Heel Pain

At a glance

Two structures located on the bottom of the foot are primarily associated with heel pain: the plantar fascia, a band of fibrous connective tissue, and a muscle which supports the arch and flexes the four small toes. The heel bone is the largest of the 26 bones in the human foot, which also has 33 joints and a network of more than 100 tendons, muscles and ligaments. Like all bones, the heel is subject to outside influences that affect its integrity and its ability to keep us on our feet. The feet can handle a heavy load, but too much stress can push them over their limits.

One of the most common forms of foot pain in adults is heel pain. The heel is the first part of the foot to hit the ground when walking or running. Not surprisingly, it often occurs as a result of daily activities and exercise. Increased prevalence of heel pain among active people over the age of 40 may result from a decrease in the elasticity of the plantar fascia and a slowing of the healing process with age.

Heel pain varies in severity. In most cases, pain is more severe following periods of inactivity (e.g. in the morning), subsides with activity, and increases in severity with prolonged activity. Indeed, inactivity causes the muscles in the foot to tighten, increasing the strain on the plantar fascia. The muscles stretch with mild activity and the heel pain subsides. Prolonged or strenuous activity increases the severity of heel pain.

Among the risk factors for heel pain are strenuous exercises without proper footwear, obesity and standing for prolonged periods of time. To reduce the risk of heel pain, it is important to wear shoes that fit correctly and to warm up properly before exercising.