Heel pain

whodafunk

Hi All,

I'm looking to see if anybody has any suggestions/recommendations around the below issue I am having please.

I have had heel pain particularly in the mornings when getting up for the last 3-5months+. I had been just trying to get on with it but a casual game of Astro football about 2-3 weeks ago just finished me off! I literally could barely apply any weight to my feet the following morning. The left heel is where the main issue lies - as the mornings go on there is no issue at all with the right heel.

What I have tried:

Visited 3 different physio's - was initially diagnosed as Fat Pad Irritation of the Heel. I got some home exercises to try - roll on the heel (I can hear some crunching when I do this), icing for 10-15mins twice a day, calf raises on stairs dropping heel to floor to stretch out Achilles, tried foam rolling both calves. All 3 physio's I saw said my calves were tight and loosened them out somewhat. I bought compression socks - tried them for a week or more - no difference at all even tried wearing them in bed.

In the last 2 weeks I have had 2 ultrasound sessions and have been fitted with custom orthotics (Foot Balance insoles) which I am trying. Physio said on last session he could feel fluid on the heel and he literally pinpointed the exact point at which the pain is there. Nearly 1 week into wearing the insoles every day and no running at all in the last 3 weeks I still have the issue in my left heel. Maybe I need to be patient and give it more time?

Has anybody any advice or recommendations here? I'm at a stage where I cannot go for a run as don't want to make the situation worse and feeling really frustrated. I just feel I am not seeing any improvement at all. I'm not sure if I have Plantar (physio doesnt think I do), Achilles tendonitis, it's not a heel spur as confirmed by physio or heel bursitis.

Finally just to add I was doing about 30km per week running the last few months. The increase in mileage may have made the situation worse.

Any advice/recommendations greatly appreciated. Thank you.

DangerMouse27

This is probably not your issue.

But if your glute is tight too, then we might have had a similar problem.

I had heel pain this summer. Had really bumped up my pace in training and found it especially sore after a session in spikes. Even had a foot rocker to really try and stretch that achilles out. Achilles splints. Physio. You name it, I tried it and all of the gadgets that you have tried too. Been at this 20+ years as a competitive athlete.

I work on an orthopedic ward too so had the physio/ortho look at it and nothing could be found, apart from ridiculously tight calf/achilles etc, referral up to hamstring etc. All tight. Sounds similar to yours in that regard.

Turned out to be sciatic in nature. Got a release exercise online. Problem gone!! The stretch was so good, that I, and kid you not, can feel a mini wave of heat in the area after doing it, such is the relief on my circulation.

****

I lie supine, on my back. Bring your knee up, 45 degrees. Attempt a straight leg lift (rudimentary hamstring stretch) but place your hands, around about semi-membranosus (look it up) try to straighten your leg up (engage in the hamstring stretch) but keep a firm pressure, that will affect your ability to stretch. Then just slowly, bring your ankle down and back up again, re-engaging the stretch. It's more of a fascia release technique as I see it. But it's fascia that's hooking up to your lower back/glute, where the overall issue might be.

All referral. All same leg. Glute/hamstring/calf.

Your going to want to try and do this release on both legs note the differences.

*****

This might be of no absolute benefit to you.

whodafunk

Thanks very much for all of that information and your reply. Interesting to read what you have tried. I’ll definitely give that exercise a try.

Ceepo

https://www.boards.ie/discussion/2058321335/heel-pain

This is more general information and may not be directly applications to your own issues.

In general the difference between fat pad syndrome and planter heel pain is. Planter heel pain is normally worse in the early morning and and starts to easy as the day goes on, until you rest for a period and it sore when you start moving again. The pain is normally more to the inside and towards the arch of the heel. Fat pad syndrome the pain usually gets worse as the day goes on with none or very little pain in the early morning. The pain is more to the centre of the heel.

Rolling this area directly is never a good Idea imo, as if there is inflammation there this will only irritate it more.

Ice can have some effect but usually it only servers to numb the pain and very little else.

I would advise to use the orthotics, but only as a temporary measure to "deload" the effected area. Then gradually reduce the use of them.

Stretching and strengthen the calf may help, but if you can, place a rolled up towel under you toes, (pulls the planter into a stretch) while performing the heel raise.

If the pain is closer to the heel/achillies tendon insertion, do not drop the heel past 90 degrees while doing this exercise.

Unfortunately rest is never the answer either, you are better doing a small bit of exercise, while trying not to make things worse. There is a bit of trial and error.

Are physios still really using "ultra sound" as a means of treatment.?

Also just on the heel spur, you can have one with or without pain. And usually has no impact of plantar heel pain.

DangerMouse27

https://www.boards.ie/discussion/comment/121337367#Comment_121337367

Ultrasound for diagnosis perhaps? Two seems a lot but maybe needed a second go if they were kinda guessing where the issue was.

Ceepo

https://www.boards.ie/discussion/comment/121337503#Comment_121337503

I was only asking the question.! Perhaps it was for diagnosis