Gradual onset heel pain

Heel pain, which comes on gradually is often due to an overuse problem. Pain under the heel is likely from either Plantar Fasciitis or Bruised Heel (Fat Pad Contusion), although a stress fracture of the heel bone (calcaneum) should not be ignored, especially if symptoms persist.

Due to the attachment of the tricep surae group (gastrocnemius, soleus and plantaris) to the heel any of the muscles may produce gradual onset of heel pain. This can be due to a tendonopathy where gradual onset can occur and may even start higher in the kinetic chain with a strain or tear may have been the initial cause. In Children Sever’s disease can be an issue with this type of pain. Other conditions that cause gradual onset heel pain are listed below:
  • Plantar Fasciitis

    What is plantar fasciitis? Probably the most common cause of heel pain. Symptoms come on gradually and are often worse first thing in the morning. The plantar fascia is the tissue under the foot which forms the arch. Treatment includes rest, reducing pain and inflammation and stretching exercises.

  • Bruised Heel

    A bruised heel, also known and Policeman's Heel is a contusion or bruising to the tissues under the heel causing pain. Treatment includes rest and protecting the area with padding or taping as well as identifying potential causes and rectifying them.

  • Sever's Disease

    Sever's disease is mainly a cause of heel pain in kids affecting active children aged 8 to 15 years old. Pain at the back of the heel from overuse that if managed correctly, is something the young athlete should grow out of. Rest is an essential part of treatment along with ice or cold therapy and managing training loads.

  • Calcaneal Stress Fracture

    A stress fracture of the calcaneus is a hairline fracture of the big heel bone and is usually caused by overuse. It is common in soldiers who march long distances and road runners. Treatment involves resting for 6 to 8 weeks followed by a gradual return to full training and fitness.

  • Heel Spur

    A heel spur is a hooked bony growth protruding from the calcaneus or heel bone. It often occurs alongside plantar fasciitis, and as such the two conditions are often confused, however they are not the same. Treatment involves rest, reducing symptoms with ice or cold therapy, stretching and correcting and biomechanical problems.

  • Metatarsalgia

    Metatarsalgia can be a bit of an umbrella term used to cover any forefoot pain, particularly metatarsal pain. Usually the term refers to inflammation which occurs in the joints between the metatarsal bones in the foot and phalanges bones of the toes.

  • Achilles Bursitis

    Achilles tendon bursitis, also known as Retrocalcaneal bursitis is a common foot pain in athletes, particularly runners. It can often be mistaken for Achilles tendonitis or can also occur in conjunction with Achilles tendonitis.

  • Haglund's Syndrome

    When retrocalcaneus bursitis exists at the same time as Achilles tendonitis in the same leg, this is known as Haglund's Syndrome. We explain the symptoms and possible treatment options available.

  • Heel Pain

    Heel injuries can be sudden onset (acute) or can come on gradually over time. The most common causes of heel pain including pain under the heel are Plantar Fasciitis and Bruised Heel whilst pain at the back of the heel in children is often Sever's disease. Select from the injuries below or if you do not know what your injury is then visit our symptom checker, or click on any of the symptoms below to view injuries with that particular symptom.