Pain in the heel

Tallonitis is an inflammatory pathology that denotes pain in the heel and includes various ailments.

The heel bone is the rearmost bone of the foot and the part that hits the ground first when walking, so it is constantly subjected to mechanical stress.
The heel forms the connecting element between the ankle and the ground; therefore, it plays a fundamental role in walking and running.
The generic term tallonitis includes diffuse pain under the heel or within its inner and outer perimeter; in this way, a differentiation is made from other heel complaints, such as heel spurs .
This pathology mainly affects football players and track and field athletes.


What are the causes of tallonitis?

Heel pain can be caused by physiological and anatomical changes in the foot, eg flat or pes cavus, i.e. a flattened or extremely pronounced foot arch.

A valgus or varus position of the hindfoot can cause the foot to strike the ground incorrectly, thereby increasing the load-bearing stress of the posterior or lateral structures of the ankle and heel.

Footwear can also be a trigger for heel pain, especially in athletes Also, women who usually wear high-heeled shoes and suddenly use sneakers can overload the Achilles tendon because it is now under more tension.

Athletes who play soccer, trekking, basketball, volleyball, track and field , and other sports that put extra stress on the feet are more likely to develop tallonitis.
The surface on which one runs or plays can be a cause or co-trigger for heel pain, because running on asphalt or hard ground continuously creates micro-traumas on the joints with every step.

Rheumatic pathologies such as rheumatoid arthritis or psoriatic arthritis and in particular gout often cause pain in the foot, especially the heel; Gout causes locally changing pain, which can appear in the front today and in the back tomorrow.

Other causes of heel pain:

Imbalanced athletic preparation or intense training sessions after a long break can traumatize the heel and cause pain. In older people, inflammation can develop due to age-related degeneration and thinning of the heel bone fat pad .

What are the symptoms of tallonitis?

The main symptom is pain , especially in the morning after getting up. During the day it decreases and disappears altogether; the symptoms may return when standing up after sitting for a long time.

How is the diagnosis made?

It is important to precisely locate the painful area ; For example, if the symptoms are concentrated in a point under the heel and are more internal, it could be a heel spur or an inflammation of the tendon plate (plantar fasciitis); If, on the other hand, the pain is behind and above the heel bone, this rather indicates an inflammation at the insertion of the Achilles tendon  (etc.). To diagnose tallonitis, the pain must be localized to a widespread area of ​​the heel, involve the entire lower area, or involve the entire circumference of the heel.

The most important imaging methods

  • -ray shows bony prominences (osteophytes) and heel spurs;
  • Ultrasound shows inflammation of the tendon plate under the sole of the foot ( plantar fasciitis), the Achilles tendon, and other tendon or ligament structures;
  • blood test provides information about uric acid levels and ANA (antinuclear antibodies) values, which can indicate a rheumatic disease such as gout or rheumatoid arthritis.
  • Magnetic resonance imaging is used extremely rarely; it displays all bone, muscle/tendon, ligament and capsule structures.

 What can you do? What is the right therapy for tallonitis?

The best form of therapy is to find and eliminate the cause of the heel pain, to heal the inflammation and prevent recurrence.

An athlete who has completed an excessive amount of training should allow themselves a break so that the inflammation does not worsen and become chronic.

The following measures can help to relieve heel pain :

  1. The painful area can be treated with cold compresses. The ice should be applied for 10-15 minutes at least twice a day, especially for the first two days.
  2. Wear appropriate footwear.
  3. Use silicone heel pads or orthotics.
  4. Apply a nighttime bandage .

Tecartherapy ® is very effective in relieving inflammation and correcting valgus or varus positions in the hindfoot in conjunction with orthopedic shoe inserts .
Stretching the tendon plate under the sole of the foot and the Achilles tendon is important to restore mobility to the foot and elasticity to the connective tissue.

Anti-inflammatory drugs can provide temporary relief, but alone they will not address the cause.
Cortisone injections will heal the inflammation but can weaken the tendons and tendon plates.
In the case of rheumatic diseases such as gout, drug treatment is carried out, which is prescribed by the rheumatologist.

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