Why Your Heel Hurts

Dr. Corey Fox
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Director of Massapequa Podiatry Associates

It’s probably not too often that English philosophers are used to explain potential sources of heel pain, but this is exactly what we’re doing today. Let’s start our discussion about why your heels hurt with a quick note on William of Ockham.

This particular gentleman was an English scholastic philosopher who lived from around 1287 to 1247. He is still known to this day for his famous “Occam’s razor,” which is a problem-solving principle. There are different ways of paraphrasing Occam’s razor, but it generally states that “the most likely explanation is often the correct one.”

As an example, if you put a dish of milk out and then return later to find it is gone, it’s possible someone broke into your house without leaving any trace of forced entry, drank the milk, and then left without taking anything. Or the cat drank it.

Between the complexity of their structures and the tremendous amounts of force they endure, there are numerous possible reasons for foot pain. When diagnosing, we start by trying to determine which one makes the most amount of sense for your particular case.

To do that, we consider two major factors – 1) Where is your heel pain? And 2) when is the pain strongest?

There are other factors that may be entailed, but having an answer for those two questions gives us a good starting point for understanding what is wrong.

Some general guidelines for determining the cause of your heel pain include:

  • If your pain is in the bottom of your heel and is strongest with first steps in the morning, you likely have plantar fasciitis. This is, by far, the most common form of heel pain for adults. The intense, sharp pain on the bottom of the heel develops following extended periods of rest and inactivity (like after a full night’s sleep).
  • If your pain is in the back of your heel and is strongest following physical activity, you likely have Achilles tendinitis. This condition develops when your Achilles tendon becomes inflamed from overuse. The pain will usually be somewhat mild at first and then increase over time (especially during, and immediately following, exercise and physical activities).
  • If your pain is in the back of your heel and you are an adolescent, you likely have Sever's disease. This condition is not actually a “disease.” Instead, it happens when the heel bone reaches physical maturity before the Achilles tendon does. This situation causes the tight tendon to pull on the back of the heel bone.
  • If heel pain started following physical trauma (like a car accident or sporting injury), you likely have a calcaneal fracture. This injury is fairly rare, but it does happen. As with any fracture, you should absolutely come in and see us for an evaluation of the damage and an appropriate treatment plan.

Keep in mind these are only starting points when it comes to diagnosing heel injuries. The best way to obtain an accurate diagnosis (and effective treatment!) is to come and see us here at Massapequa Podiatry Associates.

For more information on heel pain, or any of the foot and ankle conditions we treat, simply give us a call at (877) 674-7422 or take advantage of our online form to connect with us today.

Great post that adds immediate value. Definitely going to bookmark this particular post. Keep up the awesome and informative posts. Though not expressly the heel, another one seen often is posterior tib tendinitis. So often foot pain comes down to proper footwear, arch stability and flexibility, properly warming up. Do you agree?
by Daniel Davids April 17, 2017 at 11:17 PM
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