What’s a bump in the back of the heel?

What’s a bump in the back of the heel?

The bump on the back of the heel is called a Haglund’s Deformity.  It is actually an enlargement of the bone, usually due to spurring of the posterior (rear) aspect of the heel.  Many years ago this was called a “Pump Bump” because it was noted in women who wore certain shoes.   This condition is not gender specific, it is inherited.  Many people have an enlargement behind their heels and never noticed it, nor have they had any problems.  Some people find certain boots or shoes rub and irritate the area, so they elect to choose more comfortable, accommodating shoes.  Finally, there are some who suffer with constant pain in the area and will require surgical excision of the boney protuberance. 

I did all the exercise for Plantar Fasciitis and now I can’t walk?

I did all the exercise for Plantar Fasciitis and now I can’t walk?

If you have been stretching the band underneath your foot by hanging off a step, pushing against a wall, pulling your toes back, or even rolling a can with your foot because you read it on the internet or your doctor told you to, you may actually be doing more harm than good.  When your feet feel a little “tight” in the morning, stretching will be fine, but if you really have Plantar Fasciitis you may be irritating the heel.  The band that is attached to the heel becomes thickened over time, it no longer can flex so pulling and releasing the band at the attachment to the heel will cause irritation to the area.  Think of a thick rubber band attached to a bone, a slow consistent stretch that lasts an hour or more is fine, but a pull and release over and over is like taking a rubber band and snapping it against a painful area.  Doing the repetitive short stretches will only cause micro tears in the band leading to severe pain.  If you have heel pain and you are attempting to reduce it by stretching then get a Night Splint, these are medical devices that give a consistent even stretch to the plantar fascia allowing it to slowly stretch out over time.  Wear the splint for at least an hour a day and stop irritating your foot with inconsistent stretches.  If you do get a night splint please READ our instructions on how to wear it, there is an article on our website that explains how to wear one and why it works. 

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The back of your heel tender?

The back of my heel is tender.

The Achilles tendon attaches to the back of the heel.  When you have been very active this tendon can become strained and tender. It is actually noted to be one of the most injured tendons in the human body. Rest, ice and elevation may be all you need to reverse the tenderness.  If this is a persistent problem then there is a chance you are placing too much strain on your feet with activity so you might need heel lifts or functional orthotics.  The heel lifts are placed into your shoes to take the pressure off the Achilles tendon, but entire support for the entire foot is preferable.  If the area is just tender, not truly painful, then we recommend a product called BioFreeze, it helps reduce the inflammation.  If the condition is severe please get to a podiatrist, you may have torn or partially torn the tendon. 

My child limps after they have been running around, why?

My child limps after they have been running around, why?

Many children have a condition called Sever’s Disease, also called Calcaneal Apophysitis.   A heel becomes a solid single bone over many years, by the time a person is 16 usually the calcaneus (heel bone) has matured completely.  But, from the age of 6 on, the bone has a growth plate located just behind the heel.  This growing portion of bone has not fused with the main body of the heel; therefore it is vulnerable to trauma during any sports activity.  X-rays often show small fractures in the area.  Treatment is typically a custom insert that stabilizes the heel and takes pressure off the growth plate, allowing the child to maintain a busy sports schedule with minimum to no down time.  As a parent you should ice, elevate and rest the heel after a sport and bring your child to a podiatrist, they are the best equipped to reverse this condition and keep your child active.

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Red tender heel that is very swollen, what’s wrong?

Red tender heel that is very swollen, what’s wrong?

There are several conditions that can cause redness and swelling in the heel.  If it is the entire heel the problem may be acute gouty arthritis, although gout usually occurs in the big toe, it also affects the knees, shoulders, elbows, ankles and heels.  If there is history of gout in your family, or if you have had multiple gout attacks in other joints than the likelihood this is gout has increased.  The most common area to be red and swollen is just behind the heel, at the attachment of the Achilles tendon.  There is a bursal sac in the area that may have become inflamed, most people are aware of bursitis affecting shoulders, knees and hips, but this also is a problem in feet.  Retro-calcaneal bursitis is basically a condition that occurs when the bursa (fluid filled sac that cushions the area between the Achilles tendon and the heel bone) becomes irritated from over use or an injury.  Ice, elevation and especially rest are important, but it is also wise to avoid any shoes, or even a sock touching the area till it reduces.  Anti-inflammatories such as Aleve, Motrin, and Aspirin are all helpful but if it is very tender it’s time to see the podiatrist. 

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Electrical sharp pain from the heel into the ankle, what’s going on?

Electrical sharp pain from the heel into the ankle, what’s going on?

If you are feeling sharp, radiating, stabbing pains that may start in the heel but usually involves the ankle, you may have a condition called Tarsal Tunnel.  Just like its counterpart in the wrist Carpal Tunnel, this is a condition in which the nerves become entrapped in the fibrous tissue surrounding the area, when the nerve becomes compressed or squeezed a burning sensation may occur. Typically the nerve that runs along the inside of the ankle, called the Posterior Tibial Nerve, becomes entrapped in the Laciniate ligament in the ankle.  The pain occurs with movement in the ankle and can be very debilitating.  There is also another condition that presents similarly, which occurs when a simple heel problem goes untreated for a long time, the problem can escalate and the medial plantar nerve becomes embedded in the plantar fascia, in turn causing the neural pain described above.   Of course there are systemic conditions that may cause this problem but the two mentioned are the most common seen today.  Treatment is dependent on the severity of the problem, immobilization, oral and topical anti-inflammatories, functional orthotics, series of anesthetic blocks, Laser therapy and of course surgery. 

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Do heel injections work?

Do heel injections work?

Injections for heel pain consist of various anesthetic agents and steroids.  There are a variety of short and long acting steroids that are typically used.  There are some basic problems with heel injections, firstly in most cases the results are temporary and the pain reoccurs unless other treatments are being offered in conjunction with the steroid injection.  You may know someone that said they had the injections and they worked great, but if the injections alone alleviated the problem then less painful and less invasive measures may have also worked.  Steroid injections can be painful and can cause various systemic problems from allergic reactions (which are rare), rise in blood glucose levels, weakening of the muscles, ligaments and tendons in the area of the injection, and finally in some cases temporary worsening of symptoms. The cost of a steroid injectable has skyrocketed in past years causing some doctors to use weaker or lower strength steroids that are not as potent because of the cost.   There are less invasive and longer lasting treatments available, nevertheless,  heel injections are sometimes necessary, but should be performed as an adjunct to other therapies. 

What shoes will help your heels

 What shoes will help your heels?

Amazingly, any shoe with a slight heel can help alleviate heel pain.  For men this often means a cowboy boot, for women a slight heel in a dress type shoe.  As far as various running shoes there are a number of them that have a built in arch support.  Nevertheless, it is impossible to suggest one brand over another.  Feet vary in many ways, not just how high or low an arch is, but each person’s gait is unique and needs to be accommodated differently.  Furthermore, life style makes a great deal of difference.  A marathoner will have different needs than a tennis player, likewise a dress shoe to be worn throughout the workday will be very different than one meant for a special occasion.  Use logic, if a shoe is comfortable, is constructed of leather or breathable canvas not plastic, and has adequate cushioning and tread, and offers good support, that is great, but the most important feature is how it feels on your foot.   Regardless of the shoes you try, heel pain may continue and you may need to stop spending money on trying to alleviate the pain with various shoes and just get to a podiatrist.  Most likely a functional orthotic that will go from one shoe to the next can alleviate the problem.  Visit Eastern Shore Foot Center today. Dr. Braun and her staff will get you in the right shoes.