FACT: 70% of Patients Seen at Gotham Footcare in New York City suffer from Heel Pain
Where are you feeling the heel pain?
The most common cause of heel pain are either Plantar Fasciitis (pain at the bottom of the heel) sometimes called a heel spur syndrome when a spur is present or Achilles tendinitis (pain at the back of the heel). Heel pain may also be cause by a stress fracture, tendonitis, athritis, nerve irritation, and most rarely a cyst. A simple in-office x-ray can most of the time determine the cause of the heel pain.
If you have either heel pain you may be asking yourself
What is the best shoe types to wear for heel pain?
I recommend looking for a shoe that has a 1 inch heel or wedge height rather than one that is completely flat as it places less tension on the Achilles tendon and will feel more comfortable. I recommend avoiding shoes that are completely flat such as a flip flop, as they will contribute to pronation and collapse of the arch which may contribute to planter and posterior heel pain, shin splints, knee pain, and back pain. Walking with flip flops for prolonged periods of time allows our foot to collapse affecting our gait and posture, which can lead to a tremendous amount of stress not only to the foot but to the rest of the body. Our feet naturally pronate during the gait cycle, however when we wear flip flops we pronate for a longer period of time which then alters the biomechanics and distribution of pressure and weight across the foot. This imbalance may increase the progression of underlying foot deformities such as bunions and hammertoes and lead to painful conditions associated with excessive pronation such as arch/ heel pain, shin splints/ posterior tibial tendonitis, and Achilles tendonitis. This imbalance can then translate upward affecting other parts of the body such as our knees and back.
The same concept applies to flat sandals. Women’s sandals should have somewhat of a slight heel less than 3/4 inch in relation to the front. It’s actually better for you than sandals that are flat because it takes the stress off the Achilles which can help with the alignment of your posture, ankles, knees and spine. You should also ensure that the sandal is wide enough in the forefoot but also that the straps are not too loose to avoid injury. Make sure the sandal is also not flimsy in the middle. If it bends easily, you are not getting adequate support in the arch which will result in foot pain such as arch pain, heel pain. And, you don't want a sandal that your toes are contracting similar to flip flops. At every step your foot is exercising to hold on to the sandals and overtime it can cause foot pain, or imbalance issues.
On the other hand, high heels or stilettos are also very harmful to your feet. A square toe is better than a tight confined shoe with a narrow toe box, but generally these stilettos exceed the recommended heel height of 1.5 inches. The higher the heel, the shorter strides, which means more pressure is placed on the balls of your feet. This throws off your center of gravity putting unneeded and unnecessary stress on your knees and lower back.
Wearing high heels can cause tendonitis. When wearing high heels you put constant pressure on the Achilles tendon by shortening and tightening it. Repeated and extended wear of high heels shorten the tendon permanently. This leads to inflammation and pain when you wear flat shoes and forces the tight tendon to stretch.