Home >Foot > Hindfoot
The ‘pad’ underneath the heel is made up of small compartments of fat that allow shock absorption during activity such as running and jumping. These compartments are held together by connective tissue. In sports such as hurdling or long jump the connective tissue may be broken up by repeated jumping, allowing the fat underneath the heel to be pushed to the sides.
If this happens the heel is no longer protected during jumping and may be prone to bony bruising. Symptoms include pain on jumping and weight bearing. Also the bone may be felt through the bottom of the heel.
The plantar facia is a thick fibrous band that extends underneath the foot from the front of the heel on the inside (medial) aspect and attaching to the underneath of the toes. This facia provides stability underneath the foot when moving. Inflammation can commonly occur at the origin of the facia on the inside of the heel in those who suffer from flat feet, or in athletes wearing insufficient footwear. Those participating in sports that involve running or dancing may also be at greater risk.
Symptoms include a sharp, burning pain over the inside of the heel. This pain will increase with weight bearing and heel raise. Pain and stiffness may also be felt in the morning following rising from bed.
Heel spurs are small irregular pieces of bone that grow following chronic plantar fasciitis and are a form of arthritic change of the heel bone. Heel spurs are more common in the elderly. Symptoms such as pain and tightness underneath the heel that increases with weight bearing may or may not be present with heel spurs. Heel spurs can be confirmed with an X-ray of the foot.
The calcaneus is the weight-bearing bone of the heel. Calcaneal fractures are common following a fall from a height, such as off a bridge or from a building or during parachuting. Severe pain and swelling will follow this injury and symptoms will markedly increase upon weight bearing if this is at all possible.
Early Injury Management
For approximately the first 72 hours following an injury, the RICE regime should be followed to ensure control of inflammation and pain relief.
R - Rest
I – Ice
C - Compression
E – Elevation
Rest from aggravating activity.
Ice should be applied in the first 72 hours or when inflammation persists. Ice should be applied for 15 to 20 minutes at a time. Ice should not be applied directly to the skin, but through a wet towel or cloth.
Compression can be achieved with an elastic bandage.
Elevation is used to help swelling to return to the heart through the blood stream.
The injured area should be elevated above the level of the heart.
Strengthening programs should only be commenced when:
Exercises should be 3 sets of 8-12 repetitions.