The ankle is the most interesting, most weight-bearing joint in your body. It has a complex structure consisting of bone, cartilage, synovial fluid and ligaments. Healthy synovial fluid and cartilage in the joint serve as a cushion and gliding surface. Inflammatory conditions such as arthritis, degenerative conditions such as aging and osteoarthrosis disrupt the cartilage surface and alter the quality of synovial fluid.

Common causes

Conditions that cause heel pain generally fall into two main categories: pain under the heel and pain in the back of the heel.

Pain under the heel

If there is pain under the heel, there are situations that damage the tissues under the foot.

Plantar Fasiit

One of the most common causes of heel pain is plantar fasciitis. This is caused by the inflammation of the band of tissue that connects the heel bone to the toes. Pain due to plantar fasciitis is felt in the heel or arch of the foot and is usually worse in the morning. The first step when getting out of bed is usually the most painful step. Common causes of plantar fasciitis include excessive physical activity; prolonged standing on concrete or hard surfaces; faulty foot mechanics such as flat feet; stiff and short calf muscles; excess weight; and unsuitable

shoes. It is a common condition in long distance runners, but it is also fairly common in the general population.

Heel spurs

When plantar fasciitis persists for a long time, a heel spur (calcium buildup) may occur where the fascia attaches to the heel bone. Having heel spurs may not cause pain and surgery is unnecessary.

Stone caries

When you press a hard object such as a rock or stone, you can bruise the fat pad under your heel. The color change may or may not be visible. The pain gradually disappears with rest.

Pain in the heel

If there is pain in the back of the heel, it may be due to inflammation of the area where the Achilles tendon meets the heel bone. This may be due to shoes that wear and compress the heel too much. This pain typically develops gradually over time, during which time the skin becomes thick, red, and swollen (Haglund’s disease).

Retrocalkaneal bursitis

Bursa is a sac filled with liquid or not. Lubricant and soften the contact surface when muscles / tendons pass over bones

they serve as. Bursaas are found around the major joints of the body, including the ankle.

The bursa located behind the ankle, on the heel side, is called the retrocalcaneal bursa. Repeated / overuse of the ankle can cause inflammation of the bursa, leading to this condition called retrocalcaneal bursitis.

The most common symptoms of retrocalcaneal bursitis are;

Pain in the heel, especially with walking, running, or touching the heel

Increased pain when standing on the toes

Red, warm skin on the back of the heel

Achilles tendon diseases;

The Achilles tendon connects the calf muscle to the heel. This tendon is used for walking, running, and jumping. Achilles tendinitis is a condition in which this tendon becomes inflamed due to overuse of the foot. This condition is common in people under the age of 35 and often occurs in runners and other athletes.

Symptoms include pain in the heel and along the tendon when walking or running. Touching the tendon and / or movement of the ankle can be painful. The back of the heel may swell and you may experience pain when standing on the toes.

Achilles tendinitis can occur in the following situations;

Sudden increase in physical activity

• Working on hard surfaces

• Overwork

Excessive jumping (for example, when playing basketball)

Wearing unsuitable shoes

Ankle sprains

Ankle sprains are injuries to the ligaments that surround the bones of the leg and connect them to the foot. Injury typically occurs when you accidentally step on your ankle in an awkward way. This can stretch or tear the ligaments that hold your ankle bones and joints together.

Rheumatoid arthritis (RA)

RA is a chronic disease of the joints that occurs when the body’s immune system attacks the synovium, the thin membrane that surrounds the joints. The result can be joint damage, pain, swelling, inflammation, loss of function, and disability. In about 90% of patients with rheumatoid arthritis, the joints of the feet and ankles are affected. It is a chronic disease that is difficult to treat and progresses with acute exacerbations.


Gout is a form of arthritis that occurs when excess uric acid, a body waste product circulating in the bloodstream, accumulates as needle-shaped monosodium urate crystals in the tissues of the body, including the joints. For many people, the first sign of gout is pain and swelling in the big toe. Subsequent attacks may occur in other joints, including the ankles. As the disease progresses and years pass, uric acid lumps called tophi can also form under the skin around the ankles.

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