Medical Professionals

The County Woman Magazine www.TheCountyWoman.com July/August 2014

Heel pain has many causes. Most often it is

a result of poor foot biomechanics (walking abnormalities) that place too much stress on the heel bones and the soft tissues that attach to it. The pain may also result from

injury or a bruise incurred while walking, running, or jumping on hard surfaces or wearing poorly constructed footwear and being overweight.

There are 26 bones in the human foot, the largest being the heel bone (calcaneus). The heel bone is affected by outside influ-ences and may be injured from participating in sports, walking, or spending prolonged periods on the feet.

V HEEL SPURSA heel spur is an excessive

bony growth on the underside of the heel bone. A spur, which is visible on x-ray, appears as a pro-trusion and can extend forward as much as half an inch. Some heel spurs are never painful and are only discovered on routine x-ray examination. The spurs result from strain of the muscles and ligaments of the foot, plac-ing extra stretch on the bone causing the bone to respond with excessive bony growth. While the heel spur itself may not be painful, it usually is associated with inflammation of soft tissue structures that attach to it.

V PLANTAR FASCIITISOn the bottom (plantar)

aspect of the foot, there is a broad band of fibrous connec-tive tissue (fascia), which begins at the heel bone (calcaneus) and extends to the ball of the foot. This band of tissue may become inflamed and when it does it is called plantar fasciitis. It is com-mon among people who spend a long time on hard unforgiving surfaces like concrete, tile, or hard wood floors. It is also com-

mon in athletes who run and jump.

The plantar fascia is strained over time when forces cause it to stretch beyond its normal limits. The soft tissue fibers of the fascia tear or stretch at points along its length; this leads to inflamma-tion, pain, and possibly a growth of a bone spur where the fascia attaches to the heel bone.

The inflammation may be aggravated by shoes that lack adequate support, especially in the arch area.

Classic signs of plantar fascii-tis are pain upon rising from bed in the morning, when taking the first few steps, or pain after pro-longed sitting and then rising to get up. This occurs because while at rest, the plantar fascia has a chance to shorten and contract and then with weight bearing on the foot the fascia tries to stretch faster than it can accommodate to. This causes an intense pain that may lessen or even disappear as you begin to walk but usually

returns after prolonged rest or extensive walking.

V FLATFEETHeel pain sometimes

results from excessive pronation. Pronation is the normal flexible motion and flattening of the arch of the foot, which allows it to adapt to ground surfaces and absorb shock during walking. Excessive pronation or excessive flattening of the arch can create an abnormal amount of stretch-ing and pulling on the ligaments and tendons attaching to the bottom of the heel bone. This may also lead to injury to the hip, knee, and low back.

CHILDREN’S HEEL PAIN

Heel pain may occur in chil-dren, commonly between ages 8 and 13 years old. During this time, children become increas-ingly active in sports activities. This physical activity, par-ticularly jumping, inflames the

growth centers of the heels. This inflam-mation of the growth center (epiphysis) causes pain with walking, running and jumping. When the bones mature and the growth centers fuse, the problems dis-appear. If heel pain occurs in this age group, it is necessary to protect the growing bone and to provide pain relief.

TREATMENT OF HEEL PAIN

If pain or inflammation per-sists, limited daily activity will help. Dr. Honick will examine your foot and may perform diag-nostic x-rays or other specialized tests such as MRIs or bone scans to rule out problems of bone and soft tissues.

Conservative treatment may involve resting the foot or wear-

ing specialized splints, casts, or boots. Treatment may also require oral or injectable anti-inflammatory medications, exer-cise and shoe recommendations, taping or strapping, or use of custom molded orthotic devices.

A functional orthotic device may be prescribed for correcting biomechanical abnormalities to control excessive pronation and maintaining more neutral foot position.

Only a relatively few cases of heel pain require more advanced treatments or surgery. If surgery is required, it may involve the partial release of the plantar fas-cia, removal of a spur, removal of a bursa, or removal of a neuroma or other soft-tissue growth.

Schedule your appointment today!

Understanding The Causes Of Heel Pain

Stuart W. Honick, DPM, PT, FACFAS

Dr. Stuart W. Honick received his undergraduate degree from Rutgers University in New Brunswick, New Jersey and went on to achieve his degree in Physical Therapy at The University of Medicine and Dentistry of New Jersey/Kean College. Continuing his education at Temple University School of Podiatric Medicine Dr. Honick was awarded a degree of Doctor of Podiatric Medicine (D. P. M.) and completed a two-year surgical residency. Dr. Honick is Board Certified in Foot Surgery by the American Board of Podiatric Surgery.

Dr. Stuart W. Honick has been selected as a “Top Doc” in Southern NJ.

Stuart W. Honick, D.P.M., P.T.Podiatric Medicine & Surgery

Diplomate American Board of Podiatric SurgeryBoard Certified In Foot Surgery

392 N. White Horse PikeSuite # 2

Hammonton, NJ

609.704.9001

www.GoFeet.com

5401 Harding HighwaySuite # 5

Mays Landing, NJ

609.625.5400

4 Arthritis

4 Athlete’s Foot

4 Bunions

4 Diabetic Foot Care

4 Foot & Ankle Injuries

4 Foot Surgeries

4 Fungal Nails

4 Hammertoes

4 Heel Pain

4 Nail Problems

4 Neuromas

4 Orthotics

4 Warts

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