Health and Fitness Information

Fifteen Ways to Fight Heel Pain

by Christine Dobrowolski, DPM MS

There are many different causes of heel pain, but the most common cause 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 problem is a result of excess stress through a long ligament type structure (the plantar fascia) in the bottom of the foot. The excess stress causes tearing and results in inflammation and pain. The classic symptoms are pain in the heel at the first step in the morning, or upon rising after long periods of rest. Many will complain of a sharp pain in the heel when they step out of their car or after finishing their lunch break. Other individuals only experience heel pain at the end of the day or during certain types of activity like running, soccer or tennis. The pain may extend into the arch and feel achy at the end of the day.

Individuals develop plantar fasciitis for a variety of reasons. One of the most common reasons for the development of plantar fasciitis is wearing poor quality or worn out shoes. Another common reason is starting a new activity, such as walking or running, after a period of inactivity. Many active individuals develop plantar fasciitis after incorporating hills, stairs or uneven terrain into their training routine. A new job that requires standing all day or switching to a job with a harder surface, like cement floors, may contribute to it’s development. Individuals with flatfeet or excess pronation (rolling in of the feet) may have a natural predisposition for plantar fasciitis. Regardless of how the problem started, the treatment is aimed at decreasing the stress on the arch and decreasing the inflammation.

1. Identify the cause: There is usually 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. The pain may have gradually developed after starting a new training routine, changing the routine, running or walking on a new surface, switching shoes, wearing worn out shoes or starting a new job. Once the cause is identified, stop the activity or modify it.

2. Avoid aggravating activities: Going up and down stairs, walking or running on hills, squating, lifting heavy items and walking on uneven terrain all aggravate this condition. Try to decrease these by limiting the number of times you go up and down the stairs and avoiding hills. If you must squat down, keep the affected foot in front and flat on the ground. Do not lift or carry heavy items including your kids. Use a stroller or have your spouse, significant other or friend carry them.

3. Stop running or walking: Aerobic activity is important to maintain and cross training can help. Try biking or swimming. Most walkers hate the stationary bike at the gym, but remember this isn’t forever. Don’t drop your heel when you bike and try to avoid standing and 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 is more appropriate.

4. Use an ice massage: Freeze a sports water bottle or a juice can and place it on the floor. Roll your foot over the water bottle for at least 20 minutes twice a day. This helps decrease the inflammation in the foot while stretching out the arch.

5. Use a contrast bath: Icing helps decrease inflammation occurring within a 48-72 hour period. To help decrease chronic inflammation, try contrasting between ice and heat. Start with an ice pack on the heel and/or arch for 5 minutes. Switch to a heating pack or a hot water bath for 5 minutes. Alternate between the two for 20- 30 minutes 3-4 times a week. This may be more time consuming than the ice pack alone, but can bring considerable relief.

6. Roll a ball under your foot: Take a tennis ball, soft ball or even a rolling pin and roll your foot over it to help stretch out the plantar fascia. This can be done while watching TV or reading the paper. Rolling the foot over the tennis ball can also be done at work if you have a desk job or during a lunch break. (This should not cause pain. Don’t continue if you have pain). Article continues on next page…

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This entry was posted on Tuesday, October 19th, 2004 at Tuesday - October 19, 2004 and is filed under Remedies, Diseases & Symptoms.