Heel Compression Syndrome

with Rehab

ExitCare ImageHeel compression syndrome causes shrinkage (atrophy) of the heel pad, which causes heel pain. A fat pad exists beneath the heel bone (calcaneus) that absorbs shock and other forces that are applied to the foot. Shrinkage of this tissue results in an inability to withstand normal forces applied to the foot.

SYMPTOMS

  • General pain on the bottom of the heel.

  • Pain that gets worse when running on hard surfaces or in a shoe with poor shock absorbers.

  • No swelling or increased warmth.

  • Less cushion on bottom of the heel.

CAUSES

Heel compression syndrome is caused by shrinkage of the heel pad, after the age of 30. This process may be increased with distance running or with fracture of the heel bone or other injury to the heel.

RISK INCREASES WITH:

  • Sports that require running on a hard surface.

  • Prolonged standing.

  • Poor strength and flexibility.

  • Shoes with poor absorbers.

  • Obesity.

  • Flat feet.

  • Fracture of the heel bone.

PREVENTION

  • Warm up and stretch properly before activity.

  • Maintain physical fitness:

  • Strength, flexibility and endurance.

  • Cardiovascular fitness.

  • Maintain a healthy body weight.

  • Avoid activities that place constant or repeated strain on the foot.

  • Wear properly fitted and padded shoes.

  • Change shoes every 300 to 500 miles.

  • When possible, run on soft surfaces.

  • Wear a heel lift to reduce pressure to the heel (pushing weight to the front of the foot).

  • Emphasize cross training.

PROGNOSIS

If treated properly, heel compression syndrome may be cured. However, sometimes heel compression syndrome results in a chronic condition.

RELATED COMPLICATIONS

Frequently recurring symptoms, resulting in a chronic problem that often affects your ability to compete.

TREATMENT

Treatment first involves ice and medicine to reduce pain and inflammation. It is important to perform exercises that stretch the heel cord, and to modify activities that aggravate symptoms. These exercises may be performed at home or with a therapist. You may find changing shoes or using a heel insert helpful in reducing pain and discomfort. There are no surgical procedures that exist to treat this condition.

MEDICATION

  • If pain medicine is needed, nonsteroidal anti-inflammatory medicines (aspirin and ibuprofen), or other minor pain relievers (acetaminophen), are often advised

  • Prescription pain relievers may be given if your caregiver thinks they are needed. Use only as directed and only as much as you need.

HEAT AND COLD

  • Cold treatment (icing) relieves pain and reduces inflammation. Cold treatment should be applied for 10 to 15 minutes every 2 to 3 hours, and immediately after activity that aggravates your symptoms. Use ice packs or an ice massage.

  • Heat treatment may be used before performing stretching and strengthening activities prescribed by your caregiver, physical therapist, or athletic trainer. Use a heat pack or a warm water soak.

SEEK MEDICAL CARE IF:

Symptoms get worse or do not improve in 2 weeks, despite treatment.

EXERCISES

STRETCHING EXERCISES - Heel Compression Syndrome (Fat Pad Atrophy)

These exercises may help you when beginning to rehabilitate your injury. Your symptoms may go away with or without further involvement from your physician, physical therapist or athletic trainer. While completing these exercises, remember:

  • Restoring tissue flexibility helps normal motion to return to the joints. This allows healthier, less painful movement and activity.

  • An effective stretch should be held for at least 30 seconds.

  • A stretch should never be painful. You should only feel a gentle lengthening or release in the stretched tissue.

ExitCare Image STRETCH – Gastroc, Standing

  • Place your hands on a wall.

  • Extend your right / left leg behind you, keeping the front knee somewhat bent.

  • Slightly point your toes inward on your back foot.

  • Keeping your right / left heel on the floor and your knee straight, shift your weight toward the wall, not allowing your back to arch.

  • You should feel a gentle stretch in the right / left calf. Hold this position for __________ seconds.

Repeat __________ times. Complete this stretch __________ times per day.

ExitCare Image STRETCH – Soleus, Standing

  • Place your hands on a wall.

  • Extend your right / left leg behind you, keeping the other knee somewhat bent.

  • Slightly point your toes inward on your back foot.

  • Keep your right / left heel on the floor, bend your back knee, and slightly shift your weight over the back leg, so that you feel a gentle stretch deep in your back calf.

  • Hold this position for __________ seconds.

Repeat __________ times. Complete this stretch __________ times per day.

ExitCare Image STRETCH – Gastrocsoleus, Standing

Note: This exercise can place a lot of stress on your foot and ankle. Please complete this exercise only if specifically instructed by your caregiver.

  • Place the ball of your right / left foot on a step, keeping your other foot firmly on the same step.

  • Hold on to the wall or a rail for balance.

  • Slowly lift your other foot, allowing your body weight to press your heel down over the edge of the step.

  • You should feel a stretch in your right / left calf.

  • Hold this position for __________ seconds.

  • Repeat this exercise with a slight bend in your misc216 knee.

Repeat __________ times. Complete this stretch __________ times per day.