The hiker's first tools are his feet. So, what could be more annoying for him than feeling pain at this level... In the range of pains felt while hiking, heel pain is frequently encountered.

What is heel pain?

Heel pain is the term used to describe pain in the heel: "tal" for heel, "algia" comes from the Greek word "algos" which means localized pain.

What causes it?

Among the causes of heel pain, we find mechanical causes related to the use of the heel during physical and sports activities, and non-mechanical causes related to external factors unrelated to heel stress.

Mechanical causes

Plantar fasciitis or plantar fasciopathy, and heel spurs are the main causes of heel pain.

The plantar arch, also called the plantar aponeurosis or plantar fascia, is a thick elastic tissue that serves as a cushion for the sole of the foot and contributes to its arched shape. It fans out from the heel to the toes.

Plantar fasciitis or plantar fasciopathy is an acute or chronic inflammation of this elastic tissue, which occurs during prolonged walking activities such as hiking, but also during sports activities involving jumping or running.

Flat feet and high-arched feet are more prone to suffer from these plantar arch pains while hiking.

They are sometimes associated with a heel spur, also known as a Lenoir spur. It is a pointed bony outgrowth on the heel bone known as the calcaneus. This is where the plantar aponeurosis attaches.

Its appearance can be a direct consequence of plantar fasciitis. It can also occur in overweight individuals or those who regularly wear high heels.

Achilles tendon pain during hiking

Achilles tendonitis is an inflammation of the sheath of the tendon that connects the calf muscles (the gastrocnemius) and attaches to the heel bone or calcaneus. This very powerful tendon is subjected to significant mechanical stress during walking and sports activities. Achilles tendonitis can also be due to tendon aging.

If not promptly treated, the tendon fiber itself can weaken, leading to a risk of tendon rupture.

Heel traumas can appear in the form of fractures of the calcaneus, rupture of the plantar aponeurosis or Achilles tendon. In the case of a calcaneus fracture, only an X-ray can establish a formal diagnosis and implement appropriate treatment. In the case of a rupture of the aponeurosis or Achilles tendon, only surgical treatment allows for healing.

Non-mechanical causes

There are certain factors that increase the risk of heel pain.

Inflammatory diseases such as ankylosing spondylitis or rheumatoid arthritis often lead to bilateral heel pain, unlike mechanical causes. The pain occurs upon waking and then diminishes throughout the day.

Heel pain due to arteritis of the lower limbs is caused by narrowing of the blood vessels in the legs caused by this disease. The lack of blood supply is sometimes responsible for burns in the sole of the heel.

Heel pain can also result from nerve damage such as:

  • the S1 sciatic nerve connecting the lower back vertebrae to the toes passing through the heel
  • diabetes-related neuropathy
  • nerve compression in the back of the foot

Whatever the cause, it is best that you consult a doctor to determine the exact origin of your heel pain and to establish an appropriate treatment.
This way, you give yourself every chance to prevent heel pain, before or after your hike!