Heel Pain - Ten Tips for Treatment
The most common cause of heel pain is plantar fasciitis
(plan * tar fash* ee * I * tis). If you experience a sharp pain
in your heel when you first step down in the morning, it is
most likely due to plantar fasciitis. This type of heel pain
may also occur as achiness at the end of the day in the heel
or even burning pain in the arch. Plantar fasciitis can be
associated with a heel spur, but this is not the cause of the
pain. When the long ligament like structure (plantar fascia)
on the bottom of the foot pulls on the heel bone over a
period of time, a spur is formed. Only 50% of individuals
with plantar fasciitis have a bone spur in their heel. The
spur will never go away, but the plantar fasciitis will. Plantar
fasciitis is typically caused by a new activity, a new pair of
shoes, a worn out pair of shoes, a change of routine or
change in job. Individuals with flatfeet or abnormal motion in
the feet may have a higher chance of developing plantar
fasciitis. Once you develop plantar fasciitis, you may find it
very difficult to treat. 1. Identify the cause: There is typically a reason for the
development of plantar fasciitis, but since the condition is
not typically associated with an acute injury it may be hard to
remember. Once the cause is identified, try to stop or modify
the activity. 2. Decrease aggravating activities: Climbing up and down
stairs, walking or running on hills, squatting, carrying heavy
items and walking on uneven terrain all place excess stress
through the feet. Decrease these activities by asking your
spouse, significant other or friend for help with the kids or
carrying heavy items. Avoid multiple trips up and down the
stairs at work and home. Limit gardening to flatter more
even terrain. Stop running and walking for exercise and try
biking or swimming. Avoid the stair stepper, the treadmill
and the elliptical machine at the gym. 3. Stop running or walking: Keeping up aerobic activity is
important and cross training can help. Try biking or
swimming. Most walkers hate the stationary bike at the gym,
but this isn't forever. Don't drop your heel when you bike and
try to avoid standing and climbing steep hills if you cycle
outdoors. If you participate in spin classes, you may need to
modify the class to avoid further injury to the foot. The
recumbent stationary bike may place excess stress through
the arch because of the position. The classic stationary bike
may be more appropriate. 4. Try using an ice massage: Freeze a sports water bottle
and place it on the floor. To decrease inflammation and pain
in your arch, roll your foot over the water bottle for at least 20
minutes twice a day. Alternate between the frozen water
bottle and a heating pad, at 5 minute increments, for 20-30
minutes a day, three to four times a week. 5. Stretch your calf: Before you get out of bed, wrap the towel
or belt around the ball of your foot. Pull the foot towards you,
keeping your leg straight. You should feel a stretch in the
back of the calf, and this will also stretch the bottom of the
foot. Stretch your calf throughout the day with the runner's
stretch and spend 5-10 minutes every evening stretching
your calf. 6. Take anti-inflammatory medications: Anti-inflammatory
medications will help decrease the inflammation that
occurs in the fascia as a result of the stress and tearing.
Make sure you decrease your activity level and stretch and
ice as much as possible during the time you are taking
these medications. Otherwise, you may end up only
masking the pain. Take the medication with food and stop
taking the medication if you experience stomach discomfort. 7. Wear supportive shoes: A supportive shoe will only bend
at the toes. This step may seem logical, but many
individuals don't realize that their comfortable shoes lack
support and may be contributing to their pain. Test your
shoe by taking it, flipping it over and grabbing the toe area
and the heel. Attempt to fold the shoe in half. If the shoe
bends in half, then the shoe is not supportive. Don't go
barefoot. See the American Podiatric Medical Association's
(APMA) list of approved shoes at www.apma.org/
seal/sealaccategory.html. 8. Strengthen the muscles in your feet: Place a small towel
on the floor and curl your toes on the towel as you bring the
towel towards you. Place marbles on the floor and pick them
up with your toes and place them in a bowl. 9. Wear orthotics: Prefabricated orthotics are inserts that fit
into the shoe to help control motion in your feet. Controlling
abnormal motion in the feet can decrease the stress and
help the plantar fascia heal. Soft inserts available at the
drug store may be comfortable, but they will not help control
abnormal motion. Make sure the orthotics you buy are rigid
or stiff from the heel to the ball of the foot. 10. See a podiatrist: If your symptoms persist, make an
appointment with your podiatrist. Other treatments include
prescription anti-inflammatory medications, steroid
injections, night splints, physical therapy, cast boots, shock
wave therapy and surgery. Luckily, very few individuals need
surgery. Christine Dobrowolski is a podiatrist and the author of
Those Aching Feet: Your Guide to Diagnosis and Treatment
of Common Foot Problems. To learn more about Dr.
Dobrowolski and her book visit
http://www.skipublishing.com. For more information on how
to treat heel pain visit http://www.northcoastfootcare.com.
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