If you have played sports for very long, you've likely experienced heel pain. At times, the pain can be quite debilitating, even causing you to miss practice or training time.
Heel pain has multiple causes, but people tend to assume the cause is a heel spur, which is not always the case. Many athletes with heel pain don't have heel spurs, yet they experience the same symptoms.
What exactly is a heel spur?
Heel spurs are new bone that forms in response to stress to the heel. They serve to protect the bone against the development of microfractures. Spurs start out as cartilage and progress to solid bone. They are present in about 50 percent of the population, yet not everyone has heel pain— that's the first clue that heel spurs don't always cause heel pain.
Other causes of heel pain
Micro tears in a ligament called the plantar fascia (a condition known as plantar fasciitis) often lead to heel pain. When you stand, your foot flattens, leading to elongation of the foot and stretching of the plantar fascia. Running, jumping and other similar activities lengthen the ligament even further. The plantar fascia is not made to stretch, so it can tear due to overuse, sudden stretching or rapid increases in activity. When this occurs, rest and inactivity will allow those micro tears to begin to heal. However, when you resume activity that stretches this band of tissue again, the pain cycle can start all over again.
Most likely, the pain won't go away on its own, but occasionally it does. People try ice, over-the-counter arch supports, anti-inflammatories, stretching, night splints and changing shoes. While these can work, often they're not enough to resolve the symptoms. You may need professional treatment to resolve the pain and to resume training. Medical professionals can provide treatments that include steroid injection and platelet-rich plasma (PRP)—and a newer alternative, an injection of stem cells. Often a cortisone injection will help, but it's short-term, and the pain can come back, requiring multiple injections.
PRP is used in other parts of the body. Blood is drawn and spun to separate. Platelets that contain growth factors are injected back into the injured area to increase the healing potential. Most insurance companies do not cover this type of treatment, however.
The best long-term treatment option is orthotics, custom-made from a mold of your foot. Liken them to prescription eyeglasses. They stabilize the foot and relieve the tension on the plantar fascia. Stretching the calf muscle is also an option, although it takes several weeks or even months of stretching to achieve the desired result.
Preventative measures include replacing shoes on a regular basis, stretching and seeking treatment early in the process, not after six to 12 months of pain and self-treatment. Long, sustained calf stretches of 30-60 seconds are ideal, but don't bounce when stretching. Heel pain can be the result of a nagging injury that won't go away. Professional treatment is available when self-treatment fails.
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