Heel Pain Information

Heel Pain Information

Since the heel is the first to strike the ground during a normal gait cycle, it takes the majority of the impact from walking, running, jumping, and alike motions. As far as foot pain goes, this makes the heel one of the most commonly complained of areas.

 

 
Anatomy Of The Heel

The human foot is divided into three sections - the forefoot, midfoot, and hindfoot. The hindfoot is the area commonly referred to as the heel. The seven short tarsal bones (three cuneiforms, the talus, navicular, cuboid, and calcaneus) of the hindfoot are arranged in a proximal and distal rows. The tibia and fibula leg bones are connected to the talus at the ankle joint. The distal tarsals form a bridge to the metatarsals. The largest tarsal bone, which is also the largest bone in the foot, is the calcaneus (heel bone). The calcaneus projects backwards to provide a lever action during movement. It also forms the subtalar joint/ talocalcaneal joint with the talus. The posterior surface of the cuboid bone articulates with the anterior surface of the calcaneus to form the calcaneocuboid joint.

Other important structures in the heel of the foot include:

* The flexor retinaculum, also called the internal annular ligament, is a strong band that extends from the tibial malleolus (the bony prominence on the inside of the ankle) to the calcaneus. It forms the outer surface of a series of groves that is referred to as the tarsal tunnel. This tunnel allows the passage of tendons from the flexor muscles, the posterior tibial blood vessels, and the tibial nerve to travel to the sole of the foot.

* Another important structure is the Achilles tendon. This thick and strong tendon connects the muscles of the lower leg (calf muscles) to the heel.

* The plantar fascia runs from the heel to the toes. This thick connective tissue, which is technically a ligament, supports the arch of the foot and acts as a padding to absorb shock.

What Causes Heel Pain?

A single traumatic blow to the heel can occasionally be the cause of heel pain. However, heel pain is most often a cumulative injury process from repetitive actions or overuse during everyday activities, sports, or work-related activities that stress and weaken the structures within the hind foot. Certain factors also place individuals at a higher risk of developing heel pain:

* age (over 40-years-old)
* being overweight
* wearing shoes that don’t fit properly
* participating in strenuous exercise or sport activities, especially those that involve repetitive jumping or running
* congenital misalignment
* occupations or hobbies that involve prolonged periods of standing
* high arches

What Are Some Common Heel Injuries?

Heel injuries are generally classified as pain behind the heel or pain under the heel. Here are some of the most common injuries:

Plantar Fasciitis

This is one of the most common causes of pain under the heel. The plantar fascia (ligament) is designed to absorb a great deal of stress. However, it can weaken due to repetitive stress placed upon the hind foot and/or suffer from degenerative effects due to aging. The above can cause the plantar fascia to become irritated, overstretched, or suffer tiny microscopic tears. The resulting inflammation causes heel stiffness and pain. The heel pain is usually worse right after sitting or laying, such as first thing in the morning. It lessens after a few steps are taken, but it usually returns as the day goes on.

Achilles Tendinitis

Achilles tendinitis is a common foot condition that results in pain at the back of the heel. This tendon is instrumental in performing walking, running, and jumping motions. If the tendon is overused or repetitively stressed during such motions, it may become inflamed. Achilles tendinitis is also commonly caused by inactive individuals suddenly beginning an exercise program that is too intense for the Achilles tendon to handle. Achilles tendinitis may involve the fibers in the middle of the tendon (non-insertional Achilles tendinitis) or the lower portion of the tendon fibers (insertional Achilles tendinitis).

Heel Spurs

A heel spur is a pointed bony outgrowth on the calcaneus bone. A heel spur usually doesn’t cause pain on its own. The pain felt from a heel spur is actually related to Achilles tendinitis or plantar fasciitis. If the heel spur is on the sole of the foot, it’s commonly the result of bone trying to heal itself after plantar fasciitis. On the other hand, if the heel spur is on the back of the heel, it’s commonly associated with Achilles tendinitis and causes pain as the extra bone rubs across the tendon when pushing off the ball of the foot.

Tarsal Tunnel Syndrome

This compression neuropathy is also known as posterior tibial neuralgia. It occurs when the tibial nerve becomes impinged or compressed as it passes through the tarsal tunnel. The nerve compression causes pain, burning, and tingling at the heel of the foot and along the rest of the nerve pathway on the sole of the foot. The compression usually worsens with prolonged standing or physical activity and subsides with rest.

Stone Bruise

This is simply bruising of the fatty pad on the underside of the heel. It can occur from stepping on a stone or other hard object.
 

Strengthening Exercises

These Heel Pain Exercises are ideal to build strength and flexibility.

Massage Treatment

These Heel Pain Massage Techniques are of great value in pain relief; circulation stimulation; dispersing blood and fluid accumulations; swelling reduction; and relaxing muscle spasms, especially when used alongside the Sinew Therapeutics liniments and soaks.

 

ACUTE STAGE SYMPTOMS AND TREATMENT

 

This stage is characterized by swelling, redness, pain, and possibly a local sensation of heat, indicating inflammation. If coolness makes your pain feel better, then the Acute Stage Treatment is recommended.

 

ACUTE STAGE SYMPTOMS:

 

The acute stage starts the moment an injury occurs and lasts until the swelling and inflammation are gone. The swelling is the result of the blockage of blood, tissue fluids and circulation in the heel because their normal movement has been disrupted by the force of the injury. Just like cars back up behind a traffic jam, causing congestion, exhaust and overheating; blood and fluids back up behind the injured heel, causing pain, inflammation, lumps and swelling.

The sensation of heat is due to the warming action of the blood and fluids overheating in the injured heel as they back up and accumulate. Stiffness and decreased mobility are due to spasms in tendons and ligaments that have contracted reflexively beyond their normal range from the impact of the injury.

As ligaments and tendons stretch and tear, blood from ruptured blood vessels becomes trapped in the local tissues. As the trapped blood clots up, it sticks the tissues together creating adhesions. Adhesions cause pain, inflammation and restricted movement because the layers of tissue that used to slide smoothly across one another now adhere and snap which interferes with normal functioning. It is essential to break up clotted blood as quickly as possible to prevent adhesions and scar tissue from forming.

During the acute stage it is very important to restore normal circulation to the heel, break up clotted blood and stagnant fluids, reduce swelling, and reduce the redness and heat associated with inflammation. By restoring the flow of blood, fluids, and circulation in the heel, then pain is relieved, damaged tissues can regenerate with healthy functional tissue, and the heel can strengthen and regain it's mobility.

 

ACUTE STAGE TREATMENT:

 

1. Apply the Sinew Herbal Ice on your heel to reduce redness, swelling, and inflammation while dispersing accumulated blood and fluids to help restore normal circulation to the heel. This first-aid treatment is used in place of ice to significantly speed up the healing process. It reduces the swelling and inflammation more effectively than ice, allowing you to more quickly regain range of motion. Acute Sinew Liniment can be used in-between applications.

Ice is not recommended because it does not help repair damaged tissues and keeps everything in the injured area frozen, causing the stagnation of blood and fluids and the contraction of muscles, tendons and ligaments. In Chinese sports medicine ice is not used and is considered a culprit in injuries that donít heal well.

2. Massage your heel with Acute Sinew Liniment to relieve pain, reduce swelling and inflammation, break up clotted blood and stagnant fluids, and stimulate circulation of blood and fluids to help cells quickly repair damaged tissues. Sinew Herbal Ice can be used in-between applications.

3. The Sinew Sports Massage Oil is recommended for use before and after exercise, sports and strenuous activity. It warms and stimulates your muscles, increases circulation and relieves tightness, hence improving your performance and helping to prevent injury.

 

 

CHRONIC STAGE SYMPTOMS AND TREATMENT

 

This stage begins once the swelling and inflammation are gone, but you still feel pain, stiffness, weakness, and/or sensitivity in cold and damp weather. If heat makes your pain feel better, then the Chronic Stage Treatment is recommended.


CHRONIC STAGE SYMPTOMS:

 

The chronic stage begins once the swelling and inflammation are gone, but you still feel aching pain and stiffness. This is because there are still accumulations of stagnant blood and fluids in your heel that are blocking circulation and blood supply to damaged tissues, creating residual pain, stiffness and weakness. You may actually feel hard nodules like sand in the tissue, indicating accumulation, calcification, and adhesions, which all cause pain, stiffness, and joint instability.

Your heel may feel more sensitive to the cold and ache in cold and damp weather due to impaired circulation. These symptoms are often the result of failure to treat the injury properly from the outset and overicing.

Increasing circulation and blood supply to the damaged tissues is very important in treating chronic injuries because tendons and ligaments do not have an extensive direct supply of blood. That is why chronic injuries can be slow to heal. Increasing local circulation also prevents cold and dampness from penetrating the injured area, preventing pain and stiffness.

During the chronic stage it is very important to break up remaining accumulations of blood and fluids, and increase circulation and blood supply to the damaged tissues. By increasing circulation and blood flow in the heel, then pain and stiffness is relieved, and the damaged tissues can strengthen to restore stability.


CHRONIC STAGE TREATMENT:

 

1. Massage your foot with Chronic Sinew Liniment to relieve pain and stiffness, strongly stimulate circulation and blood flow to damaged tissues, and promote the healing of overstretched tendons and ligaments. The Sinew Relaxing Soak can be used in-between applications.

2. Soak your foot with the Sinew Relaxing Soak to relax muscles and tendons that are in spasm, ease joint pain and stiffness, and improve range of motion. Acute Sinew Liniment can be used in-between applications.

3. The Sinew Sports Massage Oil is recommended for use before and after exercise, sports and strenuous activity. It warms and stimulates your muscles, increases circulation and relieves tightness, hence improving your performance and helping to prevent injury.