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Heel pain can make even simple daily activities challenging, affecting comfort and mobility. One common area where pain occurs is at the back of the heel, where several key structures come together. This area is prone to discomfort due to the amount of stress and pressure it endures from standing, walking, running, and other activities.
The back of the heel houses the attachment point for the Achilles tendon, which plays a crucial role in movement. Constant use, improper footwear, or other conditions can lead to irritation and discomfort. Understanding what causes back side heel pain is the first step toward finding the right solutions.
The heel is primarily made up of the heel bone (known as the calcaneus) and the Achilles tendon. The calcaneus is the largest bone in the foot, responsible for supporting body weight and providing balance. The Achilles tendon connects the calf muscle to the heel bone, allowing for foot movement, including walking and running.
Around these key structures are important components that support movement and protect the heel from damage. These include soft tissues like ligaments, tendons, and the plantar fascia, a thick band of tissue supporting the foot arch. The plantar fascia is essential for maintaining proper foot alignment and distributing weight evenly.
Additionally, fluid-filled sacs called bursae act as cushions between the bones, tendons, and muscles. These bursae help reduce friction, protecting the heel and Achilles tendon from overuse injuries. Maintaining calf muscle strength and range of motion is also vital for keeping these structures functioning properly and reducing the risk of injury or strain in the heel area.
Back side heel pain can stem from a variety of conditions, and can significantly impact mobility and comfort. Let’s look into some of the most common causes of heel pain.
Achilles tendinitis and tendinopathy are common overuse injuries affecting the Achilles tendon. Repetitive stress from activities like running or jumping can cause stress and microtears in the tendon. Over time, this leads to pain and stiffness, especially after periods of inactivity. Proper footwear, rest, and strengthening exercises for the lower leg can help manage these conditions.
Haglund's deformity, also called "pump bump," is a bony enlargement that forms on the back of the heel bone. It occurs when there is constant friction between the heel and the back of the shoe, leading to irritation of the soft tissue. This condition is aggravated by rigid footwear, such as high heels, and can be managed by switching to more supportive shoes and using orthotics.
Retrocalcaneal bursitis can occur when the bursa located between the Achilles tendon and the heel bone is irritated. The bursa acts as a cushion to reduce friction during movement. When this bursa becomes irritated due to overuse, repetitive motion, or pressure from footwear, it can result in pain and swelling at the back of the heel.
Heel spurs are bony growths that form at the bottom or back of the heel bone. These spurs can develop due to repeated stress on the heel, such as from running on hard surfaces or wearing unsupportive shoes. Although heel spurs themselves may not always cause pain, they can lead to discomfort when they press against surrounding soft tissue.
Sever's disease is a common cause of heel pain in growing children and adolescents. It occurs when the growth plate in the heel bone becomes irritated due to repetitive stress, particularly in active children. The condition, also known as calcaneal apophysitis, is often linked to overuse and rapid growth, which puts stress on the calcaneus.
Similar to Sever's disease, calcaneal apophysitis is an overuse injury that affects the growth plate of the heel bone in adolescents. It usually presents as pain at the back of the heel, especially after physical activities like running or jumping. Addressing this condition requires rest, stretching exercises, and footwear modifications to reduce strain on the growing heel bone.
Heel pain can present with a range of symptoms that indicate an issue with the structures around the heel bone, Achilles tendon, or bottom of the heel. You may experience discomfort at the back of your heel or along the back of the heel bone, which can feel sharp or dull, depending on the activity. Swelling and inflammation near the Achilles tendon are also common, often accompanied by stiffness in the lower leg and calf muscles.
The pain may intensify after physical activity, and there might be a noticeable reduction in range of motion, making it challenging to walk on hard surfaces. If symptoms persist or worsen, an X-ray might be needed to diagnose potential stress fractures or bone spurs. These imaging tests are helpful in pinpointing the cause of pain, allowing for a more targeted treatment approach.
Several risk factors can increase the likelihood of developing back heel pain. Overuse is a major contributor, especially in activities that involve repetitive movements, like running or jumping on hard surfaces. This constant stress can lead to inflammation, microtears, and other injuries in the Achilles tendon and surrounding soft tissues.
Poor arch support, flat feet, and improper footwear can also play a significant role in heel pain. Shoes that lack adequate support can place additional stress on the heel bone and plantar fascia, leading to discomfort over time. Similarly, individuals with flat feet may be more prone to issues because of the altered distribution of pressure throughout the foot.
Certain sports that involve sudden movements or prolonged impact can contribute to overuse injuries. Activities like basketball, soccer, and long-distance running can place excessive strain on the Achilles tendon and heel, increasing the risk of conditions like tendinitis, heel spurs, and bursitis.
Additionally, previous sprains or injuries can weaken the heel's structures, making it more susceptible to further discomfort and issues in the future.
To determine the cause of heel pain, a healthcare provider will begin with a detailed medical history and physical examination. This helps identify any underlying factors, such as overuse or prior injuries, that could be contributing to the discomfort.
Imaging tests like X-rays are often used to check for bone spurs, stress fractures, or abnormalities in the heel bone. These evaluations are essential in ruling out other conditions and guiding an effective treatment plan. Consulting a healthcare provider is important for getting an accurate diagnosis and understanding the most suitable treatment options for heel pain.
Managing heel discomfort often requires a combination of home strategies, medical interventions, and supportive devices.
Here are some practical tips to help soothe discomfort and support mobility.
Resting the affected foot is crucial to allow the soft tissues to heal. Using an ice pack can help reduce swelling and provide effective relief when experiencing discomfort after activity.
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are helpful for managing inflammation and discomfort. These medications can offer temporary relief from heel pain caused by overuse or bursitis.
Orthotics and custom shoe inserts provide additional arch support and help redistribute pressure more evenly across the foot, which can be particularly beneficial for those with flat feet.
Physical therapy and targeted exercises can improve flexibility and strengthen the calf muscles and Achilles tendon. Maintaining a good range of motion is key to reducing strain on the heel.
Taping can help stabilize the heel during activity. Heel cups, splints, and supportive shoes are also recommended as part of a comprehensive treatment plan to provide added comfort and reduce the impact on the heel.
Compression wraps, socks, and ankle sleeves can help support healthy blood flow and can help ease discomfort. At Copper Fit, our compression wraps and socks offer graduated compression and soothing benefits, such as cooling technologies that help calm soreness and keep you comfortable throughout the day.
Preventing heel discomfort starts with proper arch support and wearing supportive shoes that fit well. This helps ensure your feet are well-protected during daily activities. It's important to avoid overuse by incorporating rest days into your routine, especially if you engage in high-impact sports.
Stretching and strengthening exercises for the calf muscle and Achilles tendon are key to maintaining flexibility and reducing the risk of injury. Make sure to use appropriate training surfaces — try to avoid hard surfaces, as they increase impact on the heel. Shoe inserts can also provide added comfort, reduce stress on the calcaneus, and protect against stress fractures.
Heel pain, particularly at the back of the heel, can significantly impact your mobility and quality of life. Common causes, like Achilles tendinitis, retrocalcaneal bursitis, and Sever’s disease, often result from overuse or improper support. Early intervention is essential for managing discomfort and preventing further injury.
A tailored treatment plan, including rest, physical therapy, supportive devices, and over-the-counter solutions, can help you regain mobility and reduce pain. Don’t let heel discomfort stop you from staying active. Taking proactive steps to prevent heel pain — such as wearing proper footwear, avoiding overuse, and stretching regularly — can help keep you moving comfortably.
For additional comfort and effective recovery, explore our full range of compression gear at Copper Fit. Let us support you on your journey to feeling better and enjoying an active, discomfort-free lifestyle.
Sources:
Achilles Tendon (Calcaneal Tendon): Function & Anatomy | Cleveland Clinic
How to use a cold compress or ice pack | St John Ambulance
Compression Clothing and Circulation Benefits | UPMC HealthBeat
