When you step forward and hit your heel to the ground in walking, it is referred to as the heel strike. A great deal of force goes through your heel and ankle during walking and each heel strike. If you have an injury such as Achilles tendinitis or plantar fasciitis, walking may become quite painful. To decrease pain and inflammation, rest, ice and take over-the-counter pain medications. If your pain worsens, consult your physician.
A tight calf muscle can pull on your Achilles tendon, which attaches to the back of your heel. The constant pulling can irritate and inflame your Achilles tendon, causing tendinitis. Symptoms include swelling, stiffness and pain, especially where your Achilles tendon inserts on your heel. Pain is often worse during flexion of your foot or toe push-off in walking, according to a 2004 "American Family Physician" article. Over time, your Achilles tendon can become thick and weak, increasing your risk of tearing your tendon during activities like walking.
Plantar Fasciitis and Bone Spurs
Your plantar fascia is tissue that is located on the bottom of your foot from your toes to your heel. It helps support your foot and arch during weight-bearing activities. High-impact exercises such as running, over-training, and shoes with inadequate arch support can lead to inflammation of your plantar fascia, causing plantar fasciitis. Walking, especially when you first get up in the morning can cause severe heel and foot pain. Chronic plantar fasciitis can also cause a bone spur, which is a bony projection that develops off of your heel. A bone spur may further increase heel pain during activities like walking.
A stress fracture on your heel, tarsal tunnel syndrome and bursitis are additional injuries that can cause significant heel pain, especially during walking or running. A stress fracture is a small crack in your heel bone and may develop due to over-training in high-impact activities such as running and jumping. Tarsal tunnel syndrome is when your nerve is compressed on the back of your ankle and heel, resulting in heel pain and numbness or tingling. Lastly, bursitis is inflammation of your bursa sac -- a sac of fluid located underneath tendons to reduce friction. When tendons such as your Achilles tendon become tight and inflamed, you may develop bursitis.
Treatment and Prevention
To manage pain and swelling, rest, ice, wear a compression wrap, elevate your ankle and foot, and take over-the-counter pain medications such as acetaminophen. Your physician may also recommend using crutches during walking, physical therapy and surgery. Additional treatments to consult your physician about include corticosteroid injections, orthotics, immobilization in a walking boot, and a night splint, which is a boot worn at night to keep your foot in extension. A 2007 “Clinical Review” article advises to use precaution, however, with corticosteroid injections due to possible negative side effects like infection. To prevent heel pain, stretch your foot, ankle and calf regularly; allow plenty of recovery between high-impact workouts; and wear shoes with plenty of arch support.
- “American Family Physician”; Diagnosing Heel Pain in Adults; Tracy Aldridge, M.D.; July 2004
- “Cleveland Clinic Journal of Medicine”; Heel Pain: Diagnosis and Treatment, Step by Step; Jose Alvarez-Nemegyei, M.D., et al.; May 2006
- “American Family Physician”; Tendinopathies of the Foot and Ankle; Michael R. Simpson, D.O., et al.; November 2009
- “Journal of Multidisciplinary Healthcare”; Plantar Fasciitis – to Jab or to Support? A Systematic Review of the Current Best Evidence; Hayley Uden, et al.; May 2011
- “Clinical Evidence”; Plantar Heel Pain and Fasciitis; Karl B Landorf, et al.; January 2007