Heel pain is one of the most common types of ailments affecting both active and sedentary people all over the world. Whether you are a professional marathon runner or a server at your local coffee shop, you are bound to experience this type of pain at some point in your life.
And in most instances the diagnosis will be plantar fasciitis.
Now to be fair nine times out of ten the diagnosis is correct as plantar fasciitis remains the number one cause of chronic heel pain. Why? Well, let me take you back a few articles and give you a quick refresher on what plantar fasciitis is:
A Quick Overview of Plantar Fasciitis
Plantar fasciitis is a common overuse injury that affects the fascial sheath that stretches the length of your feet from the calcaneus bone, also known as your foot's heel bone. All the way to the base of your metatarsal bones, also known as your toe bones.
This condition occurs when the fascial sheath becomes irritated and inflamed and over time the fibers of the sheath get damaged and cause you to experience pain in that area. And although there are many causes, the most common cause is overuse. So think, overtraining or standing on your feet for hours at a time.
Now back to the introduction…
Okay so you’re all caught up? Great! But what if your heel pain isn’t plantar fasciitis. What if you’re an overachiever that just happens to fall into the minority percentage of those affected by heel pain? If that sounds like you, then you might want to pay attention to what we are about to say!
What Other Types of Heel Pain Can You Suffer From?
Heel pain can be caused by conditions other than plantar fasciitis. Your heel pain could be caused by something more chronic such as a heel spur. A heel spur is a bony protrusion that develops at the base of your heel. This bony outgrowth is caused by calcium deposits that accumulate over time as a result of persistent micro traumas to that area of the connective tissues of your foot.
Now on the other side of the spectrum your heel pain could also be the result of something far more acute, such as a stress fracture. This is usually caused by a sharp and exponential increase in loading leading to your heel bone “cracking under pressure” of this excessive sudden load.
Both of these conditions are distinct in their presentation, as one builds over time and the other has a far more sudden onset.
Okay, but what if you don’t fall into this category? You’re in luck, well as far as luck goes when referring to chronic inflammatory conditions that affect the base of our feet/heel area.
That’s because you might be suffering from a condition known as medial heel pain. And before you jump and complain about the fact that there are just way too many forms of heel pain. Just know that we totally agree with you. But that’s what makes this article so important. Because education on this topic leads to better understanding and ultimately more prevention.
What the Heck is Medial Heel Pain?
So as I was saying, medial heel pain is a condition that affects the medial aspect of the heel-ankle area (inside of the foot). This condition has a more scientific definition known as a TARSAL TUNNEL SYNDROME. Despite it sounding extremely dangerous, it is a neuromuscular condition with a similar presentation to that of carpal tunnel syndrome experienced in the wrist area.
In Tarsal Tunnel Syndrome, or TTS for short, the tibial nerve gets compressed as it passes through the connective tissues of the medial ankle and heel. This persistent compression can lead to micro traumas damaging the tibial nerve leading to the development of TTS.
Symptoms of Tarsal Tunnel Syndrome:
Additionally, these symptoms are a result of any combination of underlying causes that may lead to Tarsal Tunnel Syndrome developing. These causes include:
Now as you can see the list of causes of TTS is extensive, so you will need to consult your primary care physician or physician specialist to obtain an accurate diagnosis.
So, How do you Treat Medial Heel Pain?
The gold standard treatment of medial heel pain or TTS remains non-operative conservative approaches. Physical therapy is a great treatment modality as it will not only treat your symptoms but it will also focus on the underlying cause of your condition and attempt to correct it. That way the therapist can make sure that the issue doesn’t come back in the future.
However, there are cases where the conservative method unfortunately can’t be considered. This is usually when there was a traumatic injury that led to the compression and damage of the tibial nerve. In these situations surgical intervention is recommended and usually does resolve the problem completely. However, be prepared for an extensive post operative rehabilitation protocol with the physical therapy team.
Final thoughts…
Medial heel pain is a neuromuscular condition that can theoretically affect any one of us. Despite that, it remains a bit more rare in the “causes of heel pain” category. Regardless, if you do find yourself suffering from Tarsal Tunnel Syndrome, I recommend you take it easy. Consult with your physician and link up with your local physical therapist and I am sure that you will be back to your old self in no time!
