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Heel Injuries & Education

Heel Injuries & Education

The calcaneus is known as the heel bone which is the largest bone in the foot .It helps absorb the shock at heel strike in our walking pattern. The calcaneus is part of the subtalar joint which is located under the ankle joint, and consists of the talus bone on top and calcaneus (heel bone) on the bottom. The calcaneus also connects to the cuboid bone, which is a bone in the middle of the foot and provides stability to the outside of our foot. Several large soft tissue structures originate at the calcaneus, including the achilles tendon and the plantar fascia.

ACHILLES TENDONITIS/
TENDONOSIS

ACHILLES TENDONITIS/
TENDONOSIS
Definition: Achilles Tendinitis or Tendinosis is a painful degenerative, overuse syndrome of the thickest and strongest tendon in the human body. The Achilles tendon attaches the calf muscle (gastrocnemius and soleus) to the back of the heel bone (calcaneus).
Function: The Achilles Tendon is responsible for plantar flexion (same movement that occurs when you point your foot) and therefore important for activities such as walking, running, jumping, climbing.
Mechanism of Injury

The Achilles tendon is prone to injury because it is used in all weight bearing activities and in many sports. Micro tearing of the tendon often results from intensive repetitive activities especially which are predominantly eccentric in nature. The Achilles tendon also does not have a good blood supply, so injury can be slow to heal.

Signs & Symptoms

• Pain at the attachment point (insertion) at the back of the heel, or in the mid-portion of the tendon (approx 1.5 cm above the heel)
• Gradual development of symptoms include: pain that occurs in the tendon or insertion while exercising or a couple of hours after, morning stiffness and pain with increased activity level
• Swelling or formations of a bump at back of heel or thickening within tendon, as well as some Achilles tendons 'creak' when touched or moved.

Causes

• Can be caused by sudden increase in training volume or intensity/overuse
• Lack of flexibility or improper stretching prior to injury
• Decreased strength or endurance
• Flat or high arched feet
• Excessive hill running
• Improper/overworn footwear
• Drastic change in footwear heel height

Pedorthic Treatments

Custom made Orthotics are one of the most effective methods to reduce your symptoms and pain. They are able to redistribute and load the foot in a different way in order to decrease the stress put onto the ankle bones and long arches. Pedorthists use interventions such as a deep heel cups, and a stabilizing arch support. Proper footwear is just as important as the orthotic to recovery. Talk to your Pedorthist about proper footwear choices for you.

Other Treatment

STRETCHING: calf stretch HEAT/ICE: 10- 15 minutes to relieve pain and reduce swelling.
OTHER TREATMENT may include pain medication, physiotherapy, massage therapy, dorsi-flexion night splint.

PLANTAR FASCIITIS

PLANTAR FASCIITIS
Definition:Plantar fasciitis is the inflammation of a dense band of thick connective tissue that originates at the heel, extends through the arch and attaches at the toe.
Function:The fascia functions to support the arch of the foot and also acts as a shock -absorber during all weight-bearing activities.
Mechanism of Injury

Plantar fascia tissue fibres become damaged, inflammed or irritated due to sudden trauma or repeated stress (similar to a rope fraying when it is under tension).

Signs & Symptoms

• Pain is most often experienced at the heel and/or thru the arch of the foot.
• Morning pain and tightness is often present, and seems to improve with use .
• Extended standing, walking, or running causes pain to reoccur and is often experienced upon rising after periods of rest

Causes

• Excessive or extended walking, running, jumping
• Sudden increase in body weight
• Improper footwear, or worn out shoes
• Tight calf muscles and/or plantar fascia
• Weak foot and ankle muscles
• Poor foot posture (mechanical alignment)
• Sudden foot trauma

Pedorthic Treatments

Custom made Orthotics are one of the most effective methods to reduce your plantar facia pain. They are able to redistribute and load the foot in a different way in order to decrease stress to the affected area. Pedorthists use interventions such as a deep heel cups, and a stabilizing arch support, along with shock absorbant cushioning. Proper footwear is also pivotal to your recovery. Talk to your Pedorthist about proper footwear choices for you.

Other Treatment

• STRETCHING: BEFORE standing in the morning, and after any period of rest (such as driving, sitting at a desk)
• ICING: 10-15 minutes after activity to relieve pain and reduce swelling (is best done with a frozen water bottle placed under foot like a rolling pin)
• OTHER TREATMENTS may include anti- inflammatory medication, physiotherapy, massage therapy, dorsi-flexion night splint.

SEVER'S SYNDROME

SEVER'S SYNDROME
Definition:Common heel injury that occurs in athletic youth (more common in boys) typically between the ages of 8-15 years old. Sever's Syndrome (also known as 'calcaneal apophysitis' ) is a growth plate disturbance at the heel bone. It usually occurs during the growth spurt of adolescence.
Mechanism of Injury

There is not always a mechanism of injury for Sever’s syndrome although a sudden impact or intense sport or activity may begin the inflammatory process.

Signs & Symptoms

• Sharp or dull pain in the heel bone which increases with weightbearing activities
• Heel is painful to touch
• Child may develop an avoidance of heel contact when walking

Causes

Condition is a product of the age of the child because the growth plate solidifies after about age 14 or 15 and is no longer a painful area

Pedorthic Treatments

Custom made Orthotics are the most effective methods to reduce your growth plate heel pain. They are able to redistribute and load the foot in a different way in order to decrease stress to the affected area. Pedorthists use interventions such as a deep heel cup, and a stabilizing arch support, along with a cushioned or elevated heel. Proper footwear is also pivotal to your recovery. Talk to your Pedorthist about proper footwear choices for you.

Other Treatment

• STRETCHING: calf stretch ICE: 10-15 minutes to relieve pain and reduce swelling.
• OTHER TREATMENT may include pain medication, physiotherapy. A ceasation of activity will limit repetitive trauma and may allow healing.

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