Painful heels when standing up: Plantar fasciitis – Symptoms and causes
Is Standing Bad for Your Feet? » Heel That Pain
Anyone who has worked as a cashier, retail assistant, or desk clerk knows that standing for long periods of time can be incredibly taxing.
Heel pain is one of the most common–and painful–symptoms for people whose jobs or lifestyles involve a lot of standing. This article will help you understand the unique forces that standing puts on your feet, how to navigate situations that require a lot of standing, and how to deal with heel pain from standing.
Why Is Standing So Hard on Our Feet?
The truth is, the phrase “standing still” is a little misleading. In order to keep you upright (without toppling over!) The muscles in your legs and feet need to stay constantly engaged, while supporting the entire weight of your body.
While taking a walk or a jog might get your heart rate going faster than standing in place, this movement is actually easier on your tendons, ligaments, and muscles. As you take a step with one foot and swing the other forward, it gets a short break and relief from supporting your body weight.
Standing, as opposed to walking or resting with the feet elevated, also makes it more difficult for the heart to pump blood to the feet and legs. That means less oxygen to these extremities, and reduced circulation.
Dealing with Long Stretches of Standing
Sometimes, it’s impossible to avoid standing for long periods of time. But the realities of of a job or other situation don’t have to mean painful feet. Try these strategies to make standing less painful on your heels and feet:
Stretching is a simple way to make a big impact on your your feet feel after standing all day. Stretch your heels, calves, and even your toes to strengthen the muscles and ligaments involved in standing. If you’re consistent with this practice (20 minutes a day!) you’ll have stronger, more flexible feet and legs that can stand up to long periods of time on your feet.
Try these stretches!
Think of good orthotic insoles as your arch’s best friend if you are on your feet a lot. Standing for long periods of time can flatten and strain the arch, resulting in heel pain or Plantar Fasciitis. By lifting the arch back to an optimal position, applying targeted acupressure, and soothing cushioning you can stave off damage while simultaneously relieving pain and discomfort.
Re-evaluate Your Shoes
A good pair of shoes is absolutely critical for comfort while standing. Choose shoes that fully support your heel and ankle, have a thick sole, and arch support. If your work shoes aren’t comfortable or don’t fit properly, this is one of the best ways you can improve heel pain from standing.
Insist on Breaks
It’s important to give your feet and legs a break regularly, whenever possible. Try to be diligent about taking scheduled breaks, and spend them off your feet as much as you can. If a break just isn’t in the cards and your feet are hurting, try shuffling or walking in place to give your muscles and ligaments small rests throughout the day.
Add a Treadmill to Your Standing Desk
If you have a standing desk, you might consider adding an inexpensive treadmill to your work setup! Remember, walking or moving your feet is easier than standing in one place for a long period of time. If your boss is willing, ask about adding a way to move your feet while you work!
Soothing Heels That Hurt From Standing
After a long day on your feet, you need quick, effective relief for heel and foot pain from standing. Try these effective and inexpensive remedies:
Ice not only numbs the body’s pain signals, it can help bring down inflammation and redness. Ice for about 10 minutes, using an ice pack or Ice Slippers that stay in place all on their own!
Massage is another great pain-relief tool. You can use your hands with simple techniques, a mobility ball, or even household items like a tennis ball or rolling pin. Massage breaks up scar tissue, improves circulation and blood flow, and disrupts the body’s pain signals.
Rest is one of the simplest–and most effective–ways to deal with heel and foot pain. Keep your feet elevated when you get home, and let your body rest and heal from the rigors of standing.
Non-steroidal anti-inflammatory medicines like Ibuprofen can reduce swelling, help with pain, and provide much needed relief when heel pain or foot pain is especially bad.
While you might be required to stand for long periods of time at your job or at home, you don’t have to stand for painful heels or feet. With a few of these simple techniques and adjustments, you can have a more pleasant day on (and off) your feet.
More Information About Heel Pain:
Causes of Heel Pain
Driving Heel Pain
Heel Pain Walking
Suffering With Plantar Fasciitis | Heel Pain Symptoms & Treatment
FOOTWEAR AND PLANTAR FASCIITIS
Commonly, people with plantar fasciitis have been using flat, flexible, and less supportive shoes. The lack of support is stressful on the plantar fascia and the heel, especially for those people with a weaker foot type. If these patients use the softer shoes for long enough periods, or as the main shoe, the stress can lead to plantar fasciitis or other types of heel pain. In these circumstances, it is essential that the patient has their foot type and shoes assessed. This will help to treat plantar fasciitis. Interestingly, higher heeled shoes for women are not the cause of plantar fasciitis, although these shoes do cause tightness in the calf muscles. Most women report, “my heel pain feels better in a high heel”.
People with higher arches receive less support from shoes and their liners, as there is less contact through the sole/arch area. The plantar fascia runs through this arch area and can become taught and strained. Functional running shoes and hiking shoes still lack the arch support that some feet need. The lack of support and the tightness can lead to heel pain and plantar fasciitis.
The flat foot (pes planus) is often caused by weak ligaments (ligament laxity). The plantar fascia works harder, along with other muscles and tendons, to compensate for this inherent weakness. The increased load can lead to plantar fasciitis or heel pain in general if the increased load is sufficient to cause strain, tearing, and inflammation.
The most common calf stretches place a certain amount of strain through the sole of the foot and therefore, the plantar fascia. Plantar fasciitis can come about when the patient stretches too much, or too hard. Some patients go through a rehab period following an injury or surgery and will develop plantar fasciitis due to the stretching technique they used. This is not to say that calf stretching should be avoided, but more so that technique is important.
BODYWEIGHT AND PLANTAR FASCIITIS
A large percentage of patients that we treat with plantar fasciitis are carrying more body weight than they want to or are used to. They often report being overweight and are sometimes attempting to shed a few kilos. The increase in body weight adds more load to the feet and hence more strain on the plantar fascia. Furthermore, the increased body mass means that the calf muscles must work harder to push the patient forwards and so these muscles become tighter and stiff. As mentioned previously, tight calf muscles pull harder on the heel and will most certainly cause a heel pain condition such as plantar fasciitis or Achilles Tendonitis. The irony lies in the fact that these patients are unable to lose weight through their desired walking or other exercise programs as their feet hurt too much. The only way they can lose weight is to engage in non-weight-bearing activities such as swimming.
Regardless of the cause, Plantar Fasciitis is not a condition that we have to live with, like arthritis. It is reversible. https://www.sydneyheelpain.com.au/how-we-treat-heel-pain/
Heel pain | healthdirect
Heel pain is usually caused by overuse. The most common causes are plantar fasciitis, Achilles tendonitis and arthritis. If you have heel pain that persists, you should see a doctor or physiotherapist.
What causes heel pain?
Plantar fasciitis is inflammation of the plantar fascia, a piece of strong, thick tissue that runs along the bottom of the foot. It connects the heel bone to the toes, creating the arch of the inner aspect of the foot.
Bruising or overstretching the plantar fascia can cause inflammation and heel pain.
Causes of plantar fasciitis include having flat feet or high-arched feet, wearing non-supportive footwear on hard surfaces, playing sports that place a lot of stress on the heel bone (like running), and being overweight, which puts more load onto the plantar fascia.
People with plantar fasciitis often say the pain is worse when they first get out of bed, or when they walk after they’ve been sitting still for a while. The pain is usually felt in the sole of the foot and the bottom of the heel. It usually eases after a few minutes of walking.
Initial treatment includes stopping the activities that caused the problem, strapping the feet, wearing supportive shoes, stretching and weight loss. Longer-term treatments include exercises to strengthen the calves and small muscles of the foot.
Achilles tendinitis is another common cause of heel pain. It is inflammation of the Achilles tendon, which runs from the heel to the calf.
It often causes pain behind the heel. It can also cause swelling, warmth and tenderness there. It might hurt to rise to stand on your toes. It can be caused by tight calf muscles and overuse.
Gently stretching the calf might help. You may need to see a physiotherapist and do special exercises if pain persists.
Arthritis can also cause pain in the heel. Other common causes of heel pain may be:
- heel bursitis — inflammation of the back of the heel, the bursa (a fibrous sac full of fluid)
- stress fracture — this can be caused by repetitive stress, strenuous exercise, sports or heavy manual work.
- Tarsal tunnel syndrome — a pinched nerve
- heel pad wear and tear
- osteomyelitis — infection of the bone
How is heel pain diagnosed?
A doctor or a physiotherapist is able to diagnose the cause of heel pain by talking to you and examining you.
How is heel pain treated?
Your doctor or physiotherapist may recommend rest and home treatments such as stretching and strengthening your calf muscles if you have plantar fasciitis or Achilles tendinitis.
Other treatments may include:
- applying ice
- anti-inflammatory medicines or painkillers
- night splints or strapping
- supportive footwear or orthotics
- losing any excess weight to reduce the stress on your feet
If you are exercising and feel a sudden pain in the back of the leg, you may have ruptured your Achilles tendon. Seek medical help immediately.
How can heel pain be prevented?
Reducing stress on the feet helps to prevent heel injury and pain. Stretching and a warm-up before exercise can help. If you feel pain in your tendon, you should stop the exercise. Always wear correctly fitted, supportive footwear suitable for your activity.
What Happens if Plantar Fasciitis is Left Untreated?
What is Plantar Fasciitis?
Plantar fasciitis is the inflammation of a thick, dense band of connective tissue that runs along the bottom of the foot and connects your heel bone to your toes (plantar fascia).
What Causes Plantar Fasciitis?
When you step down, the plantar fascia stretches, and the arch flattens to cushion the impact every time your heel hits the ground. Since the fascia is thick and tough and not flexible, repetitively stretching it on impact can cause small tears and ruptures in the fascia.
Signs of Plantar Fasciitis
One of the most common signs of plantar fasciitis is heel pain, but other signs and symptoms include:
- Shooting heel pain upon standing when you first get up in the morning, but the pain typically eases throughout the day
- Pain can come back if you stand for long periods of time
- Pain returns when you stand after long periods of resting or sitting
- Pain along the bottom of your foot results when you extend your toes
- Swelling in the heel
How is Plantar Fasciitis Diagnosed?
An orthopedic foot and ankle specialist can determine if you have plantar fasciitis by talking to you about your symptoms. Stabbing heel pain is the main symptom of plantar fasciitis. If your heel pain doesn’t subside after a few weeks, it’s a good idea to make an appointment with an orthopedic doctor.
Your orthopedist will examine your foot to make sure it’s not something else causing your pain. Your doctor may use X-rays and other tests to rule out a foot fracture or other heel pain causes.
What if Plantar Fasciitis is Left Untreated?
The following can occur if left untreated:
Heel spurs: Heel spurs are one of the most common outgrowths of untreated plantar fasciitis. It’s a common body response to generate calcium deposits to protect the arch of your foot against damage. Gradually, the calcium deposits can accumulate into sharp growths that jab the fatty part of the heel, causing stabbing pains each time you step. Heel spurs can often be prevented if heel pain from plantar fasciitis is treated early.
Plantar rupture: Plantar rupture can happen if plantar fasciitis is not treated and you continue to place heavy impacts on the plantar fascia. High impact activities include running, sports, or standing for long periods of time in shoes that don’t fit well.
You may have developed a plantar fascia rupture if you hear a loud popping sound, then experience intense pain, swelling, and bruising in the foot. It’s also painful to put weight on the affected foot. Seek medical help immediately if you think you have a plantar rupture. You may need to wear a boot or stay off your feet for a period of time after a ruptured plantar fascia.
Plantar fibromatosis: Plantar fibromatosis develops when non-cancerous nodules grow slowly along the plantar fascia. Then, they suddenly grow rapidly. As these nodules continue to grow, it becomes painful or uncomfortable to walk. Some research suggests untreated tears in the fascia can trigger plantar fibromatosis.
Allowing plantar fasciitis to go untreated can cause secondary problems that can be prevented. If you suspect plantar fasciitis, make an appointment today with one of our NY Orthopedics locations in New York City. Our “Centers of Excellence” offer top-level orthopedic treatment for feet and other joints, all in one location.
How Walking Can Make Plantar Fasciitis Worse
Plantar fasciitis is one of the most common foot-related injuries among athletes in Frisco. And it isn’t something you’ll be able to ignore, as it can send a sharp pain through your foot when it flares up. If you have plantar fasciitis, you may notice that nothing short of sitting down can ease your pain. Walking, running and even standing can put Frisco men and women in excruciating pain. But why does such a simple thing like walking cause so much pain, and does it make plantar fasciitis worse? If this is something you’ve experienced, keep reading as we discuss the ins and outs of this common ailment, and call Dr. Verville’s office to set up an appointment so she can examine and diagnose your pain.
What Is Plantar Fasciitis?
Plantar fasciitis occurs when excessive stress and pressure cause the connective tissue at the bottom of the foot (the plantar fascia) to stretch, tear, and become inflamed. When this happens, every step can cause intense pain for men and women.
Risk Factors for Plantar Fasciitis
Not all people are at risk for plantar fasciitis, but you could end up with this condition if you:
Have flat feet or very high arches
Walk, stand, or run on hard surfaces for long periods of time
Are severely overweight
Have tight Achilles tendons or calf muscles
Wear shoes that do not fit properly
Learn More About Plantar Fasciitis
Diagnosis of Plantar Fasciitis
Dr. Verville can diagnose plantar fasciitis by asking specific diagnostic questions and completing a full examination of your foot in her Frisco office. During your appointment she will:
- Determine where your pain is coming from
- Find out how much tenderness and swelling you have in your foot
- Test your ankle and foot reflexes
- Determine the flexibility, alignment, and range of motion of your injured foot
If you have been experiencing swelling, pain, or stiffness in your foot that has been present for more than two weeks, it is best that you make an appointment to visit Dr. Verville at RNV Podiatry so that she can get you back in action.
Can Walking Make Plantar Fasciitis Worse?
Obviously, Frisco residents can’t completely avoid walking when they have plantar fasciitis, but if they do it incorrectly, it could make their symptoms worse. Walking habits that make plantar fasciitis worse can include:
Walking on hard surfaces
Walking too fast
Wearing shoes that do not fit properly
Walking too much at one time
Preventing Added Pain When Walking with Plantar Fasciitis
So, in truth, the act of walking is not in itself what causes plantar fasciitis to get worse. It’s how you walk that matters. In order to avoid increased or added pain when walking, be sure to:
Wear shoes that fit you properly
Ice your feet when you are done walking to help reduce inflammation
Avoid walking on very hard surfaces for prolonged periods of time
Wrap your feet to increase support
Stretch your feet when you have finished walking
Wear shoe inserts to add cushion and provide extra arch support
Verville Is Just A Phone Call Away
If you are suffering from plantar fasciitis, call Dr. Verville at her Frisco area office today to book an appointment. She will be able to fully examine your feet, and with over 10 years of experience, she will be able to put you on a path to recovery.
You can reach her office by calling (214) 385-8822 today!
Signs You May Have Plantar Fasciitis
How Long is The Treatment Process for Plantar Fasciitis?
Why is Plantar Fasciitis Worse in the Morning?
Does Standing for Long Periods of Time Worsen Plantar Fasciitis?
Plantar Fasciitis – Causes, Symptoms, Treatment, Diagnosis
To find out where this condition gets its name, we need to look at a specific area of the foot. Your foot is made up of bones, muscles, tendons, and ligaments. The plantar fascia is a relatively inflexible, strong, fibrous band on the bottom of the foot that supports the arch of your foot.
Beginning at the heel bone, the plantar fascia extends the length of your foot to connect with your toes at the ball of the foot. When you walk, your weight is distributed across your feet. Any imbalances in the mechanics of your foot and distribution of weight can potentially cause pain.
Diseases involving inflammation end with “itis.” This explains the name of the condition as being an inflammation of the plantar fascia, thus plantar fasciitis.
Repetitive movements such as walking or running stretch the plantar fascia. Because it is not very flexible, this can cause small tears in the fascia, which leads to inflammation and pain. Other factors such as high arches, fallen arches, or a change in the walking surface contribute to the stress placed on the plantar fascia and heel.
A variety of causes exist for plantar fasciitis. Some of the most common causes include:
- excessive weight load on the foot due to obesity or prolonged standing
- mechanical imbalances of the foot
- osteoarthritis and rheumatoid arthritis
- sudden increase in body weight (e. g., pregnancy)
- sudden increase in walking or running
- tight calf muscles is a very common cause of the disorder
- wearing shoes with poor support, including flip-flops or high-heels
Having very high or low foot arches increases risk of developing plantar fasciitis. Other disorders that increase risk include rheumatoid arthritis and psoriatic arthritis.
Another cause of pain is the shortening of the plantar fascia overnight due to the ankle bending, causing the toes to point towards the ground. The plantar fascia stretches in the morning when you stand. The act of lengthening it causes a great deal of pain. However, this is not limited to an overnight occurrence – it can happen any time the foot is flexed (i.e., pointed) for extended periods of time. For example, driving in the car for long periods can cause fasciitis in the right foot, which steps on the accelerator.
Symptoms and Complications
People with this condition sometimes describe the feeling as a hot, sharp sensation in the heel. You usually notice the pain first thing in the morning when you stand. After walking for a period of time, the pain usually lessens or even disappears. However, sharp pain in the center of the heel may return after resting for a period of time and then resuming activity. The pain is usually worse when pushing off with the heel.
Making the Diagnosis
Physical examination is the best way to determine if you have plantar fasciitis. Your doctor examines the affected area to determine if plantar fasciitis is the cause of your pain. The doctor may also examine you while you are sitting, standing, and walking.
It is important to discuss your daily routine with your doctor. An occupation in which you stand for long periods of time may cause plantar fasciitis.
An X-ray may reveal a heel spur. The actual heel spur is not painful. The presence of a heel spur suggests that the plantar fascia has been pulled and stretched excessively for a long period of time, sometimes months or years. If you have plantar fasciitis, you may or may not have a heel spur. Even if your plantar fasciitis becomes less bothersome, the heel spur will remain.
Treatment and Prevention
Your doctor will determine what treatment is best for your condition.
The most common treatments for plantar fasciitis include:
- avoid aggravating activities such as excessive running, dancing or jumping
- icing the affected area
- inserting gel heel cups into your shoes
- massaging the plantar fascia
- nonsteroidal anti-inflammatory drugs (NSAIDs)
- physical therapy
- steroid injections
- strengthening the foot
- wearing a night splint
- avoid walking barefoot
- wearing shoes with arch support
- physical therapy
- stretching the calf muscles
- shockwave therapy or radiotherapy
- topical pain or anti-inflammatory creams
To keep the plantar fascia lengthened as you sleep, your doctor may ask you to wear night splints. In the morning, taking your first steps is less painful because the plantar fascia remains stretched throughout the night.
Avoiding activities such as walking or running helps the healing process. Losing weight, if it is a factor in the condition, may help to reduce the stress placed on the plantar fascia. Taking shorter strides while walking can help reduces stress on the plantar fascia.
Surgery is not a common treatment for this condition. Less than 5% of people with plantar fasciitis require surgery if non-surgical methods do not help to relieve pain within a year. The surgical procedure involves making an incision in the plantar fascia in order to decrease the tension of the ligament.
Potential risks of this surgical procedure include:
- irritation of the nerves around the heel
- continued plantar fasciitis
- heel or foot pain
- flattening of the arch
- problems relating to the anesthetic
There is some limited evidence to support the use of chiropractic treatments such as manipulative therapy of the ankle or the foot combined with multimodal or exercise therapy to manage pain for those who suffer from plantar fasciitis.
All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Plantar-Fasciitis
Common Conditions Causing Heel Pain
What causes heel pain?
The heel is the largest bone in the foot, and is often prone to injury due to overuse. Heel pain may range from mild to disabling, depending on the severity of the condition. The pain may be caused by inflammation, trauma, or a systemic disease such as rheumatoid arthritis.
We explain 2 common conditions that often lead to heel pain – plantar fasciitis and Achilles tendonitis.
1. Plantar fasciitis
Plantar fasciitis refers to an inflammation of the plantar fascia, which is a thick fibrous band that connects your heel to the front of your foot. The plantar fascia supports the arch of the foot and absorbs pressure, and when it is inflamed or torn, putting pressure on the foot may result in sharp pain. Although the exact cause of plantar fasciitis is not clear, wearing inappropriate shoes, heavy work demands, obesity, running, and abnormal foot mechanics are some of the probable causes.
Symptoms of plantar fasciitis
Plantar fasciitis causes pain in the bottom of the heel, which extends into the arch of the foot. The intensity of pain may vary; the pain may be sharp or may feel like widespread soreness in the area surrounding the heel and the arch. A common symptom of plantar fasciitis is a stabbing pain that occurs when you take your first steps in the morning. The pain usually decreases as the day progresses with use of the foot, but may return after long periods of standing or when you stand up from a sitting posture.
Who is at risk of plantar fasciitis?
While the cause of this condition is unclear, there are factors that can increase your risk of developing plantar fasciitis:
- Age – the condition is more common among those aged 40 – 60
- Flat feet, high arches, or tight calf muscles
- Obesity – extra pressure on your feet due to significant body weight
- Medical conditions such as arthritis
- Exercises that repeatedly impacts the plantar fascia such as running
- Standing for extended periods
- Wearing high-heeled shoes
2. Achilles Tendonitis
The Achilles tendon is the largest and strongest tendon (tissue connecting a muscle to a bone) in the body, connecting the calf muscles to the heel bone. The Achilles tendon helps you in walking, running and jumping.
Achilles tendonitis refers to the inflammation of the Achilles tendon. It can be caused by any activity which causes repetitive stress to the tendon, such as playing basketball or running. A sudden increase in the amount or intensity of exercise activity may also lead to Achilles tendonitis. Another condition which may cause Achilles tendonitis is a bone spur, which are bone projections caused by conditions such as inflammation and degeneration.
Symptoms of Achilles tendonitis
A common sign of Achilles tendonitis includes pain in the back of your heel that worsens with activity. You may also experience severe pain the day after exercising. Other symptoms include swelling along the tendon, and tenderness or stiffness, which may improve with mild activity. However, it is also possible that you may not have any signs or symptoms.
Who is at risk of Achilles tendonitis?
Achilles tendonitis is more common in men than in women. Other risk factors for Achilles tendonitis include old age, a naturally flat arch in the foot, obesity, and tight calf muscles. Medical conditions such as psoriasis or high blood pressure and use of certain medications such as antibiotics may also increase your risk of Achilles tendonitis.
What are the treatments available for heel pain?
Conservative treatment methods include resting, icing the affected area, and stretching. You may consider physical therapy to learn the appropriate exercises for stretching the affected area and building up supporting muscles. A night splint or arch support may also be recommended to aid recovery.
If these measures do not seem to work, your doctor may recommend steroid injections or shockwave therapy. Shockwave therapy is a non-invasive procedure that uses mechanical high energy sound waves to target the affected area and stimulate healing. Patients can expect pain reduction and improvement in functionality of the affected area after the treatment.
If the pain is severe and both conservative and non-invasive treatments are ineffective, surgery may be required.
When should you see a doctor for your heel pain?
The exact cause of heel pain may be difficult to identify as the different conditions may have similar and overlapping symptoms. Consult a doctor if you observe any of the following symptoms:
- Difficulty in walking
- Heel pain that occurs at night or while resting
- Persistent heel pain
- Swelling or discolouration of the foot
- Signs of an infection
Receiving prompt treatment can aid recovery and prevent complications, allowing you to resume your daily activities.
Article reviewed by Dr Kevin Koo, orthopaedic surgeon at Mount Elizabeth Hospital
Foot problems – heel pain, retrieved on 02 November 2020 from https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/foot-problems-heel-pain
Foot and Heel Pain, retrieved on 02 November 2020 from https://my.clevelandclinic.org/health/articles/10060-heel-pain-common-causes-symptoms-and-treatments. (14 December 2017)
Plantar fasciitis, retrieved on 02 November 2020 from https://www.mayoclinic.org/diseases-conditions/plantar-fasciitis/symptoms-causes/syc-20354846.
Achilles Tendinitis, retrieved on 02 November 2020 from https://orthoinfo.aaos.org/en/diseases–conditions/achilles-tendinitis/.
Effectiveness and Safety of Shockwave Therapy in Tendinopathies, retrieved on 02 November 2020 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6029898/
90,000 Heel pain
Possible causes. Due to the spongy structure of the calcaneus, the large number of nerves and blood vessels passing through it, it is very vulnerable and sensitive to injury or disease. Damage to many nerve endings leads to constant pain when walking, difficulty, and sometimes inability to step on the heel.
Pain when resting on the heel can occur due to many reasons, conventionally divided into several groups:
factors not associated with any disease;
diseases with direct damage to the structures of the foot;
diseases affecting the osteoarticular apparatus;
How to proceed? It is worthwhile to see a doctor in a planned manner. No emergency action required.
Which doctor should I contact? To a rheumatologist, orthopedic surgeon. You may need to consult other “narrow” specialists – an oncologist, infectious disease specialist, surgeon or neurologist.
What studies are indicated? The scheme of diagnostic measures is determined after a physical examination of the patient.Taking anamnesis and complaints to clarify the presence of chronic or recent diseases, visual objective examination with palpation of the painful area allow the doctor at this stage to make a preliminary diagnosis and prescribe the necessary examinations.
First aid. Reduced to the creation of the most sparing regime until pathology is detected:
rest more and exclude everyday long walks or being on your feet;
refuse shoes with uncomfortable high-heeled shoes or no shoes at all;
reduce weight with obesity;
use instep supports or wear orthopedic shoes;
to engage in therapeutic exercises for the feet (if the likelihood of injury is excluded).
Why do your legs hurt? 14 Possible Causes From Flat Feet to Diabetes | Healthy life | Health
The most innocent pain in the legs arises from banal fatigue. It passes without a trace by itself, and we will not take it into account. Let’s talk about more serious things.
This is an inflammation of the inner lining of the arteries.
Symptoms. Acute pain and numbness in the legs occurs when walking after the first 50–100 steps.A short rest – and the symptoms disappear, only to return after two dozen steps. Therefore, a person is forced to periodically make stops along the way. Pain in the foot or calf can be troubling even when you are lying down, but if you lower your leg down, the discomfort decreases.
What to do. Quit smoking (nicotine is the main risk factor for vascular ischemia) and contact a vascular surgeon. The doctor will prescribe a set of studies: MRI, angiography, ultrasound of blood vessels, various blood tests (including for nonspecific factors of inflammation).In case of severe sudden pain, it is better to call an ambulance – this may be a sign of blockage of a large artery. In this case, there are only a few hours during which the leg can be saved. The disease is treated conservatively and surgically (vascular plastic is used).
Atherosclerosis of the arteries
Symptoms. Compressive calf pain and cramps worse when walking, running, climbing stairs, and may bother at night. Cold feet in winter and summer. Lack of clear pulsation on the big toe.In men – the disappearance of hair on the toes and problems with potency.
What to do. Stop smoking and see a vascular surgeon. For diagnostics, ultrasound, magnetic resonance contrast angiography is used. Timely treatment will save you from gangrene and amputation.
Symptoms. Acute “twisting” pain in the joint area when walking or standing for a long time, the joints themselves are deformed and begin to “click”.The pain is worse when the weather changes. Soreness, swelling, redness in the joint area.
What to do. Visit a rheumatologist as soon as possible, have an X-ray of the joints and a general clinical blood test. The diagnostic and at the same time also the therapeutic method is arthroscopy. Treatment is only complex, therefore, in addition to taking medications, you will need special orthopedic devices, physiotherapy, diet, exercise therapy, etc.
Symptoms. Pain in the hips.
What to do. Ultrasound of the pelvic organs.
Symptoms. In the calf muscles – constant throbbing pain, often turning into a burning sensation. Redness and swelling, painful lumps along the veins.
What to do. Go to a vascular surgeon immediately. Do an angioscanning – to assess the veins along their entire length, to determine the degree of their “blockage”, to identify the threat of a thrombus rupture.Pass a blood test for nonspecific factors of inflammation. Most patients can be treated on an outpatient basis under the supervision of a physician.
Consequences of fractures
Symptoms. Severe pain when walking.
What to do. Wear special orthopedic devices – orthoses. They allow the injured limb to move, and the muscles to remain in good shape, but at the same time take on some of the load.
Symptoms. Sharp, sudden pain in the heel, usually while walking or running. Often, the only medicine that can heal your heel pain is time, and while awaiting relief, go swimming and cycling.
What to do. Wait is just the case when time heals. Lose weight: being overweight is a risk factor. See a podiatrist and have an x-ray done. For treatment, anti-inflammatory drugs, special transverse massage and laser therapy, orthopedic insoles and heel tabs are used.
Symptoms. Cramps occur in the legs (especially at night), swelling, weakness and pain, the skin on the legs becomes dry, peeling and itching appear. Often the legs “go numb”, they have crawling, tingling sensations.
What to do. Donate blood for sugar.
Symptoms. Leg cramps and severe pain in the calves are some of the manifestations of calcium deficiency. The problem is more typical for women over 40.Blue-eyed blondes are at particular risk.
What to do. Make a painless study – densitometry (measurement of the level and density of bone tissue in the body). If it is found to be deficient, the doctor will prescribe special calcium preparations.
Symptoms. Pain in the muscles of the thighs is twitching, pulling or cutting. It can increase with physical overload, damp or cold weather.
What to do. See a neurologist. For treatment, anti-inflammatory drugs are used, as well as pain relieving ointments and gels.
Symptoms. Sharp throbbing pain in the big toe at any time of the day or night, regardless of the load. The thumb is swollen, reddened, hot and very sensitive.
What to do. A simple examination by a rheumatologist and a blood test from a vein is sufficient to make a diagnosis. Gout is treated with non-steroidal anti-inflammatory drugs (NSAIDs) and uric acid suppressants.At the initial stage of the disease, it is enough to simply change the diet: limit alcohol, meat and fish dishes, rich broths, spicy snacks and seasonings, mushrooms, legumes, tomatoes, spinach, coffee, cocoa, chocolate.
Symptoms. Dragging unpleasant pains intensify towards the end of the working day. Legs “buzz” so that you want to lie down and throw them higher.
What to do. Wear compression hosiery. It will relieve pain and temporarily slow down the development of the disease.But that doesn’t solve the problem. Therefore, at the first alarming symptoms, you need to go to a vascular surgeon and do an ultrasound scan of the veins (Doppler ultrasound). Further treatment will be prescribed by a doctor. In the early stages, the disease is treated conservatively: injection sclerotherapy.
Symptoms. “Shooting” pain in the legs can be troubling even at rest, but intensifies with increasing load and sudden movements. However, rest does not lead to relief.Pain along the back or side of the leg from heel to buttock is a sign of sciatica (sciatica) inflammation.
What to do. Contact a neurologist or spine surgeon. An MRI (magnetic resonance imaging) can help detect a strangulated intervertebral hernia. After analyzing the data, the doctor decides which treatment to choose – conservative or surgical.
Symptoms. Aching pain in feet and legs, which worsens towards evening.Fatigue when walking.
What to do. See an orthopedist. We’ll have to forget about high heels and shoes with narrow toes. Make foot baths with sea salt. Perform special exercises, wear instep supports prescribed by a doctor, and not purchased at the nearest market.
90,000 Heel hurts. What does heel pain mean? Heels of feet hurt and how to treat
The heels are an integral part of the foot. They consist of bone and a soft layer of fat.This structure helps the legs to withstand the significant loads that occur when walking and running. The heel tissue relieves the pressure generated during movement and protects the spine from possible injury. Together with the foot, they act as a shock absorber.
The heel bone is filled with blood vessels, nerve fibers and tendons that increase the sensitivity of this part of the foot to external trauma. It is not difficult to damage it, and, as a result, pain will be felt when walking. The greater likelihood of injury is largely due to the anatomical structure of the heels.
It hurts to step on the heel in the morning after waking up
Pain in the heel in the morning is a frequent occurrence. Painful sensations appear immediately after sleep. One has only to get out of bed – and an unpleasant pain covers almost the entire foot. You have to walk on tiptoes, since it is painful to completely step on your foot.
Gradually the pain goes away, but may return after prolonged sitting or lying position. An unpleasant syndrome makes itself felt immediately after a person steps on his foot.
The reason for this condition is plantar fasciitis
. Heel pain is the main symptom of this condition. In most cases, painful sensations are caused by inflammatory-degenerative changes occurring in the plantar (plantar) connective tissue membrane – the fascia.
Reasons contributing to negative processes:
- Foot overload. It arises when:
- wearing shoes, sandals or flat boots;
- significant and rapid increase in physical activity;
- being constantly on your feet, this is due to the type of production activity;
- quick set of extra pounds.
- Flat feet, in which the arch of the foot drops and the plantar sheath is overly stretched. The result is micro-injuries that cause pain.
Inflammation of the fascia can become chronic over time. This process leads to the deposition of calcium salts in the area of inflammation. A bone growth is gradually formed – a heel spur. It causes pain, especially unpleasant in the morning.
It hurts to step on the heel: possible causes
The causes of painful sensations can be combined into several groups.
I. Systemic ailments:
- Ankylosing spondylitis (ankylosing spondylitis)
– chronic inflammation of the joints and spine. The cause of the disease is the hostility of the human immune system to the tissues of the ligaments and joints of its own body. The vertebrae are fused with one another, and the spine is no longer flexible and mobile. Often it is pain in the heels that is the first symptom of the disease. She is so excruciating that she does not allow her to stand on a hard floor.
- Rheumatoid arthritis
is one of the most severe joint ailments. It proceeds with multiple complications. Painful syndrome initially appears only during movement. When the inflammation increases, painful sensations can wake up at night and disturb until morning.
. This metabolic disease is characterized by the accumulation of urate crystals in the form of uric acid in various tissues of the body. Acute pain appears in the joints.They turn red, hot, and swollen. Gout most commonly affects the joints of the thumb on the lower extremities, spreading pain to the heel bone.
- Heel bone contusion
, which is further accompanied by inflammation of adjacent tissues. Burning pain is felt under the heel, as if it had been pierced with a sharp arrow. She becomes unbearable when trying to stand on a bruised leg.
- Calcaneus fracture
.Pain syndrome is born in the area of damage. The heel is deformed inward or outward. The entire foot is swollen and covered with small bruises. It is impossible to step on the foot: the pain does not allow.
- Tendon rupture or sprain
. It is better not to bend the sole: the sensations are very painful.
- Sever’s disease (calcaneal epiphysitis)
. The disease manifests itself in the form of a micro-rupture of connective tissue fibers in the area of the calcaneus. Pain on the side and back of the heel worries.It can be felt on palpation of the foot, but mainly occurs with active movement.
ІІІ. Inflammatory ailments:
IV. Infectious diseases:
- Bone tuberculosis
. It begins with necrosis of large areas of the skin or with fusion of bone matter. The infectious process covers a large area, provokes the formation of purulent fistulas. After a few weeks, it may stop and the person will be in remission. But more often the disease leads to limb deformity and lameness.
- Reactive arthritis
. Urogenital and intestinal infections that occur in a latent form provoke ailment. Heel pain is not limited to walking. They are often disturbing at night. At the same time, the painful sensations are quite strong and more unpleasant than in the daytime.
- Osteomyelitis of the calcaneus
– a purulent-necrotic process caused by bacteria. It develops in the bone and bone marrow and covers the surrounding soft tissues. The painful sensations are sharp and boring, bursting from the inside.They intensify with the slightest movement. At the same time, the heel becomes red and swollen.
V. Other diseases:
- diabetes mellitus;
- malignant neoplasms;
- neuropathy of the tibial nerve.
Only a doctor can diagnose a specific disease. It is necessary to consult a rheumatologist or traumatologist. You may also need a consultation with a neurologist, surgeon, oncologist.
Heel Pain Therapy
After passing the examination, the specialist prescribes complex therapy.Its composition depends on the cause of the pain.
To reduce pain and its prevention, you should use the following recommendations:
- Pay attention to the selection of the right footwear. Let it be more expensive, but more convenient and comfortable. The most acceptable heel height is 4-5 centimeters.
- If you have excess weight, you should work to get rid of it. Excessive pounds overload the muscles of the feet.
- Do a little exercise for the legs. It includes flexion and extension of the feet for two or three minutes.Exercising is best done while sitting. It’s a good idea to roll the massage ball with your bare feet, and try to pick up some small objects with your toes.
- If possible, walk barefoot on the sand and grass.
Treatment of heel pain with folk remedies
Many traditional medicine tips are effective in reducing painful sensations. Here are some methods:
- Contrast foot baths. You need to prepare two dishes: one with warm water, the other with cold water.Feet should be dipped in them one by one and kept for several minutes. Then wipe your feet dry and put on cotton socks.
- Relaxing baths. Add 100 grams of sea salt and a teaspoon of pine extract to warm water (4–5 liters). Dip your feet into the bath and hold for a quarter of an hour. The second way of carrying out the procedure: chop the cabbage stump with a grater and pour boiling water; leave to brew for half an hour and add a little hot water. In such a bath, you should hold your feet for twenty minutes.
- Transform 0.25 kg of iris root into gruel. Pour in the same amount of vodka and leave in a dark room for a couple of weeks. The tincture is used to prepare compresses: moisten a bandage, attach to the heel and wrap it with plastic wrap. Remove the bandage in the morning. It is necessary to use compresses with iris for at least twenty days in a row.
- Prepare a mixture of honey and mummy. The components should be dissolved in the following amount: 2 tablespoons of honey (tablespoons) and 5 grams of mummy. Homemade ointment should be applied to the heels before bed.
Propolis, black radish, lilac flowers, garlic, potato gruel are also used.
Folk remedies can be used in parallel with taking medications and carrying out the procedures prescribed by the doctor.
The simple methods described above can only temporarily relieve discomfort. To stop heel pain from bothering you, you need to diagnose the cause of the problem. This can only be done by a specialist.
The life of a modern woman, as a rule, passes on her feet.Therefore, leg pain, especially acute heel pain, becomes a serious problem for many women
Why does heel pain occur?
Acute heel pain can be caused by a variety of factors. It is important to know that you should not endure heel pain for a long time, since the disease that caused it can progress and turn into a more dangerous form. In order to get rid of discomfort when walking and restore health to your legs, you need to find out what caused the heel pain.
The causes of pain in the heel can be both external negative factors and a number of different diseases.
External causes of heel pain
- Uncomfortable shoes – a sharp transition from a high heel to a completely flat, non-shock-absorbing sole, will burn and lead to acute pain in the area of the foot and heel.
- Excessive sports activity – if pain appears after jogging, you should temporarily prefer another type of physical activity.
- Bruises and injuries are also one of the causes of heel pain. If the occurrence of pain was preceded by an injury, you should try not to step on the injured leg and consult a doctor as soon as possible.
Diseases that can cause heel pain
- Cracked heels – those people who have not encountered such a phenomenon as cracked heels do not even know how much discomfort they bring. Deep cracks in a thick layer of hardened skin can cause severe pain when walking and even bleed.
- Plantar fasciitis is an inflammation that develops in a dense connective tissue formation, which is located in the form of a wide strip on the plantar surface of the foot. It’s called the plantar fascia. A common symptom of heel pain is usually associated with stretching and subsequent inflammation of the fascia where it attaches to the calcaneal tuberosity. If the fasciist is not treated in a timely manner, calcium salts can be deposited at the site of chronic inflammation, which lead to the formation of a heel spur.
- A heel spur is a bony growth on the plantar surface of the heel bone. The main symptom of a heel spur is pain, especially acute in the morning, when a person has just got out of bed. You can determine if you have a heel spur with an ultrasound or X-ray of your foot.
- Chronic inflammatory diseases of the joints – rheumatoid, reactive, psoriatic arthritis, ankylosing spondylitis – diseases associated with metabolic disorders. The pain in this case is due to acute inflammation of the calcaneal tendons.You can determine if you have one of these diseases using a blood test and a doctor’s examination.
How to treat heel pain?
Heels can hurt for a variety of reasons
Treatment for heel pain depends on the underlying cause.
- Uncomfortable shoes – if you have to walk in heels for a long time, try to pick up a comfortable last, sit as often as possible with your shoes off. To avoid a sharp transition from a heel to a flat sole, which greatly increases the load on the heel, you can purchase home slippers with a small heel or platform.
- Cracked heels – the first step is to consult a dermatologist in order to exclude the possibility of fungal infection of the feet. Dry skin is another cause of cracked heels. This is especially acute in the summer, when we wear open shoes. To prevent the appearance of deep cracks, it is necessary to moisturize the soles of the feet with creams and remove the keratinized skin using pedicure devices.
Plantar fasciitis – there is no universal treatment for this disease.But there are several ways to alleviate the condition and prevent further development of the disease:
first of all, you need to reduce the load on the legs, try to refrain from doing sports related to running or walking for a while;
to reduce swelling and pain in the legs, ice should be applied to the feet, you can also take over-the-counter pain relievers based on ibuprofen;
Before getting out of bed, do a foot warm-up, which includes stretching the calf.
- Inflammatory processes in the heel area – the cause of the inflammation, can only be determined during a medical diagnostic examination.Do not delay going to the doctor, as the disease can progress and lead to serious complications.
Heel spur – complex treatment of a heel spur includes:
Unloading the foot from excessive pressure;
the use of thrust bearings and orthopedic insoles;
physiotherapy: mud applications, mineral baths, ultrasound therapy;
drug therapy – local administration of corticosteroids;
in extreme cases – surgery to remove bone growth.
Reactive arthritis – if inflammation of the heel area is the result of diseases such as chlamydia, gonorrhea and other genital infections, they must be treated urgently. Distinctive symptoms of reactive arthritis, in addition to pain in the heels, worse at night, are discomfort in the genital area, inflammation of the joints, eyes.
First aid for heel pain
To quickly relieve heel pain:
- Place an ice cube on the arch of the foot and move it along the arch of the foot from the toes to the heel.
- Place your feet in a basin of room temperature water.
- A pain relieving tablet based on ibuprofen (Ibufen, Markofen, Nurafen, Solpaflex) will help relieve pain.
- The heel and the area of the foot above it can be smeared with any ointment with anti-inflammatory and analgesic effect (indomethacin, hydrocartisone, butadiene, cartek, pelan, etc.).
Gymnastics to strengthen the arch of the foot and relieve heel pain
- Knead the feet and calves with gentle massage movements.
- Lying on the bed with your legs straightened, pull your foot towards you until you feel a slight pain, and then stretch the sock as far as possible.Do this exercise slowly 5-7 times.
- Walk on your toes, then on your heels, stretching the arch of your foot as much as possible.
- Using the outer arch of the foot, perform several toe raises.
- Spread a towel on the floor, then use your toes to fold and smooth out the folds, then lift the towel up.
- Roll the small massage ball with the arches of your feet.
The human foot contains 24 bones that form a transverse and longitudinal arch.Every day, it is on the feet that a large load is placed, they help to keep a person balance, soften tremors when walking and give support to the whole body.
In youth, legs rarely create problems for us, at an older age, problems with joints begin, and this is understandable. But why do the heels of the feet hurt, why does such a symptom bother at a young age and how to treat the ailment? Pain in this area signals a disturbance in the functioning of the body and you need to know what to do so that discomfort does not spoil the usual rhythm of life.
When foot pain bothers you, pay attention to the shoes you are walking in. If it is a heel higher than 5 cm or a thin stiletto heel, then the foot is overloaded. Standing work, strong sports loads, excess weight, lifting weights and many other factors provoke the appearance of pain.
The causes of pain in the feet can be a variety of factors, acquired and congenital: from traumatic injuries to complications of other diseases:
Traumatic injuries to the feet, in which the patient feels pain, is a sprain, fracture or dislocation.Stretching is characterized by swelling and severe discomfort. With a fracture of the bones, the leg also swells, and severe pain does not allow to step on the injured limb.
- Neoplasms and inflammations
Another cause of pain is benign growths in the tissues of the soles of the feet. At the same time, nerve tissue (neuroma) grows. Such formation occurs more often in women on one leg, and affects the base of the fourth or third toe. The neuroma is characterized by moderate pain, and only when the condition is neglected, the foot hurts severely.
Heel spurs are growths and cause severe pain in the back of the foot, which makes the person unable to stand or walk.
Joint inflammation (arthritis) is diagnosed by hyperthermia of the skin over the joint and its redness. In this case, the fingers are constrained in their movement and swollen.
- Congenital anomalies
Flat feet are a congenital cause of foot pain. Flat feet are characterized by touching the floor of the entire plane of the foot, it does not perform the spring function, quickly gets tired and hurts.This ailment rarely occurs in a person throughout his life. Acquired flat feet are associated with increased body weight or with the constant carrying of weights, a fracture of the bones of the foot or ankles.
- Other diseases
Other diseases cause pain in the feet. In this case, their pain syndrome is regarded as a complication: with untreated varicose veins, vein thrombosis occurs, the veins become clogged and this provokes pain in the feet. Varicose veins provoke inflamed veins or phlebitis.Often these consequences occur at the same time. Diabetes mellitus leads to the formation of the so-called diabetic foot, which also makes itself felt with pain.
Important! When feet hurt, a person tries to walk so that the pain is less. From this, the gait changes, the distribution of the load on the spine and muscles is disturbed, and this entails even greater problems with the musculoskeletal system.
As statistics show, most often patients complain of plantar fasciitis – an inflammation or tear of a strip of fibrous connective tissue that covers the entire sole from the heel to the toes.Sources of fasciitis can be both uncomfortable shoes and a violation of the structure of bones due to heavy loads, flat feet and other mechanical problems with the legs.
Heel pain can also be caused by inflammation of the tendon tissue, which is accompanied by a “needle-in-the-heel” sensation. Rheumatoid arthritis is another source of heel pain. In such a situation, doctors recommend wearing open-heeled shoes.
Pain when walking
Heel spur is the main cause of heel pain.
Painful feelings of the heel when moving the foot provoke such ailments: fasciitis, heel spur, arthritis and inflammation of the Achilles tendon.
Fasciitis of the sole is a dense neoplasm that is localized in the connective tissue and spreads along the perimeter of the entire foot.
Such consequences are caused by wearing uncomfortable shoes, in which the foot does not feel free, for a long time. At the site of the inflammatory process, the accumulation of salts begins and a heel spur forms.
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Heel spur is a chronic ailment. Salts that accumulate on the sole cause a build-up on the heel bone. This growth cuts into soft tissue when a person walks, which provokes severe pain.
When a person “paces” throughout the day, the soft tissues get used to a foreign body, and the pain weakens a little, but in the morning everything repeats. Heel pain when walking further increases in intensity.
It hurts after sleep
Heel pain after sleep and in the morning provoke the following diseases: heel spur, arthritis, reactive arthritis and other ailments.
Pain in the heels after sleep is often caused by arthritis. Arthritis is inflammation of the joints. It captures the bones along the foot that connect the heel and toes. Painful sensations with such a disease increase gradually, increasing its intensity. In the morning, the pain is stronger, it subsides with a light massage.After walking or other exertion, the pain returns again.
Soreness manifests itself not only when walking, but also at night, when the legs are absolutely calm. In some situations, discomfort accompanies the patient throughout the entire time.
Pain in the morning
Infectious diseases cause heel pain.
Sore heels in the morning or throughout the day provoke infectious processes in the body.This number also includes sexually transmitted infections. These are such ailments as chlamydia, gonorrhea, ureaplasmosis or latent intestinal infections (salmonellosis, dysentery, and others).
An infection that progresses in the human body provokes inflammation of the heel tendon tissue. This leads to reactive arthritis.
There are a number of other ailments that cause this discomfort in the heel area. Gout can cause soreness. It develops against the background of inflammation of the chronic nature of the human body, as a result of which the metabolism is disrupted.
In addition, inflammation of the eyes and joints joins the inflammatory process of the heels, there is discomfort in the region of the reproductive system.
Pain in the back of the heel
This symptom occurs in calcaneal apophysitis (inflammation of the nucleus of the forming calcaneus). The disease manifests itself in adolescence (9 – 13 years), and more often affects boys. The same lesion is characteristic of both heels. A sick child complains of pain in the back of the heel after sports activities or long walking.
You can see how he avoids rolling of the foot when walking, and fixes it at a right angle to the lower leg. Pain can pass, and then come back again after regular sports. In this case, up to the age of 13, additional loads on the legs will have to be completely eliminated.
In adults, pain in the back of the heel may be a sign of Achillodynia (inflammation of the heel sac, which is made up of connective tissue and surrounding the Achilles tendon). You may notice a slight swelling in the area of attachment of the Achilles tendon (this is behind the calcaneus) and an increase in skin temperature.Characterized by increased pain in the lower leg and ankle joint in a motionless state, as well as during sports. Touching the back of the foot is very painful.
Important! Pain in the back of the calcaneus can also manifest as calcaneal exostosis. This disease is similar to the heel spur, but differs from it in that the pathological growth of bone tissue is observed not on the plantar side of the heel, but behind it. Most often affects young women.
The disease lasts for a long time, and is accompanied by severe bursitis (inflammation of the mucous bags, normally protecting the ligaments from friction with each other).This disease is treated in the same way as the heel spur.
Pain in the middle of the heel
This pain is characteristic of Achilles bursitis (bursitis in conjunction with inflammation of the Achilles tendon). The disease affects the area of attachment of the Achilles tendon. Therefore, it is characteristic that pain in the middle of the heel increases with flexion of the foot or movement in it.
With a load on the leg, the nature of the pain practically does not change. The back of the heel looks swollen and painful to touch.The disease is chronic. Treatment is carried out by a doctor with complete rest of the limb.
The specialist talks about the causes of heel pain in this video:
If you rule out the possibility of accidental injury, your heel constantly hurts for a long time – perhaps it is the cause or consequence of various diseases:
- Arthritis, bursitis An inflammatory process that affects the tissue along the foot and connects the heel bone to the toes.In this case, the pain builds up gradually. Worst of all in the morning if you massage your legs, the pain subsides, but may return after standing on tiptoe or walking up stairs.
- Plantar Fasciitis The sole fascia is a dense formation in the connective tissue that extends along the entire sole of the foot. With constant and prolonged wearing of uncomfortable tight shoes, an inflammatory process in this area can begin. The development of such a disease is accompanied by the deposition of salts in the inflamed part, which can lead to the formation of a heel spur.
- Calcaneal spur Chronic inflammation of the plantar fascia. This build-up on the heel is deeply distressing. The heel hurts especially badly in the morning when a person gets out of bed. During the day, in the process of walking, the pain subsides a little. But as soon as you sit for a while, the painful sensations resume with a vengeance.
- Achilles tendon inflammation When your legs hurt while walking, it is possible that Achilles tendon inflammation is developing.In this case, the focus of pain is concentrated above the heel or below it from the side of the sole.
- Reactive arthritis Some infections (chlamydia, sexually transmitted diseases) can also be accompanied by pain in the feet. Latent infections can provoke reactive inflammation of the heel tendons. In the case of such a disease, the heels hurt constantly, the pain is especially strong at night.
- Other diseases Inflammatory processes in the heel area can also be caused by diseases such as gout (ankylosing spondylitis).With this chronic inflammation of the joints, metabolic disorders in the body occur.
If you have one of the listed diseases, only a doctor can help get rid of heel pain. You should go to an appointment with a traumatologist or rheumatologist and get expert advice from a specialist.
Treatment of foot pain depends on its cause. If the pain has arisen due to problems with the vessels, then the circulatory system is treated, and if the discomfort is caused by a disease of the joints, flat feet or injury, then the treatment can be complex – strengthening bones, blood vessels, removing puffiness, correction with shoes or insoles.To do this, a patient who feels discomfort in the legs should consult an orthopedic surgeon.
It does not matter if there is pain in the heel when walking or when calm, to get rid of this symptom, you need to treat the underlying disease. When the patient undergoes a complete examination and the cause has been determined, the doctor will prescribe appropriate therapy for him.
For a while, analgesic drugs can relieve pain, these are Ketorol and others. But by taking pain relievers, they will not relieve you of the cause of the pain, but will only eliminate the pain itself.Therefore, you should undergo an examination and begin to treat the underlying ailment.
If the cause of the pain is an infection, antibiotics are prescribed. There is no single remedy, each bacterium is sensitive to a certain type of medicinal substance. It can be drugs in tablets, for genital infections – and in the form of suppositories. Sometimes antimicrobial injections are required.
In the treatment of arthritis and gout, NSAIDs are used – Diclofenac, Ibuprofen and others.They relieve inflammation and pain.
The following drugs are prescribed for therapy:
- broad-spectrum antibiotics;
- medicines against fungi;
- antiviral drugs.
As an additional procedure, patients are recommended to exercise therapy complexes. This treatment is aimed at improving the flexibility and elasticity of muscles, capillaries and blood vessels, as well as increasing their strength.
Various physiotherapy and massages provide effective treatment for pain in the feet.
In addition to drug treatment, specialists prescribe procedures that improve the performance of the feet, as well as get rid of pain in this area. For this purpose, shock wave therapy or magnetic resonance manipulation is prescribed.
For patients with such problems, it is imperative to wear comfortable shoes, special orthoses and instep support insoles. In cases where conservative methods of treatment do not give results, direct surgical intervention is used.
Operations are often prescribed for serious foot injuries and when the patient is sick with an acquired disease.
Gymnastics is used for treatment.
In addition to drugs, gymnastics for the legs is prescribed. With heel pain, doctors recommend giving up walking and jogging. Better to go cycling, swimming. And with flat feet, in addition to gymnastics, pay attention to shoes.
These are the exercises:
- Tennis ball exercise: roll it between the feet;
- Stretching the feet with a towel: grasp the foot under your toes with a towel, pull up;
- Stretching the Achilles tendon – for example, heel squats.
An excellent and effective exercise for people with plantar fasciitis is rolling the feet of a golf ball for 2 minutes. Massage can help relieve swelling and pain. Pluck your heel several times. Then rub the heel firmly with your fingers. From the heel, move to the Achilles tendon and repeat the same movements. It is effective to use ice for massage.
Often patients ignore referral to a specialist, try to relieve heel pain and cope with the problem on their own.Traditional medicine for the treatment of heel pain exists, but they may not give the desired result, in which case a visit to the doctor is necessary.
The first methods of relieving heel pain with folk remedies are as follows:
- salt baths;
Salt foot baths are taken hot. Dissolve 300 grams of salt in one liter of water.
Important! If the patient’s pain is caused by trauma or provoked by osteoporosis, then salt baths are prohibited.
Homemade ointments and tinctures for grinding are very simple to prepare:
- The ointment is made from garlic by grinding it into a gruel consistency.
- Put the egg in a glass of vinegar essence. The egg is taken out after 10 days, peeled and its contents are rubbed. About 35 grams of oil is added to the resulting liquid and the heels are smeared with such an ointment overnight.
- Shilajit is used to lubricate the painful area: 5 grams of this substance is dissolved in 100 grams of honey.The process takes place in a vessel heated by a water bath. Then rub the heel with the mixture.
- Rubbing is carried out using a tincture of dry lilac and vodka, in a ratio of 1: 1. The tincture costs 10 days, then it is used.
- Warm the sore spot with pepper poured into the sock. Apply to the surface of the heel and iodine mesh. You should walk like this all day.
- Grate raw potatoes, put in a plastic bag and put them on your leg so that the potatoes touch the sole.Put on a tight sock on top. Keep for 2-3 hours, repeat daily at night, course – 1-2 weeks.
- Steam the leg in a hot bath: for 1 liter of water add 2 tablets of furacilin and analgin, 1 tbsp. l. honey and 2 tbsp. l. apple cider vinegar. After a hot bath for 20 minutes, place a clay cake on the foot. Keep until it starts to warm. To be treated like this until the condition improves.
- Compress with black radish helps well. To do this, wash the radish and grate on a fine grater together with the skin.Put the gruel on a rag (by the size of the foot), then – a plastic bag and a thick sock. Do this daily at night until the pain goes away.
- Boil peeling potatoes and whole small potatoes, pour them into a bowl and wait until they cool slightly so that you can endure. Mash the mashed potatoes, gradually adding lugol (1 bottle for 1 procedure). Hold your foot with this mixture until it cools, then put on wool socks. The course of treatment is 1 week.
- Put fresh knotweed (knotweed) grass in your shoes and walk like that all day.The next day, replace the grass with a new one.
- Mix 1 tbsp. spoon with top of honey, 1 bottle of iodine (50 ml), 1 teaspoon of fine salt “Extra”. This amount of the mixture is designed for 5 procedures. Before going to bed, apply the mixture to a cotton swab or bandage, apply it to the heel, cover it with polyethylene on top and bandage it so that the bandage does not slip off during sleep. Remove the bandage in the morning. It is possible that in 5 nights you will get rid of your heel spur. For preventive purposes, it is recommended to repeat this treatment after six months.
Another way is to knead boiled potatoes in their uniforms with your feet. The procedure is carried out until the potatoes cool, then rinse the feet with warm water.
The use of orthopedic insoles prevents heel pain.
In order to get rid of painful sensations in the heel area when moving and in a state of calm, the underlying disease that led to this symptom should be cured. It is possible to reduce the manifestation of pain in the heel by following these recommendations:
- use of orthopedic shoes;
- Wearing orthopedic insoles, in particular for flat feet;
- the heel should not exceed 5 cm, but wearing shoes without a heel is not recommended;
- struggle with excess weight, as it provokes an increase in the load on the feet;
- Remedial gymnastics and exercise for the feet.
To relieve sudden, severe pain in the heel, apply a piece of ice wrapped in a cloth to it. Keep it cold for 20 minutes.
If heel pains when walking or in the morning touched you, do not rush to self-medicate, consult a therapist. It is important to detect at an early stage the disease that led to the pain and start treating it. If you do not do this and ignore the advice, then there is a possibility of complications.
For more information on heel pain, watch the video:
Pain in heels or feet is not uncommon, which causes discomfort and does not make it possible to do the usual things. In this case, you should not only familiarize yourself with common situations and their solution options, but also pay attention to going to an experienced specialist, because you cannot do without medical help, as this may be a sign of a serious problem that cannot be dealt with at home at home. it will work, but you can only make it worse.Read on in another article about how and how to cure it.
This article summarizes the main problems associated with heel pain and suggests known solutions, but this information is offered for informational purposes only.
Why and what to do if heels of feet hurt folk remedies
Knotweed or burdock can help with heel pain. The grass is placed in shoes or socks, which are not removed throughout the day. Compresses made from grated potatoes or shabby black radish along with the peel also help relieve pain.Compresses can be done at night by wrapping a plastic bag around your leg and wearing socks.
What to do if feet and heels hurt how to treat
The cause of pain in the feet and heels of the legs can be primarily overweight, an inactive lifestyle, flat feet or improperly fitted shoes. Massages of the feet, baths with crushed ice (one heel is immersed in the water), as well as rolling the feet of a small ball help to relieve pain syndrome.
Medicines and pain relieving ointments must be prescribed by a doctor.
Why do heels and calves hurt, reasons
Pain in the calves of the legs can be caused by intense physical exertion. Also, the cause of pain in the calves of the legs can be hidden in the feet – if a person has flat feet, or vice versa, the rise is too high, and he stays in uncomfortable shoes for a long time. Sometimes the pain is caused by a tear or inflammation of the Achilles tendon, inflammation of the veins, or narrowing of the arteries. In general, a doctor’s verdict is required.
Why does the heel on the left leg hurt when walking, treatment with folk remedies
People associate heel pain with heel spurs.Sometimes 30-minute compresses of kefir or warm boiled crushed potatoes with the addition of a tablespoon of kerosene help to calm it down.
Why do the heels and feet of both feet hurt in the morning in men
Pain in the heels and feet of both legs in the morning – symptoms of inflammation of the plantar fascia, arising from the accumulation of salts in the area of inflammation. This leads to the formation of a bone growth, popularly referred to as a heel spur.
Pain in this disease can disturb not only in the morning, but also after a short rest.If you do not see a doctor, the condition will only worsen.
Why does the heel hurt? It hurts to step on how and how to treat it
In addition to external causes (uncomfortable shoes, excessive exertion, bruises), pain in the heel can be triggered by plantar fasciitis, heel spurs, rheumatism, psoriatic arthritis, ankylosing spondylitis, etc. Take the survey and get an answer to your question.
Why do heels hurt so much, if it’s not a spur
In most cases, pain in the heels, if it is not a spur, can occur for several reasons, namely, due to:
– improper posture;
– long standing on the legs;
– significant physical activity;
– loads associated with the transfer of weights;
– Injuries and sprains of the tendons.
Why do heels hurt from running, shoes, heels, standing work, cold, slippers
Permanent overstrain of the arch of the foot leads to pain in the heels, especially when the wrong shoes, too high heels or overweight (with obesity). Symptoms of pain in the heels are also inherent in a number of diseases – rheumatoid arthritis, gout, Bekhterov’s disease, osteomyelitis and injuries – tendon sprains, tears, bruises and fractures.
Why do heels hurt if you stand for a long time, stand, walk, after a long walk
You can find out the cause of heel pain from a surgeon, neurosurgeon, traumatologist, orthopedist, neurologist, since there are more than enough reasons for this – heel spur, arthritis, tendon injuries, plantar fasciitis, etc.d.
Why do heels hurt during and after pregnancy in pregnant women
During pregnancy, the growing fetus makes the woman involuntarily lean back. Naturally, the greatest load in this case falls on the heels, which is why painful sensations arise in them. This is fine.
“Feeling of a hammered nail at every step”! – this is how patients describe heel pain and believe that it occurs only because of the heel spur.What is a spur? The plantar fascia starts from the median prominence of the calcaneus and attaches to the metatarsal heads. A calcaneal spur arises on the anterior surface of the calcaneal tuberosity at the insertion of the plantar aponeurosis.
When walking, at the moment of heel lift-off, the fascia is pulled. When wearing uncomfortable shoes, flat feet, sports overloads, this tension can become excessive and lead to chronic inflammation of the attachment site of the fascia to the heel bone. When the foot is overloaded, there is a slow stretching of the plantar aponeurosis, detachment from the attachment site to the heel, and gradual calcification of the attachment site.
This process is slow, stretching over the years. Subsequently, calcium salts are deposited in this place, and the picture shows a horizontal “spike” up to 2 cm long (heel spur). Thus, the heel spur is the outcome, not the cause of the disease. When the heel starts to hurt due to tendon inflammation, the bone “spike” is not yet visible on the X-ray. The presence or absence of a heel spur does not in any way affect the diagnosis and treatment of heel pain. Many people have heel spurs on radiographs and have never had pain in their heels.When this osteophyte matures completely, it does not hurt.
So, heel pain should never be blamed on the “notorious” heel spur. What then could be the cause of heel pain
? And many other serious illnesses make their debut or manifest as heel pain. Only a specialist can make an accurate diagnosis and prescribe a competent treatment. With pain in the heel, the main thing is not to miss a serious illness that can lead to surgery and disability.
Risk factors for heel pain are overweight, high-heeled shoes, flat feet, chronic overloading of the feet, sports injuries, heel contusions when jumping from a height. In this article, we will not discuss the traumatic causes of heel pain. Fractures, dislocations, bruises, sprains require treatment from a traumatologist.
Heel pain: symptoms.
Heel pain causes considerable distress with every step. The clinical picture largely depends on the disease that caused the pain in the heel.Heel pains can be aching, dull, sharp, burning, shooting. More often, heel pain bothers when walking. Sometimes pain occurs even at rest, at night, disturbing sleep. The nature of heel pain, as well as the underlying cause, may vary.
Diseases in which there is pain in the heel.
Plantar fasciitis or heel spur
“. The main symptom of the disease is acute pain under the heel, especially pronounced during the first steps after sleep or long rest.The pain can be so severe that during the first minutes patients move with support on the edge of the foot or toes, avoiding stepping on the heel. After a few steps, the pain in the heel is noticeably reduced. On palpation, the middle of the heel from the plantar side is sharply painful. If such a painful point is absent, then the diagnosis is in doubt.
(inflammation of the Achilles tendon and its bursae). The Achilles (calcaneus) tendon attaches the calf and soleus muscles to the calcaneus.The cause of heel pain is long-term chronic overstrain or acute situational overload of the gastrocnemius muscle, taking anabolic steroids or frequent blockade with corticosteroids. Achilles bursitis occurs primarily in athletes, ballet dancers and dancers, often accompanied by tears or ruptures of the tendon.
Pain localized above the heel and on the back of the lower leg, accompanied by lameness and inability to stand on the toes. Clinically, there is tenderness, swelling, and redness on both sides of the Achilles tendon.The calf muscles are tense and painful. Pain in the heel and calf worse in the morning, the patient, when getting up, can hardly lean on the sore leg.
Bursitis of the posterior bursa of the Achilles tendon
often develops as a result of excessive friction and pressure from an uncomfortable heel counter. But it can be an early symptom of rheumatoid arthritis. Such bursitis is clearly visible above the calcaneus, as a round, painless subcutaneous mass.
Ankylosing spondylitis, reactive arthritis
may debut with “spontaneous” heel pain in young adults even before the onset of typical clinical manifestations of the underlying disease.
Reactive arthritis in infections (chlamydia, ureaplasmosis) has characteristic signs: pain in the heels worries not only when walking, but also at rest, increases at night. In addition to pain in the heels, other joints, eyes become inflamed, urethritis appears (Reiter’s disease).
occurs when a prolapsed L5-S1 disc herniation occurs. When the S1 root is compressed, the pain spreads along the back of the leg below the knee to the heel.The Achilles reflex falls out, the sensitivity in the heel is impaired.
in the zone of ossification of the calcaneal tubercle occurs in adolescents 12-15 years old. A delay in realigning this zone during growth causes severe heel pain. The disease is treated conservatively, the effect is weak. In most cases, heel pain goes away on its own after the child stops growing. In adults, this pathology does not occur.
Very rarely, heel pain occurs with tumors, osteomyelitis, tuberculosis.
When should I see a doctor urgently?
- when very severe heel pain occurs;
- The intensity of pain in the heel increases with time;
- for redness, swelling of the heel area;
- with an increase in body temperature.
Which doctor to contact
if your heel hurts? In case of acute trauma, consultation with a traumatologist or surgeon is necessary. In other cases, you should visit a therapist who will prescribe an examination and refer, if necessary, to a rheumatologist, orthopedist or neurologist or other specialist for consultation.
Diagnosis of heel pain.
Complete blood count
(leukocytes, ESR) confirms inflammatory processes in the body. The higher the leukocytes and ESR (erythrocyte sedimentation rate), the stronger the inflammation. An increase in ESR in combination with nocturnal pains indicates a rheumatic disease.
Blood test for rheumatic tests.
In rheumatic diseases, the level of CRP is sharply increased. Negative rheumatic tests rule out rheumatic causes of heel pain.A positive rheumatoid factor supports an association of heel pain with rheumatoid arthritis.
Blood test for antibodies
to chlamydia and ureaplasma, scraping from the urethra allows you to exclude reactive arthritis with pain in the heels.
displays bone changes in the heel area, excludes traumatic causes of heel pain, swelling, osteomyelitis, bone tuberculosis.
MRI of the calcaneus
helps to detect the earliest changes in cartilage, tendons, ligaments.MRI of the lumbosacral spine confirms the presence of a herniated disc in radiculopathy.
Heel pain treatment
depends on the reason. Different diseases require a different approach to treatment. To reduce pain in the heel, there are general rules:
- to limit the time you are on your feet;
- Provide rest of the lower limb for 2-3 weeks;
- abandon high heels;
- to reduce weight in case of obesity;
- to use instep supports, insoles or orthopedic shoes;
- to engage in physiotherapy exercises for the feet.
Non-steroidal anti-inflammatory drugs (NSAIDs) can help relieve pain during inflammation. Long-term uncontrolled use can cause stomach or heart problems. Be careful with self-medication.
With Achilles bursitis for external use, you can use compresses with Dimexidum or medical bile, ointments with NSAIDs. You should be careful with warming ointments and compresses. In case of injuries, edema, warming up procedures are contraindicated. In this situation, it is better to apply an ice pack wrapped in a towel to the sore spot for 10-15 minutes.
Physiotherapy and mud therapy are shown. If the tendon is torn off, surgical treatment is required. With a “heel spur”, ointments, compresses, laser therapy, acupuncture and physiotherapy have no effect. Shock wave therapy relieves pain well.
In case of inflammation, a sharp pain in the heel is quickly relieved by therapeutic blockages with corticosteroids directly at the source of the pain. But they should be carried out by competent doctors, strictly according to indications, no more than 3 procedures at one point. Frequent administration of corticosteroids tends to tear the tendon, so it is dangerous to abuse this method!
Rheumatoid arthritis should be treated by a rheumatologist.The constant intake of specific basic drugs, non-steroidal or steroidal anti-inflammatory drugs is shown. With radiculopathy, treatment is carried out by a competent neurologist.
For urogenital infections, antibiotics are prescribed under the supervision of a dermatovenerologist. For tumors, tuberculosis, osteomyelitis, specific treatment is required from specialized specialists.
In my hands, the best treatment for heel pain is interstitial electrical stimulation. Only 2-3 VTES procedures relieve the patient from pain in the heel for several years, or even for life.
Calcaneal spur (plantar fasciitis)
Plantar fasciitis (plantar fasciitis) is one of the most common causes of pain in the heel bone. This disease is caused by inflammation of the fascia, which is located on the plantar surface of the foot from the heel to the toes. The main function of the fascia is shock-absorbing and supporting.
Plantar fasciitis usually causes stabbing pain that usually occurs from the first steps in the morning
Plantar fasciitis usually causes stabbing pain that usually occurs from the first steps in the morning.In a position where a person does not lean on the foot, the pain usually disappears, however, renewed static-dynamic loads after standing up from a sitting position can resume it again.
Plantar fasciitis is especially common in runners. Overweight people and those who wear uncomfortable shoes with insufficient arch support are also at risk.
Plantar fasciitis typically causes stabbing pain in the plantar part of the foot near the heel.The pain usually gets worse from the first steps after waking up. It can also be caused by long periods of standing.
In everyday life, the fascia acts like a shock-absorbing bowstring to support the arches of the foot. Repeated stretching and micro-tearing of the fascia can lead to inflammation.
Factors that can increase your risk of developing plantar fasciitis include:
- Age. Plantar fasciitis is most common between the ages of 40 and 60.
- Some types of exercise . Some sports, such as running, dancing, can put undue stress on the heel bone and surrounding tissues, thereby causing inflammation.
- Disorders of foot biomechanics . If the patient has flat feet, due to the uneven distribution of weight, it causes stress and overload of the plantar fascia.
- Obesity. Excessive pounds put additional stress on the plantar fascia.
- Occupations related to long-term stay on the feet . Factory workers, teachers, and others who spend most of their work time walking or standing on hard surfaces are prone to developing plantar fasciitis.
Complications Ignoring plantar fasciitis can lead to chronic heel pain that interferes with your daily activities.By adjusting the load and taking preventive measures, you can minimize the chances of getting plantar fasciitis.
Tests and diagnostics
During a physical examination, the doctor checks the points of greatest pain in your foot. Localizing the pain can help determine the cause.
Usually, specific tests are not used to diagnose fasciitis. Diagnosis is based on medical history and physical examination.Sometimes your doctor may suggest x-rays, ultrasounds, or magnetic resonance imaging (MRI) scans to make sure your pain is not caused by another problem, such as a stress fracture or a pinched nerve.
Sometimes on a radiograph, the doctor can diagnose a heel spur protruding forward from the calcaneus. In the past, these bone spurs were thought to be to blame for heel pain and were therefore surgically removed. However, today it is known that many people who have bone spurs on the heels may not feel pain at all.
Most people who develop plantar fasciitis can get rid of it with conservative treatment within a few weeks.
Pain relievers such as ibuprofen and diclofenac may relieve pain and inflammation associated with plantar fasciitis.
Stretching and strengthening exercises, or the use of specialized devices, may provide symptom relief.These include:
- Kinesiotherapy. Your rehabilitation therapist may instruct you to do a series of exercises to stretch the fascia and Achilles tendon and strengthen the muscles in the foot, which stabilize the ankle and heel. A physical therapist can also teach you how to use an athletic (elastic) band to support your foot.
- Night tires. Your therapist or physician may recommend wearing a splint that will fix the bones in the arch of your foot while you sleep.This temporary immobilization will keep the fascia and Achilles tendon in a stretched, relaxed position and facilitate the relief of the arch of the foot overnight.
- Orthopedic structures . Your doctor may order you to wear a specific insole or heel pad to help distribute the load more evenly on your feet.
If conservative treatment is ineffective, your doctor may recommend:
Steroid Injection .Injecting steroids into the fascia may provide temporary pain relief. Multiple injections are not recommended as they can weaken the fascia and possibly rupture it and reduce the fatty tissue surrounding the heel bone.
One of the most modern, fast and effective treatments for plantar fasciitis is radiofrequency ablation
Extracorporeal shock wave therapy . In this procedure, the action of sound waves is directed to the painful areas of the calcaneus, in order to stimulate the blood circulation processes and reduce the painful focus of the lesion.This procedure is commonly used to treat chronic plantar fasciitis that does not respond to other conservative treatments. This procedure can also cause side effects such as swelling, numbness or tingling sensations, and studies have shown that it is not always effective.
Radiofrequency ablation. One of the most modern, fast and effective treatments for plantar fasciitis is radiofrequency ablation. This method allows you to get rid of the pain syndrome for a long time.
Surgery. Few people need surgery to remove the fascia from the heel bone. This option is considered only if the pain is very severe, and all other methods are ineffective. Side effects include weakening of the arches of the foot.
Lifestyle & Home Remedies
To reduce pain from plantar fasciitis, try these personal care tips:
- Maintain a healthy weight. This minimizes stress on the plantar fascia.
- Select arch support shoe . Avoid high-heeled shoes. Buy shoes with low heels and good instep supports. Do not walk with bare feet, especially on hard surfaces.
- Do not wear worn athletic shoes . Replace your old athletic shoes before they no longer support the cushioning of your foot. If you are a track and field athlete, buy new shoes after about 3,000 kilometers.
- Change sport . Try a sport with a low axial load on your feet, such as swimming or cycling, rather than walking or jogging.