Most frequently heel pain is not the result of any single injury, such as a fall or twist, but rather the result of repetitive or excessive heel pounding.

Plantar fasciitis is inflammation of the thick connective tissue on the sole of your foot that attaches to your heel. The pain is usually felt at the bottom of your heel and is often worse in the morning because of stiffness that occurs overnight. The following increase your risk of developing this painful problem:

• Shoes with poor arch support or soft soles
• Quick turns that put stress on your foot
• Tight calf muscles
• Repetitive pounding on your feet from long-distance running, especially running downhill or on uneven surfaces
• Pronation -- landing on the outside of your foot and rolling inward when walking or running; to know if you pronate, check the soles of your shoes to see if they are worn along the outer edge

Bone spurs in the heel can accompany plantar fasciitis, but are generally not the source of the pain. If you treat the plantar fasciitis appropriately, the bone spur is likely to no longer bother you.

Heel bursitis (inflammation of the back of the heel) can be caused by landing hard or awkwardly on the heel, or by pressure from shoes.

Achilles tendinitis is inflammation of the large tendon that connects your calf muscle to your heel. This can be caused by:

• Running, especially on hard surfaces like concrete
• Tightness and lack of flexibility in your calf muscles
• Shoes with inadequate stability or shock absorption
• Sudden inward or outward turning of your heel when hitting the ground