As an 80-year-old fitness instructor teaching at the Chaplin Family YMCA in Cambridge, Ontario, I’ve heard countless stories from my fellow seniors about heel pain.
“Bob, my heel is killing me when I get out of bed in the morning,” or “I can barely walk after my exercise class because of this pain in my heel.”
I get it. Heel pain can stop you in your tracks—literally.
Important Note: I’m not a doctor or medical professional. I’m a certified YMCA group fitness instructor who has been teaching seniors for about 30 years. Everything I share here comes from my experience, research, and what I’ve learned from maintaining my fitness instructor’s certificate. If you’re experiencing heel pain, please consult with your healthcare provider, physiotherapist, or podiatrist for a proper diagnosis and treatment plan.
That said, understanding what might be causing your heel pain can help you have better conversations with your doctor and give you some ideas for relief. Let me walk you through seven common reasons your heel might be sore.
1. Plantar Fasciitis (The Most Common Culprit)
This is the big one. About 80% of heel pain cases involve plantar fasciitis, and I see it all the time in my Friday morning “Move Together Strength” class at the YMCA.
What It Is: Your plantar fascia is a thick band of tissue that runs along the bottom of your foot, connecting your heel bone to your toes. Think of it like a bowstring that supports the arch of your foot. When this tissue gets inflamed or develops tiny tears from overuse, you get plantar fasciitis.
Common Symptoms:
- Sharp, stabbing pain in the bottom of your heel
- Pain is worst with your first steps in the morning
- Pain after standing or sitting for long periods
- Pain that improves with movement but returns after rest
- Tenderness when you press on the bottom of your heel
Who’s Most at Risk: People over 40, those who are overweight, runners, people who stand for long periods at work, and folks with flat feet or high arches are more prone to developing this condition.
What You Can Do: In my classes, I emphasize the importance of calf stretches and foot flexibility exercises. Here are some approaches that many people find helpful:
- Stretch your calves regularly: Tight calf muscles can contribute to plantar fasciitis. Stand facing a wall, place one foot behind you, keep your heel down, and lean forward. Hold for 30 seconds on each side.
- Roll your foot: Use a frozen water bottle or tennis ball to massage the bottom of your foot for 10 minutes a few times per day.
- Wear supportive shoes: Those old slippers or flip-flops aren’t doing you any favors. Invest in shoes with good arch support.
- Rest and ice: When it’s flaring up, ice the area for 15-20 minutes several times a day.
2. Heel Fat Pad Syndrome (Your Heel’s Cushion Wearing Thin)
Here’s something many people don’t know about: the natural cushioning under your heel can wear down as you age. It’s called fat pad syndrome, and it’s exactly what it sounds like.
What It Is: Under your heel bone, there’s a thick pad of fatty tissue that acts as a shock absorber when you walk, run, or jump. Over time—especially as we get older—this fat pad can thin out, shift, or deteriorate. When that happens, it’s like walking around with less padding in your shoes.
Common Symptoms:
- Deep, bruise-like pain in the center of your heel
- Pain that gets worse when walking on hard surfaces
- Feeling like you’re walking directly on bone
- Pain that improves when you’re sitting or lying down
- Discomfort that worsens throughout the day
Who’s Most at Risk: Older adults (the fat pad naturally thins with age), people who’ve had cortisone injections in the heel, athletes who do high-impact activities, and individuals who are overweight.
What You Can Do:
- Cushioned footwear is essential: Look for shoes with extra heel cushioning or add gel heel cups to your existing shoes.
- Avoid hard surfaces: When possible, walk on grass, carpet, or softer surfaces rather than concrete or hardwood.
- Maintain a healthy weight: Extra weight puts more pressure on that thinning fat pad.
- Consider orthotics: Custom or over-the-counter heel cups can provide extra cushioning where you need it most.
3. Baxter’s Nerve Entrapment (The Sneaky One)
This condition often gets mistaken for plantar fasciitis because the symptoms are similar, but it’s actually a nerve problem. I learned about this one when my son was dealing with it.
What It Is: Baxter’s nerve (also called the first branch of the lateral plantar nerve) runs along the inside of your heel. When this nerve gets compressed or trapped—usually between muscles or other structures—it causes pain that radiates through your heel.
Common Symptoms:
- Burning or tingling pain in the heel
- Pain that radiates along the inside of your heel and arch
- Symptoms that worsen with activity
- Night pain that can wake you up
- Numbness or pins-and-needles sensation
Who’s Most at Risk: People with flat feet, those who overpronate (roll their feet inward when walking), athletes, and individuals with plantar fasciitis that hasn’t responded to typical treatments.
What You Can Do: Nerve entrapment usually requires professional help, but here are some supportive measures:
- Reduce inflammation: Ice and anti-inflammatory approaches can help reduce swelling around the nerve.
- Modify your activities: Avoid movements that aggravate the nerve compression.
- Supportive footwear: Proper arch support can reduce pressure on the nerve.
- Gentle stretching: Careful calf and foot stretches may help, but don’t overdo it.
This is definitely one to bring to your doctor’s attention, as you may need physical therapy or other interventions.
4. Heel Spurs (The Calcium Buildup)
Despite what many people think, heel spurs themselves usually aren’t painful. But they often develop alongside other conditions that do cause pain.
What It Is: A heel spur is a calcium deposit that creates a bony protrusion on the underside of your heel bone. These typically develop over months or years due to strain on foot muscles and ligaments.
Common Symptoms: Most people with heel spurs have no symptoms at all! When pain does occur, it’s usually because the spur is associated with plantar fasciitis or another condition:
- Pain when standing up after sitting
- Dull ache that becomes sharp with certain movements
- Inflammation and tenderness at the front of your heel
Who’s Most at Risk: Runners and joggers, people with abnormal walking gait, those wearing poorly fitting or worn-out shoes, individuals with flat feet or high arches, and people who are overweight or obese.
What You Can Do: Treatment focuses on the underlying condition rather than the spur itself:
- Stretching exercises: Keep those calf muscles and plantar fascia flexible.
- Proper footwear: Cushioned shoes with good arch support are crucial.
- Orthotics: These can help distribute pressure more evenly across your foot.
- Weight management: Reducing stress on your heels helps prevent further issues.
5. Achilles Tendinitis (The Back-of-Heel Pain)
While most people think of heel pain as being on the bottom of the foot, pain at the back of your heel is also common, especially in active seniors.
What It Is: Your Achilles tendon is the large tendon that connects your calf muscles to your heel bone. When this tendon becomes inflamed through overuse or sudden increases in activity, you develop Achilles tendinitis.
Common Symptoms:
- Pain along the back of your heel and lower calf
- Stiffness in the Achilles tendon, especially in the morning
- Pain that worsens with activity
- Swelling along the tendon
- Thickening of the tendon
- A creaking or crackling sound when you move your ankle
Who’s Most at Risk: Weekend warriors who suddenly increase activity, people who wear high heels regularly and then switch to flat shoes, those with tight calf muscles, and individuals who’ve recently intensified their exercise routine.
What You Can Do: This is something I’m particularly careful about in my YMCA classes. We always warm up properly and I remind everyone to listen to their bodies:
- Gradual progression: Don’t suddenly ramp up your exercise intensity or duration.
- Calf stretches: Regular gentle stretching of the calf muscles is essential.
- Eccentric exercises: These special exercises where you slowly lower your heel can help strengthen the tendon.
- Ice after activity: This helps reduce inflammation.
- Proper footwear: Shoes with adequate heel cushioning and support are important.
6. Stress Fractures (The Overuse Injury)
Stress fractures are tiny cracks in the bone that develop from repetitive force or overuse. In the heel, they’re less common than in other parts of the foot, but they do happen.
What It Is: Unlike a regular fracture that happens from a single traumatic event, a stress fracture develops gradually from repeated stress on the bone. Think of it like bending a paperclip back and forth until it breaks—except this is your heel bone.
Common Symptoms:
- Pain that develops gradually and worsens with activity
- Relief when resting
- Swelling on top of the foot or around the ankle
- Tenderness when you touch the specific spot
- Pain that becomes constant if you don’t rest
Who’s Most at Risk: People who suddenly increase their physical activity, those with osteoporosis or low bone density, individuals with poor nutrition (especially low calcium and vitamin D), and people who train on hard surfaces.
What You Can Do: Stress fractures need rest to heal properly. If you suspect you have one:
- Stop the aggravating activity immediately: This is not a “push through the pain” situation.
- See a doctor: You need proper diagnosis, often with imaging.
- Rest: This might mean several weeks of modified activity.
- Nutrition: Ensure you’re getting adequate calcium, vitamin D, and protein.
- Gradual return: When you do resume activity, build back slowly.
In my 30 years of teaching at the YMCA, I’ve learned that rest is just as important as exercise. Your body needs time to heal and rebuild.
7. Bursitis (The Inflamed Cushion)
Bursae are small, fluid-filled sacs that cushion the bones, tendons, and muscles near your joints. When these become inflamed, it’s called bursitis.
What It Is: In your heel, there are bursae located between your Achilles tendon and heel bone (retrocalcaneal bursitis) and at the back of the heel where shoes rub (Haglund’s deformity or “pump bump”).
Common Symptoms:
- Pain at the back of the heel
- Swelling and warmth
- Red, tender skin
- Pain that worsens when you stand on tiptoes or wear certain shoes
- A noticeable bump at the back of the heel
Who’s Most at Risk: People who wear poorly fitting shoes (especially high heels or stiff dress shoes), runners who suddenly increase their mileage, individuals with tight Achilles tendons, and those with rheumatoid arthritis or gout.
What You Can Do:
- Change your footwear: Avoid shoes that rub against the back of your heel.
- Heel pads or cushions: These can reduce pressure on the bursa.
- Ice the area: Apply ice for 15-20 minutes several times daily.
- Avoid aggravating activities: Give that inflamed bursa time to calm down.
- Gentle stretching: Once acute pain subsides, gentle calf stretches can help.
When to See a Doctor
While many cases of heel pain improve with self-care, there are times when you need professional help. See your healthcare provider if:
- Pain is severe or prevents you from walking normally
- Heel pain persists for more than a few weeks despite rest and self-care
- You have swelling, redness, or warmth in your heel
- You have numbness or tingling in your heel or foot
- You can’t bend your foot downward or rise on your toes
- You have diabetes (foot problems can be more serious)
- Pain is present even when you’re not putting weight on your foot
General Prevention Tips for Healthy Heels
After three decades of teaching fitness to seniors in Cambridge, here’s what I’ve learned about keeping your heels happy:
Wear Proper Footwear: I can’t stress this enough. Those bargain shoes or worn-out sneakers are not worth the heel pain they cause. Invest in quality shoes with good arch support and cushioning.
Maintain a Healthy Weight: Every extra pound puts additional stress on your heels. Even losing 5-10 pounds can make a significant difference.
Stretch Regularly: Tight calf muscles are involved in many heel problems. In my Friday morning class at the YMCA, we always include calf stretches. Make them part of your daily routine.
Strengthen Your Feet: Don’t forget that your feet have muscles too! Simple exercises like picking up marbles with your toes or doing heel raises can build strength and stability.
Progress Gradually: Whether you’re starting a new exercise program or increasing your walking distance, take it slow. Your body needs time to adapt.
Listen to Your Body: This is something I always tell my class participants. A little soreness is normal, but pain is your body’s warning signal. Don’t ignore it.
Final Thoughts from the Silverfox
Heel pain doesn’t have to be a normal part of aging. In my 80 years, I’ve learned that staying active and taking care of your feet are essential for maintaining the mobility and independence we all value.
Whether it’s plantar fasciitis, fat pad syndrome, or one of the other conditions I’ve discussed, there are usually steps you can take to feel better. Start with the self-care approaches I’ve outlined, but don’t hesitate to seek professional help when you need it.
Remember, your feet carry you through life. They deserve your attention and care.
If you’re in the Cambridge, Ontario area and want to work on your overall fitness, strength, and balance in a supportive environment, come join me at the Chaplin Family YMCA for my “Move Together Strength” class at 9am every Friday. We work on functional fitness that helps with everyday activities—including keeping those heels healthy!
Stay active, stay mobile, and take care of those feet.
Warm regards,
Robert (Silverfox) Fox
Need help with fitness coaching or have questions? Contact me:
- Phone: (519) 623-6246
- Email: theoldfoxx@rogers.com
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