The most common cause of heel or rear foot pain is plantar fasciitis or as it is sometimes called, ‘heel spurs’. This condition occurs mainly in runners and is often associated with a biomechanical abnormality, such as excessive pronation/supination of the foot o stiff sub-talar joint. Pain is worse in the morning and improves during the day. There is a point of tenderness on the inside border of the heel bone that often extends along the inside border of the foot. Treatment involves avoidance of aggravating activity, ice, stretching, inserts for the shoes and wearing footwear with adequate support.
Fat Pad Syndrome
Another common cause of heel pain is the fat pad syndrome or contusion. This is also known as a ‘bruised heel’. This may develop acutely from a fall onto the heels or chronically from excessive heel strike with poor heel cushioning. Treatment involves rest, the use of a heel cup, good footwear and taping.
Calcaneal Stress Fractures
Calcaneal stress fractures result from overuse. They require X-ray and treatment as the fracture heals.