Heel Pain Explained
Causes of Chronic Heel Pain
Plantar fasciitis is the most common cause of localized chronic heel pain and is the most common foot problem seen in medical practices. More than 2.5 million new cases of this condition are reported each year. It is an inflammation of the plantar fascia, a ligament structure that supports the arch of the foot. The plantar fascia is a tough, fibrous band of connective tissue that runs from the heel bone to the ball of the foot. Plantar Fasciitis plays an important part in the normal foot mechanics during walking and running. It occurs when the plantar fascia is strained as a result of increased or over activity, poor foot biomechanics, or in association with the normal aging process. The onset of this condition usually follows the repeated straining of the ligament over time. As this ligament stretches beyond its normal extension it causes the soft tissues of the fascia to tear, usually at the point where it is attached to the heel bone. This leads to inflammation, pain, and possible growth of a bone spur (calcaneus) at the heel bone attachment.
In active young and middle aged adults chronic heel pain is typically caused from running, jumping, doing high impact aerobics, or walking on hard surfaces. Runners, tennis players and basketball players are often affected by it. Biomechanic factors of the foot can cause it. People with high arches, flat feet, or tight tendons (Achilles tendons) are particularly susceptible to developing this condition. Excessive inward twisting (pronation) can cause tension on the plantar fascia as the arch lowers during standing or walking. Aggravating factors, such as being overweight or wearing poorly cushioned shoes with no arch support can also contribute to the development of plantar fasciitis. In the natural aging process tendons, ligaments and muscles start to lose their normal elasticity and resilience making them more prone to strain just during normal daily activities. It is very common in the active elderly.
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Symptoms of Plantar Fasciitis
Generally the first tell-tale sign is pain during the first steps after getting out of bed or sitting for a long period of time. The degree of pain can sometimes lessen with activity, leading to a false sense of relief. The pain often returns after prolonged rest or extensive walking. Pain often progresses if the condition is left untreated and can become excruciating and persistent as the ligament is more severely strained. Heel pain is typically located on the medial (inside) area of the heel and usually starts as a dull, intermittent pain or arch pain, progressing to a sharp, persistent pain.