Heel Aches The Causes, Signals And Cure Options

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Overview

Foot Pain

Every mile you walk puts tons of stress on each foot. Your feet can handle a heavy load, but too much stress pushes them over their limits. When you pound your feet on hard surfaces playing sports or wear shoes that irritate sensitive tissues, you may develop Heel Pain, the most common problem affecting the foot and ankle. A sore Heel will usually get better on its own without surgery if you give it enough rest. However, many people try to ignore the early signs of Heel pain and keep on doing the activities that caused it. When you continue to walk on a sore Heel, it will only get worse and could become a chronic condition leading to more problems.Surgery is rarely necessary.

Causes

Heel pain is most often the result of overuse. Rarely, it may be caused by an injury. Your heel may become tender or swollen from shoes with poor support or shock absorption, running on hard surfaces, like concrete, running too often, tightness in your calf muscle or the Achilles tendon. Sudden inward or outward turning of your heel, landing hard or awkwardly on the heel. Conditions that may cause heel pain include when the tendon that connects the back of your leg to your heel becomes swollen and painful near the bottom of the foot, swelling of the fluid-filled sac (bursa) at the back of the heel bone under the Achilles tendon (bursitis). Bone spurs in the heel. Swelling of the thick band of tissue on the bottom of your foot (plantar fasciitis). Fracture of the heel bone that is related to landing very hard on your heel from a fall (calcaneus fracture).

Symptoms

Plantar fasciitis is a condition of irritation to the plantar fascia, the thick ligament on the bottom of your foot. It classically causes pain and stiffness on the bottom of your heel and feels worse in the morning with the first steps out of bed and also in the beginning of an activity after a period of rest. For instance, after driving a car, people feel pain when they first get out, or runners will feel discomfort for the first few minutes of their run. This occurs because the plantar fascia is not well supplied by blood, which makes this condition slow in healing, and a certain amount of activity is needed to get the area to warm up. Plantar fasciitis can occur for various reasons: use of improper, non-supportive shoes; over-training in sports; lack of flexibility; weight gain; prolonged standing; and, interestingly, prolonged bed rest.

Diagnosis

In most cases, your GP or a podiatrist (a specialist in foot problems and foot care) should be able to diagnose the cause of your heel pain by asking about your symptoms and medical history, examining your heel and foot.

Non Surgical Treatment

Treatments to add to your stretching program include wearing good-quality shoes, icing the painful area, and massaging the arch. Do not walk barefoot; walk in shoes with good heel and arch supports such as high-quality walking or running shoes. Keep a pair of shoes next to your bed so you can put them on before taking your first step. Your doctor may recommend that you wear an additional arch support or a heel cup in the shoes. Icing your foot can help relieve pain. Rub a frozen bottle of water or an ice cup over the tender areas for five minutes two times each day. Massage your foot by rolling a tennis, golf ball, or baseball along your sole and heel. This friction massage can help break up adhesions and stretch the plantar fascia. Do this for five minutes two times each day. If you are a runner or just started a walking or running program, evaluate your training for errors such as warming up improperly, increasing mileage too quickly, running hills excessively, running on surfaces that are too hard, or wearing broken down shoes. Adjusting your training program can help relieve your pain. While recovering from heel pain, walk or jog in a pool or crosstrain by biking and swimming. These activities maintain your cardiovascular fitness without stressing your heel cord or plantar fascia. Heel pain takes time to go away. Be patient and remember that no treatment is a substitute for STRETCHING!

Surgical Treatment

It is rare to need an operation for heel pain. It would only be offered if all simpler treatments have failed and, in particular, you are a reasonable weight for your height and the stresses on your heel cannot be improved by modifying your activities or footwear. The aim of an operation is to release part of the plantar fascia from the heel bone and reduce the tension in it. Many surgeons would also explore and free the small nerves on the inner side of your heel as these are sometimes trapped by bands of tight tissue. This sort of surgery can be done through a cut about 3cm long on the inner side of your heel. Recently there has been a lot of interest in doing the operation by keyhole surgery, but this has not yet been proven to be effective and safe. Most people who have an operation are better afterwards, but it can take months to get the benefit of the operation and the wound can take a while to heal fully. Tingling or numbness on the side of the heel may occur after operation.

Prevention

Pain In The Heel

Make sure you wear appropriate supportive shoes. Don’t over-train in sports. Make sure you warm up, cool down and undertake an exercise regime that helps maintain flexibility. Manage your weight, obesity is a factor in causing plantar fasciitis. Avoid walking and running on hard surfaces if you are prone to pain. You should follow the recognized management protocol “RICED” rest, ice, compression, elevation and diagnosis. Rest, keep off the injured ankle as much as possible. Ice, applied for 20 minutes at a time every hour as long as swelling persists. Compression, support the ankle and foot with a firmly (not tightly) wrapped elastic bandage. Elevation, keep foot above heart level to minimize bruising and swelling. Diagnosis. Consult a medical professional (such as a Podiatrist or doctor) especially if you are worried about the injury, or if the pain or swelling gets worse. If the pain or swelling has not gone down significantly within 48 hours, also seek treatment. An accurate diagnosis is essential for proper rehabilitation of moderate to severe injuries.

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What Is The Leading Cause Of Achilles Tendinitis Painfulness ?

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Overview

Achilles TendonitisThe Achilles tendon connects the calf muscle to the back of the heel. Injuries to the Achilles tendon are common, as it is in constant use during walking and running. These injuries, known as Achilles tendinitis, are usually the result of overuse damage and minor tears that have accumulated over years. Your risk of developing Achilles tendinitis increases with age and activity level. Many athletes develop Achilles tendinitis. The tendon may be injured several inches away from where it attaches to the foot or at the point of attachment. An injury at the point of attachment is called Achilles enthesopathy. We recommend a combination of treatments over a period of months that may include wearing supportive shoes or orthotic devices, performing stretching exercises, and icing the affected area. If these treatments are not effective, or if the tendon is completely torn, we may recommend surgery.

Causes

Achilles tendonitis occurs in sports such as running, jumping, dancing and tennis. Other risk factors include participation in a new sporting activity or increasing the intensity of participation. Poor running technique, excessive pronation of the foot and poorly fitting footwear may contribute. In cyclists, the problem may be a low saddle, which causes extra dorsiflexion of the ankle when pedalling. Quinolone antibiotics (eg, ciprofloxacin, ofloxacin) can cause inflammation of tendons and predispose them to rupture.

Symptoms

In most cases, symptoms of Achilles tendonitis, also sometimes called Achilles tendinitis, develop gradually. Pain may be mild at first and worsen with continued activity. Repeated or continued stress on the Achilles tendon increases inflammation and may cause it to rupture. Partial or complete rupture results in traumatic damage and severe pain, making walking virtually impossible and requiring a long recovery period. Patients with tendinosis may experience a sensation of fullness in the back of the lower leg or develop a hard knot of tissue (nodule).

Diagnosis

Studies such as x-rays and MRIs are not usually needed to make the diagnosis of tendonitis. While they are not needed for diagnosis of tendonitis, x-rays may be performed to ensure there is no other problem, such as a fracture, that could be causing the symptoms of pain and swelling. X-rays may show evidence of swelling around the tendon. MRIs are also good tests identify swelling, and will show evidence of tendonitis. However, these tests are not usually needed to confirm the diagnosis; MRIs are usually only performed if there is a suspicion of another problem that could be causing the symptoms. Once the diagnosis of tendonitis is confirmed, the next step is to proceed with appropriate treatment. Treatment depends on the specific type of tendonitis. Once the specific diagnosis is confirmed, the appropriate treatment of tendonitis can be initiated.

Nonsurgical Treatment

NSAIDs help decrease swelling and pain or fever. This medicine is available with or without a doctor’s order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions. Steroid injections. Steroids decrease pain and swelling. After you get this shot, you may feel like your Achilles tendon is healed. Do not return to your regular exercise until your caregiver says it is okay. You could make the tendinitis worse, or even tear the tendon. Surgery. If your tendinitis does not heal with other treatments, you may need surgery. Surgery may be done to repair a tear in the tendon, or to remove parts of the tendon. The most important way to manage Achilles tendinitis is to rest. Rest decreases swelling and keeps your tendinitis from getting worse. You may feel pain when you begin to run or exercise. The pain usually goes away as your muscles warm up, but it may come back. Your caregiver may tell you to stop your usual training or exercise activities. He may give you other exercises to do until your Achilles tendon heals. Ice decreases swelling and pain. Put ice in a plastic bag. Cover it with a towel. Put this on your Achilles tendon for 15 to 20 minutes, 3 to 4 times each day. Do this for 2 to 3 days or until the pain goes away. After 2 or 3 days, you may use heat to decrease pain and stiffness. Use a hot water bottle, heating pad, whirlpool, or warm compress. To make a compress, soak a clean washcloth in warm water. Wring out the extra water and put it on your Achilles tendon 15 to 20 minutes, 3 to 4 times each day. Stretching and making the muscles stronger may help decrease stress on your Achilles tendon. Physical therapists can teach you exercises and treatments to help your tendinitis heal faster. You may need to wear inserts in your shoes. You may need to wrap tape around your heel and back of the leg. You may need to wear a cast, brace, or support boot.

Achilles Tendonitis

Surgical Treatment

If non-surgical treatment fails to cure the condition then surgery can be considered. This is more likely to be the case if the pain has been present for six months or more. The nature of the surgery depends if you have insertional, or non-insertional disease. In non-insertional tendonosis the damaged tendon is thinned and cleaned. The damage is then repaired. If there is extensive damage one of the tendons which moves your big toe (the flexor hallucis longus) may be used to reinforce the damaged Achilles tendon. In insertional tendonosis there is often rubbing of the tendon by a prominent part of the heel bone. This bone is removed. In removing the bone the attachment of the tendon to the bone may be weakened. In these cases the attachment of the tendon to the bone may need to be reinforced with sutures and bone anchors.

Prevention

Achilles tendinitis cannot always be prevented but the following tips will help you reduce your risk. If you are new to a sport, gradually ramp up your activity level to your desired intensity and duration. If you experience pain while exercising, stop. Avoid strenuous activity that puts excessive stress on your Achilles tendon. If you have a demanding workout planned, warm up slowly and thoroughly. Always exercise in shoes that are in good condition and appropriate for your activity or sport. Be sure to stretch your calf muscles and Achilles tendon before and after working out. If you suffer from Achilles tendinitis make sure you treat it properly and promptly. If self-care techniques don?t work, don?t delay. Book a consultation with a foot care expert or you may find yourself sidelined from your favourite sports and activities.