Pain in the lateral heel
definition
Pain can occur in many places around the ankle and heel. Although the pain is often localized in the lateral heel, it can be caused by the upper or lower ankle, calf, arch, ankles, or metatarsus.
The heel itself is a bony protrusion of the foot on which a person rests a large part of the body weight. It is padded with firm fatty tissue to cushion the occurrence in front of the heel bone. In technical jargon, the heel is called "Calcaneus" designated. Among other things, it has the important function of being the connecting link between the calf and metatarsus and forming the base and origin for the Achilles tendon and the longitudinal arch of the foot. Pain can be caused by many of the musculoskeletal features. Important differentiators are the type of pain and when it occurred.
causes
Pain in the lateral heel is most often caused by the calf muscles and the metatarsus. In this area there are important anatomical and filigree structures that enable complex movements in the ankle and foot and at the same time have to carry a high weight load through the whole body. The ankle joints are formed from the fibula and shin in the area of the lower leg, and from the ankle and heel bone in the area of the base of the foot. Lateral heel pain can be attributed to damage to the bony structures of these bones. Tendon and ligament structures can also be damaged and painful as a result of injuries or wear and tear.
Probably the most common cause of side heel pain is that Peroneal tendon syndrome. It occurs to very different degrees and is a common condition among endurance athletes. This can also happen quickly if you have just started sports or if you have poor footwear. Tendons behind the outer ankle that belong to the calf muscles are stimulated. Overuse or constant friction and irritation on the bones can cause the tendons to become inflamed and painful with every movement.
Another very common disease is the heel spur. Here, bony outgrowths, the so-called "spurs", form in the attachment of the Achilles tendon or the plantar tendon of the foot surface, which can lead to severe pain in the heel every time it occurs. This can be accompanied by the so-called "Subachillic bursitis“, A bursitis, which can also lead to severe movement-dependent pain. Less common causes of lateral heel pain can be a torn ligament or tarsal tunnel syndrome. The latter is a nerve entrapment in the area of the medial malleolus.
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My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
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Athletes (joggers, soccer players, etc.) are particularly often affected by diseases of the foot. In some cases, the cause of the foot discomfort cannot be identified at first.
Therefore, the treatment of the foot (e.g. Achilles tendonitis, heel spurs, etc.) requires a lot of experience.
I focus on a wide variety of foot diseases.
The aim of every treatment is treatment without surgery with a complete recovery of performance.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
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Further information about myself can be found at Dr. Nicolas Gumpert
Subachillic bursitis
Bursitis subachillea means translated "Inflammation of the bursa and Achilles tendon". Bursae are parts of the joint capsule that are filled with synovial fluid. They do not exist in all people, but are a variant of the joint capsule in which a small pouch has formed after an injury or without a cause. The bursa can become inflamed by bacterial or viral pathogens, but above all by mechanical friction and irritation. This leads to severe pain with pressure and movement, as the bursa is below the Achilles tendon. A common cause of mechanical irritation is the upper heel spur. The protruding bone can cause pain and irritation of the tendon and bursa with every movement of the Achilles tendon. In some cases, the inflamed bursa can tear. Surgery is often necessary to remove the bursa and remove the inflammation.
Read more about this under
- Inflammation of the heel
- The operation of a bursitis
Posterior heel spur
The posterior heel spur is significantly more common than the upper heel spur. It is a very common disease that more than one in three people suffers in their lifetime. The spur can often be seen in the X-ray image on the sole of the foot as a small protrusion of bone. However, the x-ray cannot provide any information about the pain. There may also be severe pain, although no abnormalities can be seen in the X-ray.
Heel spur is more of a disease of old age, but it is also more common in athletes. The pain can often be very severe, as the heel spur is not infrequently accompanied by local inflammation. In these cases, the foot must first be relieved. Padding in the shoe can also initially relieve the pain until the local inflammation has subsided. In the long term, physiotherapy in particular helps to improve the symptoms of heel spurs. New therapy methods, such as shock wave therapy or radiation, are also being researched. In rare cases, surgery can also alleviate the symptoms.
Read about this too Heel spur - what is it?
Peroneal tendon syndrome
The peroneal muscles are located in the calf and are particularly stressed during endurance sports such as jogging. In the area of the ankle, the muscle pulls its tendon around the outer ankle and then attaches to the foot. During this process, the tendon can become irritated by overuse and incorrect loading and become painfully inflamed.
Since the tendon participates in every movement in the ankle and rubs against the outer ankle, the pain occurs with every step. Experienced and inexperienced joggers are particularly at risk for peroneal tendon syndrome. Tendon irritation can occur if the patient is overstrained with frequent jogging, as can inexperienced, new, unfamiliar sporting activities. Often the latter result in incorrect loads, for example due to incorrect footwear. The most important first therapeutic measure is the sports leave. The tendon needs protection and time to regenerate. Even after the pain has subsided, further rest must first be observed in order to allow the tendon the necessary recovery.
Read more about this under
- Peroneal tendon syndrome
- Inflammation of the peroneal tendon
Outer ligament tear
A lateral ligament tear is a typical consequence of an ankle injury. The most common cause of the outer ligament tear is the so-called "Supination trauma". This means nothing other than an inward twist. As a result, the outer ankle often swells up due to a bruise.
The first steps after twisting an ankle consist of cooling, protection, elevation and compression. In most cases, the subsequent treatment consists only of rest and rest.
Read more about this under
- Torn ligament at the ankle
- Treatment of a ligament stretch
Tarsal tunnel syndrome
Tarsal tunnel syndrome is a very rare condition that can be accompanied by pain in the heel. Several nerves, which take on the muscle supply and sensitive perception in the calf and foot, pull over the ankle to their supply areas in the foot. The so-called "Tibial nerve“Runs in the area of the inner ankle close to the bone through the tarsal tunnel. In very rare cases, a broken bone, a bruise, or for no apparent cause, compression of the nerve can occur. As a result, the toes begin to tingle, then pain and become numb. A failure of the foot muscles can also occur. The nerve must be relieved promptly so that the restrictions do not persist permanently.
Read more about this under Tarsal tunnel syndrome
Concomitant symptoms
The accompanying symptoms can vary with the present cause and thus provide valuable information about the underlying problem.
If there is tingling or weakness in the foot, nerve damage should be considered.
Acute swelling and reddening often suggest a bruise, but local inflammation is also conceivable if there are other signs of inflammation such as overheating and pain.
Diseases of the bones and tendons are particularly characterized by the fact that the pain can be provoked by targeted movements and external pressure.
diagnosis
The most important steps to a diagnosis are the exact questioning and physical examination. Even if the causes appear numerous, the accompanying circumstances and precise complaints can severely limit the potential clinical pictures in advance. Further examinations can be carried out to confirm the individual suspected diagnoses. X-rays often provide additional information in the event of bone and tendon complaints. In the case of acute inflammation and complaints in soft tissue, an MRI examination can also provide important information.
treatment
Treatment should always be decided together with an orthopedic surgeon in the event of severe symptoms.
Many of the diseases of the tendons and ligaments can be cured by consistent and targeted rest and rest.
The heel spur is also initially spared. Then physiotherapy under professional guidance can eliminate the symptoms in the long term. In rare cases, operations can also be useful for symptoms such as heel spurs or peroneal tendon syndrome. Novel therapy methods with the help of shock waves or X-rays are being researched but not yet used across the board.
Duration
The duration depends heavily on the degree and type of discomfort. Much pain caused by tendon irritation, muscle discomfort or inflammation subside after adequate rest. The sooner the immobilization occurs, the faster the anatomical structures will recover. Even with a torn ligament or acute injuries to the ankle, a few weeks of rest can lead to freedom from symptoms. In many cases, healing progresses faster after operations, as stress and physiotherapy can start again at an early stage.
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