July 2023

Have you ever gotten up from a chair or out of bed in the morning, and upon taking that first step, feel like your heel has stepped on a tack? Many people experience a feeling of sharp pain which radiates into their arch from their heel and which does not allow them to put their heel on the floor. Sometimes they need to sit back down, stand only on their toes and use the wall for balance. If you can take a few steps, it seems to go away and lessen, allowing you to then resume your activity. Later, throughout your day and after a period of rest, it can happen again. If this sounds familiar you may be suffering from your first attack of heel pain.

Heel pain is a debilitating condition that affects day to day activities. Running and walking both causes stress on the heel because the heel is the part of the foot that hits the ground first. This means that the heel is taking on your entire weight. Diagnosis and treatments for heel pain can be easily found through your podiatrist.

Plantar Fasciitis

One of the main causes of heel pain is a condition known as plantar fasciitis. The plantar fascia is a band of tissue that extends along the bottom of the foot, from the toe to the bottom of the heel. A rip or tear in this ligament can cause inflammation of these tissues, resulting in heel pain. People who do not wear proper fitting shoes are often at risk of developing problems such as plantar fasciitis. Unnecessary stress from ill-fitting shoes, weight change, excessive running, and wearing non-supportive shoes on hard surfaces are all causes of plantar fasciitis.

Achilles Tendonitis

Achilles tendonitis is another cause of heel pain. Similar to plantar fasciitis, inflammation of the Achilles tendon will cause heel pain due to stress fractures and muscle tearing. A lack of flexibility of the ankle and heel is an indicator of Achilles tendonitis. If left untreated, this condition can lead to plantar fasciitis and cause even more pain on your heel.

Heel Spur

A third cause of heel pain is a heel spur. A heel spur occurs when the tissues of the plantar fascia undergo a great deal of stress, leading to a separation of the ligament from the heel bone entirely. This results in a pointed fragment of bone on the ball of the foot, known as a heel spur.

Trauma to the foot, especially the toes, can occur in many ways. Banging them, stubbing them, or dropping something on them are a few different ways this trauma can occur. Given the fact that toes are positioned in front of the feet, they typically sustain the brunt of such trauma. When trauma occurs to a toe, the result can be a painful break or fracture. Another type of trauma that can break a toe is repeated activity that places stress on the toe for prolonged periods of time.

Broken toes can be categorized as either minor or severe fractures. Symptoms of minor toe fractures include throbbing pain, swelling, bruising on the skin and toenail, and the inability to move the toe with ease. Severe toe fractures require medical attention and are indicated when the broken toe appears crooked or disfigured, when there is tingling or numbness in the toe, or when there is an open, bleeding wound present on the toe.

Generally, a minor toe break will heal without long-term complications. However, it is important to discontinue activities that put pressure on the toe. It is best to stay off of the injured toe and immediately get a splint or cast to prevent any more additional movement of the toe bones. You can also immobilize your toe by placing a small cotton ball between the injured toe and the toe beside it. Then, tape the two toes together with medical tape. Swelling can be alleviated by placing an ice pack on the broken toe directly as well as elevating your feet above your head.

Severe toe fractures may be treated with a splint, cast, and in some cases, minor surgery, especially when the big toe has been broken. Due to its position and the pressure the big toe endures with daily activity, future complications can occur if it is not properly treated. Pain associated with minor toe fractures can be managed with over-the-counter pain medications. Prescription pain killers may be necessary for severe toe fractures.

The healing time for a broken toe is approximately four to six weeks. In severe cases where the toe becomes infected or requires surgery, healing time can take up to eight weeks or more. While complications associated with a broken toe are immediately apparent, it is important to note that there are rare cases when additional complications, such as osteoarthritis, can develop over time. You should immediately speak with your podiatrist if you think you have broken your toe due to trauma. They will be able to diagnose the injury and recommend the appropriate treatment options. 

Ingrown toenails (onychocryptosis) are a common foot ailment and it is very unpleasant to experience. The condition is caused by an increase in pressure from the ingrowth of the nail edge into the skin of the toe. Ingrown toenails commonly cause pain in those who experience them. In some cases, the skin surrounding the ingrown toenail may break which may lead bacteria to enter through and cause an infection. Common symptoms of this ailment include pain, redness, swelling, and warmth around the toe.

An imbalance between the size of the nail and the enlargement of the nail skin edge causes ingrown toenails. This condition is often caused by improperly trimming the toenails. If you are trying you cut your nails, you should always try to trim straight across instead of in a rounded shape. Ingrown toenails can also be an inherited condition and they may also be caused by improper shoe fitting.

Another common cause of the condition is wearing shoes that are either too small or too large. Other causes include poor foot hygiene, obesity, diabetes, arthritis, edema, and fungal infections. There are many risk factors that may make a person more likely to develop an ingrown toenail. Athletes who play “stop and start” sports such as tennis, soccer, and basketball are most likely to have ingrown toenails.

People who have diabetes, a compromised immune system, or poor circulation should immediately seek care from a podiatrist if they have an ingrown toenail. It is also recommended to seek professional assistance if at-home remedies are not successful within a week or if there is persistent pain.

Tendons are fibrous tissues that connect muscles with bone. The Achilles tendon is the largest tendon in the body. It connects the calf muscles at the back of the leg with the heel, and facilitates movements such as jumping, running, and walking. 

Because the Achilles tendon is engaged so frequently and bears a great deal of pressure and stress throughout the day, it can become injured. Achilles tendon injuries cause the tissue to become irritated, inflamed, and swollen. Pain can come on gradually or be immediate, and will vary from mild to severe depending upon the injury. Where the pain occurs will vary as well, from just above the heel up through the back of the leg. There may also be stiffness in the tendon.

Achilles tendon injuries can often be caused by repetitive stress. They may also occur while running, playing tennis, gymnastics, football, basketball, dancing, soccer, baseball or other sports that require speeding up, slowing down, or pivoting quickly. Wearing high heels, falling from an elevation, stepping in a hole, having flat feet, bone spurs, tight leg muscles or tendons, wearing improper athletic shoes, exercising on uneven surfaces, or starting a new type of exercise can also cause Achilles tendon injuries.

The two most common Achilles tendon injuries are tendonitis and ruptures. Tendonitis causes painful inflammation and can occur in different parts of the tendon. Non-insertional Achilles tendonitis occurs when the fibers in middle of the tendon begin to break down, thicken, and swell. This condition typically affects younger, more active adults. Insertional Achilles tendonitis occurs where the tendon inserts into the heel bone. It is common for bone spurs to form with this type of injury. This condition can affect people of any age and level of activity.

Achilles tendon ruptures are a tear in the tendon. These breaks may be partial or complete. There may be an audible popping noise at the moment of injury and the pain will be sudden and severe.

An Achilles tendon injury can be diagnosed by your podiatrist after they examine you, check your range of motion, and possibly perform a calf squeeze test or review an X-ray or MRI. Depending on the type and severity of your injury, your podiatrist may treat your condition with rest/ice/compression/elevation (RICE), nonsteroidal anti-inflammatory medications, heel lifts, and stretching and strengthening exercises. If you have torn your Achilles tendon, treatment may include physical therapy, ultrasound, shockwave therapy, or possibly even surgery.