Heel Pain
If we ranked the things in life that we take for granted, the heel would rank near the top of that list. But a brief look at the heel will give us a much greater appreciation of this unique structure and its' ability to carry us through our day to day activities. As we take a little closer look at the heel bone we'll see that it's actually a remarkable feat of engineering. The heel bone, or calcaneus, is composed of two different types of bone; an outer hard bone and a soft inner bone. Think of the heel bone being much like an egg; firm, yet fragile. And like all other bone, the calcaneus has the ability to change. Apply a load to the heel and it will adapt over time to carry that load.
Each step that we take applies a phenomenal load to the heel. Consider the fact that in a simple slow walk, the load applied to the heel can be more than twice our body weight. If we increase the speed of our walk, take bigger steps or jump, the load applied to the heel at heel strike is significantly increased. This load may be more than three times our body weight. And consider how many times this loading occurs in the course of a normal day. Step after step, over and over again. The ability of the heel to sustain these loads is quite incredible.
First, let's talk a little bit about the definition of load. Load, as an engineering term can describe many things. The first definition that comes to mind is typically the amount of load. The amount of load usually refers to our body weight. In addition to the amount of load, load can also be applied to the heel in several different ways. The duration of load, or time spent standing or walking often becomes a critical loading issue. The number of steps taken in a day, or frequency of loading, is also a variable to be considered when discussing load. The sum of each of these loading issues is what contributes to the majority of heel problems. These problems of 'overloading' are often referred to as overuse syndromes. An overuse syndrome simply means that the amount of load being applied to the heel is greater than what the heel can physically repair in a 24 hour period of time. When we cross this threshold of overloading, and if it's done on a regular basis, problems arise such as tendonitis, fasciitis or fractures.
Another form of mechanical load that is applied to the heel comes from the structures that are attached to the heel. Some of the soft tissue structures that attach to the calcaneus (heel bone) include the Achilles tendon, the plantar fascia, several muscles and ligaments. The Achilles tendon is the largest, most powerful tendon in the human body. Over activity, tightness or a host of other Achilles tendon problems can contribute to heel pain. On the bottom of the heel, the plantar fascia is the structure that pulls away from the heel to cause plantar fasciitis and heel spur syndrome. Many other tendons and ligaments either attach or influence the heel in its' normal function, and subsequently contribute to loading.
You can see from this brief description of heel pain that there may be many different causes of heel pain. The most common causes of heel pain are due to overuse, or what we may even call 'overload'. For a more detailed discussion regarding heel pain, please refer to the additional articles found on our website, http://www.myfootshop.comMyfootshop.com.
About the Author
Jeffrey A. Oster, DPM, C.Ped is a board certified foot and ankle surgeon. Dr. Oster is also board certified in pedorthics. Dr. Oster is medical director of http://www.myfootshop.comMyfootshop.com and is in active practice in Granville, Ohio.
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