Causes of Pain in the Back of the Heel (and Helpful Exercises)

You have just finished walking, hiking, or biking when it hits: pain in the back of the heel. One of the most common causes of heel pain results from plantar fasciitis and/or bone spurs (also referred to as heel spurs).

As unpleasant as plantar fasciitis and bone spurs can be, they often respond well to conservative treatment and don’t require surgery. At EmergeOrtho—Triangle Region, our renowned Foot and Ankle Team offers precision diagnosis and personalized treatment to help patients alleviate heel pain and Emerge Stronger. Healthier. Better.

What Causes Plantar Fasciitis and Bone Spurs?

Often, plantar fasciitis is caused by repetitive stress to the plantar fascia (from walking, running, and sports, for example). Other times, simply wearing poor fitting shoes can trigger the condition. To avoid plantar fasciitis, it is best to wear shoes that support the arches of your feet.

Bone spurs are likely what you would imagine them to be—small bony objects that protrude from the edges of the bone. These protrusions commonly develop where the bones come together along the joints. In addition to the heel bone, bone spurs can be found near the bones surrounding the knee, spine, and hip.

Bone spurs typically result from joint damage due to osteoarthritis. Many patients with plantar fasciitis also have heel spurs. It is important to note, however, that although 1 out of 10 patients with plantar fasciitis is diagnosed with heel spurs, only 1 in 20 individuals with heel spurs experience heel pain. In fact, bone spurs often remain undetectable with little to no symptoms for years.

For those who do experience symptoms from heel spurs, pain may manifest in the following ways:

  • Pain near the heel and/or bottom of the foot
  • Pain that worsens following activity
  • Pain that develops when applying pressure on the foot (such as standing, walking, jogging, and running)
  • Pain that occurs after long periods of rest and inactivity

If you suspect that bone spurs may be the cause of your heel pain, our EmergeOrtho Foot and Ankle doctors will perform a physical examination of your foot and likely take an X-ray to confirm a heel spur diagnosis.

Heel Pain Treatment

As previously discussed, heel spurs and pain in the back of the heel can often be addressed conservatively. Your doctor will likely suggest one or more of the following pain-relief treatments:

  • Medication

Over-the-counter non-steroidal, anti-inflammatory medications are helpful in reducing pain and inflammation surrounding the heel and ankle area.

  • Cortisone Injections

Cortisone is another way to help reduce pain and inflammation and is injected into the plantar fascia for patients experiencing plantar fasciitis pain.

  • Orthotics and Supportive Shoes

Special shoe inserts, called orthotics and specialty-cushioned shoes help to reduce pain when standing, walking, and engaging in other activities.

  • Physical Therapy

Special exercises and stretches that lengthen and strengthen the heel’s supporting muscles and ligaments, such as the calf muscle and plantar fascia, can both ease and prevent pain in the back of the heel.

Surgical intervention is only considered when conservative treatment methods have failed to provide relief. Usually, your orthopedic physician will recommend waiting at least one year before considering surgery for a heel spur.

Three Helpful Exercises and Stretches for Heel Pain

Whether the source of your heel pain is due to bone spurs, plantar fasciitis, or another orthopedic-related condition, performing the following three exercises and stretches can both treat and prevent foot pain.

1. Calf Stretch

Form: Start by leaning against something stationary (like a wall, tree, or railing) in a short lunge position. Bend the front knee, while keeping the back leg straight. Make sure both feet are in parallel alignment facing forward. Stretch the calf muscles in the back leg and heel cord slightly and carefully until you feel the stretch in the calf/heel cord.

Repetition: Hold the stretch for 10 seconds and then release. Perform the stretch on the other leg (calf/heel cord) and alternate up to 20 times on each side.

2. Plantar Fascia Stretch

Form: There are a few ways to perform a plantar fascia stretch. You can practice the stretch in a seated position by crossing one foot over the knee of the opposite leg. Grasping the toes, slowly and carefully pull them back so that you can feel a good stretch in the fascia/arch of your foot. If it is more comfortable, you can extend both legs straight in front of you (rather than having to cross one foot over your knee) with both feet flexed. Either simultaneously, or one at a time, you can wrap a towel around your foot or feet—toward the top of your foot near your toes—and gently pull the towel toward you until you feel a stretch in the fascia/arch of the foot.

Repetition: Hold the stretch for 10 seconds and then release. Practice on each foot up to 20 times.

A woman’s foot is pictured performing a plantar fascia foot stretch with the aid of a pink exercise band.
3. Ball Exercise

Form: Place a golf ball (or similar sized ball) under your foot. Gently roll the ball around the whole underside of the foot.

Repetition: Practice this simple exercise for one to two minutes, several times a day.

A male’s foot is pictured practicing a foot exercise with a small golf-ball-sized ball between his foot and hardwood floor.

More Help for Heel Pain

For more helpful tips and information on heel spurs, plantar fasciitis, osteoarthritis, Achilles tendinitis, or other Foot and Ankle conditions self-schedule an appointment now with one of our highly qualified EmergeOrtho–Triangle Region doctors. Or, call us any time at (919) 220-5255.

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