Heel pain is a problem that we take very seriously here. On a daily basis, we see how it can turn a happy and healthy person into one that is struggling to walk and feeling miserable. Today, we thought we’d share six reasons that we see for a person’s heel pain not getting better.
But first - if you’re not sure what causes heel pain and how we treat it - read this first.
1. You’re treating the symptoms, not the cause of the problem
You’ve been taking pain-killers and anti-inflammatories as needed for a couple of months now, but that stupid heel pain still won’t go away. Sound familiar? It does to us!
A common problem people make when trying to self-manage their heel pain is to treat just the symptoms by masking them with medications. While that gives you some much-needed relief, it’s temporary, and it doesn’t do anything to fix the cause of the problem. In fact, by walking around and using your plantar fascia (the injured tissue) completely normally because you can’t feel it on the meds, you may actually worsen the severity of the injury.
Pain is actually our body’s way of saying “HEY THERE, something is wrong, take it easy, use caution”. Your body wants you to avoid doing the action/activity that will cause pain so that it can heal. But instead, you’re removing your ability to feel that warning sign, and then are wondering why months have gone past and it hasn’t healed.
Please, please make sure you treat the cause of the problem, and not just the symptoms. That way, you can also reduce the likelihood of the problem flaring up again in the future.
2. You’re still doing the same things, but expecting different results
You know how the saying goes… same actions, same result. Different actions, different result. If you’re expecting a damaged tissue to recover well and quickly while you continue to cross-fit, run, gym and walk 5km to and from work, then it may come as no surprise that you’re not getting the results you want.
Your plantar fascia is stretched and engaged with every step you take - and even more so when the intensity of the activity increases. That’s why modifying your activities, or keeping your fascia and arch supported throughout the activities that you need to do, must be an essential component of your rehab.
Your podiatrist will help you do this - and it’s important for you to stick to their recommendations, and not fall back into old habits with the ‘she’ll be right’ mentality.
3. You’re trying to treat the wrong problem (misdiagnosis)
If you haven’t received a confirmed diagnosis from a health professional for the cause of your heel pain, this is for you. When you have pain, it’s only natural to consult Dr. Google to help understand it, we get it. The problem here is that multiple problems can have similar symptoms. When we’re talking about heel pain, and specifically about plantar fasciitis heel pain, all of the following problems can actually also produce pain at the bottom of the heel:
- Calcaneal (heel bone) stress fracture
- Plantar fat pad atrophy
- Abductor hallucis tendinopathy (has a similar insertion point at the heel as the plantar fascia)
- Sever’s disease (growing pain in kids at the heels)
- Achilles tendinopathy (can refer pain from the back of the heel to the bottom of the heel)
Different problems need different care - and if you’re trying to treat the wrong problem, you may be doing so for a while to come without getting the results you want. We highly recommend getting diagnosed by a health professional - namely, your Podiatrist, who specialises in foot and leg care.
4. Your shoes are setting you backwards
Your shoes act as the ground beneath your feet. They have the power to help support you, cushion you, give you more stability - or they can instead lead to more pain and work against other treatments that you’re currently undertaking.
If your shoes are worn down, unsupportive, completely flat, don’t have a strapping mechanism (velcro or laces) or aren’t the right shoe for your foot type, then you may be missing out on optimising your recovery - or even working against it.
Wearing the right shoes is an essential part of heel pain recovery, so make sure you’re confident that you have the right shoes, and wear them as often as you can. Seriously, even inside the house. The more, the better.
5. You’re not doing your stretches or strengthening exercises
This might be our #1. When we treat heel pain and patients come in for their checks, we expect the pain to be decreasing with every appointment. If it doesn’t, one of the first questions we’ll ask is if you’re doing your exercises. And often, in patients that haven’t experienced that reduction in pain, their answer will either be ‘no I’m not’ or more like ‘yeah I do them sometimes... maybe not every day... maybe not as often as you told me to’. And then that lightbulb of explanation goes off in our minds and we have our answer.
When your tissue is injured, it’s weak. We need to gradually work to strengthen it. Other surrounding tissues and muscles may also be tight - which often is a contributing factor to the development of plantar fasciitis heel pain - tight calf muscles. As we want you to have long-term pain relief (you know, for it to not come back just months after we treat it), we make a plan to address all of the causes of your heel pain, including the tight calf muscles. When you don’t stretch them, they’ll keep pulling on your heel and affecting your fascia.
From every podiatrist and physio we’ve ever met: please do your exercises.
6. You’re going at it alone
Yeah, you saw this one coming. When you try to fix your heel pain alone, without a team that are very experienced and knowledgeable when it comes to treating heel pain, you miss out. You miss out on valuable information about both your specific injury and the condition in general, advice, tips, and of course, the treatments we have available.
A great example is shockwave. We’ve been getting fantastic results for long-standing heel pain (6+ weeks) with shockwave, and it’s just not an option outside of a clinic.
If you have heel pain and it’s not getting better, we’d love to help. You can book an appointment with our podiatry team by clicking here or calling us on 07 4162 7633.