Achilles Tendon Pain

Posts Tagged ‘Fasciitis’

Plantar fasciitis is a health development that develops heel pain. It is stimulated when individuals stress their plantar fascia – a circle of tendons that helps to unite your heel bone to the toes. It is likewise used to sustain the arch of your foot. Individuals who hurt from this trouble will have a swollen and inflamed heel that will leave them in pain whenever they stand up or walk round.

It is most general for older middle aged individuals to hurt from this condition – but it is able to occur in younger people who commonly walk around for long periods of time. Athletes and soldiers are at an increased chance for this problem and can experience it in either one or both of their feet.

As we stated originally this problem is made when the fascia is strained. When not addressed unnecessary twisting will tear the fascia and stimulate swelling and extensive pain. This have the ability to happen when:

Your feet are flat or have high arches You are obese Your feet roll in when walking You walk or run too much You wear shoes that are too small Your Achilles tendon and calf muscles are too tight

One of the more common symptoms that you can suffer from when you have this condition is an intensive infliction that will take place whenever you move a few steps after sitting down for long periods of time or waking up in the morning. While the stiffness in your feet will lessen after a just a couple of steps the anguish will step-up through the day.

The doctor will have the means to diagnosis plantar fasciitis by testing how you are able to stand up and walk round. They will also need to know about health problems in the past that you have had, the symptoms you are experiencing, and the kind of physical activity you do. They will also need to take x-rays of your foot to discover if it might be a problem with the bones.

The most common cause of heel pain and heel spurs is a condition called Plantar Fasciitis (sometimes misspelled Planter Fascitis). This is Latin for inflammation of the Plantar Fascia. The Plantar Fascia is the broad band of fibrous tissue that runs under the foot and that forms your arch. Because of a number of different factors the plantar fascia are being overly stretched and this continuous pulling results in inflammation and pain at the heel, at the point where the ligaments insert into the heel bone.

Over-pronation of the feet (fallen arches + rolling inward of the feet and ankles), tight calf muscles, as well as ageing and being overweight are the main causes for the plantar fascia being overly stretched. There are many ways to treat Plantar Fasciitis, including cortisone injections and surgery. However, in most cases heel pain relief can be achieved through self-help by following a number of easy, simple steps, most of which are aimed at reducing the pulling of the plantar fascia.

1. Rest or reduce activity
When you have heel pain avoid any activity that can further aggravate the problem. This includes walking for long distances, walking up or down stairs, running, sports etc. If you want to keep fit swimming is the safest activity, until your heel pain has been treated properly. Or you can ride a bike or a stationary exercise bike. Basically, try to be as little on your feet as possible, allowing the plantar fascia to heal itself.

2. Cold & Hot therapy
Use an ice pack and apply it onto the sore heel for 5-10 mins at a time, 3 to 4 times per day. The ice will reduce the inflammation in the heel area. To help reduce any chronic inflammation, you can try alternating between ice and heat. Place an ice pack on the heel for 5 minutes and then switch to a hot pack (or hot water foot bath) for another 5 minutes. Do this for about 20-30 minutes per day and you’ll notice some considerable heel pain relief.

3. Roll a ball under the foot
Many people with Plantar Fasciitis experience a sharp heel pain in the morning, when taking the first steps after getting out of bed. This pain comes from the tightening of the plantar fascia that occurs during sleep. Stretching and massaging the plantar fascia before standing up will help reduce heel pain for the rest of your day! Massaging the plantar fascia can be done simply by rolling a tennisball (or rolling pin) under the foot, all the way from the heel to the toes. You may do this sitting down, applying a fair amount of pressure onto the arch, or even standing up as long this causes not too much discomfort. Keep rolling the ball or pin under the foot for about 5 minutes.

4. Stretch your feet with a towel
Stretching the plantar fascia is your next Plantar Fasciitis exercise, using a bath towel. Put a rolled up towel under the ball of one foot, holding both ends of the towel with your left and right hand. Next, slowly pull the towel towards you, while keeping your knee straight (the other knee may be bent). Hold this position for 15 to 20 seconds. Repeat 4 times and change to the other foot, if necessary. If you don’t have a towel handy, simply put your foot on your knee and grab your toes and pull them towards your shin, hold for about 10 seconds.

5. Stretch your calf muscles
Stand facing a wall with your hands on the wall at about eye level. Put one leg about a step behind your other leg, keeping your back heel flat on the floor. Make sure this leg stays straight at all times. Now bend the knee of the front leg slowly, lowering your body until you feel a stretch in the calf of the back leg. Hold the stretch for 15 to 20 seconds. Repeat 4 times. Do the same for the other leg.

Please make sure you don’t walk barefoot at home in the morning, as this will undo all the hard work! Wear shoes or supportive sandals as soon as you have done the Plantar Fasciitis exercises.

You can repeat any of these heel pain exercises during the day, if you wish. For example the tennis/golf ball rolling can be done as you watch TV or read the paper. There’s one more exercise you may want to do which is called the Achilles Tendon stretch. Stand on a step with both feet on the same step and slowly let your heels down over the edge of the step as you relax your calf muscles. Hold this stretch for about 15 to 20 seconds, then tighten your calf muscle a little to bring your heel back up to the level of the step. Repeat 4 times.
Please note that stretching exercises should create a pulling feeling, they should never cause pain!

6. Take an anti-inflammatory drug, like Ibuprofen
To ease your Plantar Fasciitis you can take an anti-inflammatory that contains Ibuprofen, like Nurofen or Advil. This is a short term fix that will help decrease the inflammation of the plantar fascia. You still need to do take all the other measures such as stretching, ice, orthotics etc to achieve long term pain relief from your heel problem. For many people Ibuprofen is pretty heavy on the stomach and therefore these drugs should be taken in moderation.

7. Lose some weight
As we get older we tend to put in a bit of extra weight. The combination of weight gain and ageing means we put a lot of extra tension on our muscles and ligaments in the feet, legs and back. Most people tend to over-pronate because of weight gain. Over-pronation (fallen arches) is the main cause of Plantar Fasciitis and heel pain. Therefore by losing weight you will decrease the tension on the plantar fascia.

8. Wear the right footwear
Supportive footwear is paramount, especially as we get older. Floppy footwear causes ankle instability during walking and contributes to the problem of over-pronation, leading to heel pain and other foot problems. A good supportive shoe should only bend at the sole in the forefoot area and should be firm elsewhere, especially the back section of the shoe (heel counter) should be firm. Many footwear companies advertise shock-absorption and cushioning as the major benefits of their (sports) shoes. Stability is far more important than cushioning!

9. Use a night splint
A night splint holds the foot at 90 degrees during your sleep. The aim of the splints is to keep your foot and calf muscles stretched during the night. Normally during rest the plantar fascia and calves tend to tighten and shorten. So when you wake up in the morning and take your first steps, the fascia are being pulled all of a sudden, causing the sharp pain in the heel.
The problem with night splints is that they can be quite uncomfortable. This is why they are so-called sock night splints on the market which are more bearable than rigid night splints.

10. Wear orthotics in your shoes
Research has shown that by far the most effective way to treat Plantar Fasciitis is wearing a corrective device inside the shoe. Orthotics are designed to correct the problem of over-pronation, the major cause of plantar fasciitis and heel pain. Orthotics support the arches and control abnormal motion of the feet, thereby greatly reducing the tension in the plantar fascia band. Especially when combined with daily exercises, orthotics will provide relief to the majority of Plantar Fasciitis sufferers. Orthotics can be obtained from a foot specialist (podiatrist). These are called custom orthotics and they usually quite hard. Nowadays there are softer orthotics on the market, which are made of EVA and which mould themselves to the wearer’s foot shape because of body heat and body weight. These softer orthotics are pre-made and available without a prescription from pharmacies and specialty websites.

Reasons Why Feet Sometimes Hurt

Human bodies are extraordinarily astounding; they are the perfect harmony of bones, flesh, and natural body fluids. Unique cushioning is provided in our joints and at crucial areas in any place on the body that bears weight. However, when this delicate harmony is interrupted by injury or certain conditions, excruciating pain can be the result. Heel spurs and plantar fasciitis are a couple of conditions of the feet that can cause a complete lack of mobility.

The Reasons You May Have Heel Spurs or Plantar Fasciitis

A heel spur is a pointed portion of bone that tends to grow out of the heel bone (calcaneus). They can be located either underneath or on the rear of the heel. When a heel spur is present, it can cause swelling and tearing of the softer foot tissues, which is made worse with simple movements or standing on the affected foot. When the location of the body growth is on the back side of the heel, it can irritate the Achilles tendon and cause tenderness and swelling in that zone. As cited on MedicineNet’s site, pressure on the ball of the foot makes this certain condition worse. Alternatively, when the heel spur is located under the heel, it aggravates the plantar fascia ligament, thus causing a condition called plantar fasciitis. MedicineNet describes this condition as being more of a problem when standing or walking.

Why Feet Can Get Heel Spurs and Plantar Fasciitis

Nevertheless, most times, heel spurs are caused by repetitive motion and excessive stretching of the plantar fascia ligament because of physical activity, and can also be caused by heavy lifting. Plantar-Fasciitis.org cites that certain types of arthritis as well as diabetes can raise the chances of developing either of these painful conditions. They warn that shoes that are too tight can also cause painful foot problems.

Recommended Treatments for Heel Spurs and Plantar Fasciitis

The goals in treatment of these conditions are to diminish the inflammation of muscles and ligaments as well as prevent re-injury. According to foot specialist Dr. William Shiel, Jr., MD, FACP, FACR, this can be accomplished in several ways:

Use of NSAID medicines As a last resort, surgery to remove the heel spur to allow for tissue and tendon healing Wearing circular shoe inserts for the heel Use of the best orthotic inserts available to properly align the foot and take pressure off of the affected areas Regularly icing on the affected regions Sufficiently-cushioned shoes

Have you ever feel nagging foot pain with the first couple of steps each morning? If you do, you might be one of the millions of Plantar Fasciitis sufferers in the planet. One of the symptom of this illness is intense heel pain in the morning. If you want to know how to treat plantar fasciitis, then keep reading the article.

Plantar fasciitis is one of the most common types of heel pain problems developed in most people. (including myself!) It is a painful inflammatory condition caused by excessive wear and tear to the plantar fascia area of a person’s foot.

The pains associate with it is usually felt on the underside of the heel and very often is most intense and painful when you begin your day – the time when you stand up from your bed after a night sleep. The pain will also resurface after a period of rest and inactivity. While women are more likely to suffer from it, it affects many who are overweight and plump. You are also at risk of getting plantar fasciitis if you holds a job that require a lot of walking or standing on hard surface for long period of time.

Resting your feet off the weight of your body is the primary method of plantar fasciitis treatment. Since many foot injuries are a result of muscles and tendon imbalances, stretching some of your muscle groups apart from strengthening can help to alleviate your heel pain problems. Your stretching exercises should concentrate on the Achilles tendon and calf muscles group. These exercises can be done at the comfort of your home to treat the condition and lessening the chance of recurrence pain.

Exercise 1: Bend 1 leg forward in a semi-lunge position and thrust the other leg straight back. Hold the position for a minute and switch leg.
Exercise 2: Stand on a step and balance on the balls of your feet with your heels hanging over the edge. Drop your heels below the step and hold for a minute.

There are some form of stretches and exercises that can be done to reduce the risk of recurrence of plantar fasciitis. Your physician may give you specific instructions for a suitable exercise program that is appropriate for you. Exercises for plantar fasciitis focus on stretching the Achilles tendon, calf, and plantar fascia. These stretches can be done whenever you experience pain from plantar fasciitis. Try them.

It is sometimes recommended that you warm up a little before doing plantar fasciitis stretches. An easy and not complex warm up is to walk up some stairs. Always ask your physician for advice on doing exercises and stretches for plantar fasciitis.

One of the plantar fasciitis stretches starts by standing about two feet away from a wall. Lean against the wall. With one leg bent comfortably, straighten the other leg, placing it about six inches behind you with the heel on the floor. Hold for ten seconds. You should feel a gentle stretch of the Achilles tendon in the extended leg. Switch positions and stretch the other leg. Repeat twenty times.

The second plantar fasciitis stretch starts with your toes against the wall with heels on the floor. Bring your hips nearer to the wall so that your other foot is at a 45 degrees angle. This will stretch the calf and the plantar fascia.

Sit on a chair. Rest the ankle of the injured foot on the knee of the opposite leg. Gently push the toes backward until you feel a stretch in the bottom of your foot.

Another exercise starts by leaning forward onto a countertop. Your feet should be spread apart with one foot in front of the other. Squat down. Keep your heels on the floor. Hold for ten seconds and relax. Repeat twenty times.

Sit on a table with your knees bent. Holding onto the ends of the towel, loop a towel under the ball of the foot. Keep knees bent as you gently pull the towel while flexing the foot upward. Try to press your foot against the towel.

If you experience pain in the morning, do the next simple exercise before getting out of bed. Lying on your back, using your big toes to try to write the alphabet in the air. After writing the alphabet, gently raise your big toes towards you.

Some people find massage helpful to reduce pain. One way to massage the area yourself is to rest the foot on a tennis or golf ball. Gently roll the foot over the ball. Rolling back and forth over the ball of the foot yields a gentle massage of the plantar fascia ligament. You can try using an empty tennis ball container that you filled with water and froze. The ice pack will smoothe the pain and the rolling action sort of massages the foot.

Plantar Fasciitis or heel pain is a condition in which a person experiences an inflammation in the foot accompanied by unbearable pain. This is mainly caused due to the wear and tear in the foot muscles that provide support to the foot arches. The pain is generally experienced in the base of the heel and the pain increases at the time of the first step in the morning. The condition results out of the changes in the weight bearing activities or due to the over-working of the foot. The problem can also arise due to activities that require walking bare footed with no support to the foot muscles.

Plantar Fasciitis is also known as ‘Morning Heel Pain’ and the best product that can provide you with amazing relief are night splints (have to be used during the night). It is the same type of relief that you get out of a medications prescribed by your doctor. The splints are adjustable and can keep the toes and foot in a stretched position overnight. This helps in stretching the plantar fascia as well as the Achilles tendon providing long term relief from the excruciating pain.

Some of the features of Night Splint are as follows:

a) After regular use of 4 to 12 weeks you can expect to be completely cured of the problem. This is not at all surprising but has scientific data to be backed with.

b) Actually, Night Splint keeps the toes and foot relaxed overnight and relieves you of the unbearable pain in the morning.

c) Most of the Night splint available in the market are easily removable and are not made of materials that would get entangled with your bed linen.

d) It is easily attachable to the legs and you do not need to be worried about how to go about wearing same.

Most of the Night splints available in the market are made up of nylon or urethane, so you can easily wash them when they get dirty. One must try to choose the night splint according to one’s preferences as both rigid as well as soft night splints are available. Both are good and keep the plantar fascia relaxed during the night.

The medicines that our doctor prescribes can have side effects, but use of night splint to cure heel pain is completely natural. It does not make you vulnerable to any form of side effects and the cure can be completely natural and absolutely effective. Long term cure is only possible through the use of night splint as it stretches the muscles responsible for the problem. The choice should be obvious and must come straight to your mind the next time you experience a pain in your heel- Night Splint.

The bottoms of things have, in general, been much maligned. The bottom of the barrel, bottom of the ocean, bottom of the slag-heap, and more bottoms are generally thought of as dark, dirty, or otherwise unpleasant places. But just think how important bottoms can be: the bottom of a ship, for instance, while sometimes sloshing with bilge-water, is nonetheless essential in a ship’s overall well-being. When its bottom fails, the ship goes down to the bottom of the ocean. Which is full of bottom-dwellers, as we well know.

The bottoms of feet are likewise very important. Think about it: all the weight of your body presses down on your poor, overworked feet. And towards the bottom of the foot is a band of tissue called the plantar fascia (a fascia is similar to a ligament) which connects to the bottom of your heel bone and fans out to the base of your toes. It helps support the structure of the bones at the bottom of your foot. Unfortunately, we don’t seem to appreciate what the plantar fascia does for us until it decides to go bottoms-up.

Like many tissues, the plantar fascia can become stretched over time, particularly in people with unusually high or low arches, or who are overweight, tend to do a lot of physical activity like running and jumping, wear shoes with little or no support, or have a tight Achilles tendon. Spending a lot of time on hard, flat surfaces (like a concrete floor) can also lead to problems. Plantar fasciitis may show up in either gender, although it most often affects people in late middle age (about 40 to 60).

When the plantar fascia stretches too far, it can develop small tears (or in extreme cases may even rupture). These tears make the plantar fascia irritated and inflamed, a condition known as plantar fasciitis.

1)Plantar fasciitis tends to manifest itself as pain at the bottom of the heel (although it can occur at any point along the arch of the foot) which is usually most severe when getting up in the morning (or in the afternoon if you like to sleep in a lot).

2)The pain often subsides during the day as you walk around a little, although it may become worse again if you’re on your feet a great deal, or if you sit for awhile and then try to stand again.

3)Many patients feel a searing or sharp pain when they first get on their feet after a period of rest. This may subside to a dull ache as the day goes on.

4)This condition tends to get worse over time, so you may start off with very little pain that gradually progresses to severe over a period of months. Your arches may also gradually flatten as the plantar fascia stretches out.

5)Additionally, you may develop a heel spur (a bone growth along the bottom of your heel bone). In the past, it was thought that the spur contributed to the pain, but, since many people with heel spurs experience no symptoms, this is no longer thought to be the case.

When you go in to see your podiatrist about the pain in the bottom of your heel, be sure to come prepared to answer questions (and ask questions of your own, of course). Your doctor will probably want to know a history of your symptoms and will perform a physical exam of your foot to check for swelling and redness. He or she may also check for tenderness on the foot to find out where the pain is coming from. You may need to get X-rays to check for other possible sources of your pain (such as stress fractures).

Getting your plantar fascia to feel better usually revolves around some conservative treatments. These may include anti-inflammatory medication (such as ibuprofen), ice (20 minutes on the foot over a thin towel, then 40 minutes off), doing exercises to stretch the calf muscle, wearing shoes that give better support to the foot (such as those with a slightly elevated heel and decent arch support), avoiding going barefoot, and giving your feet a rest by avoiding activities that stress them out (like certain sports or standing for long periods).

Persistent pain may need slightly more extensive treatment, such as the use of orthotics (custom-made shoe inserts), a walking cast to keep your foot immobile or a night splint to stretch the plantar fascia out. Your podiatrist may also suggest physical therapy (including extracorporeal shock wave therapy), padding and strapping (or taping) the foot to ensure things stay in their proper positions, and cortisone injections (although you don’t really want to have more than one of these, since repeated injections can weaken the fascia).

Although it’s rare, very persistent plantar fasciitis may need to be addressed with surgery if it fails to respond adequately to the above treatments. Surgery usually involves releasing the fascia from the bottom of the heel bone, although this may weaken the arch of the foot, and may have other complications, including as infection and nerve injury. Be sure to discuss all possible treatments with your foot doctor.

After receiving treatment, your plantar fascia should stop causing you so much pain. But really, the whole experience should make you appreciate the bottom of your foot that much more. And then you can thank it. From the bottom of your heart.

The most common cause of heel pain and heel spurs is a condition called Plantar Fasciitis. This is Latin for inflammation of the Plantar Fascia. The Plantar Fascia is the broad band of fibrous tissue that runs under the foot and that forms your arch. Because of a number of different factors the plantar fascia are being overly stretched and this continuous pulling results in inflammation and pain at the heel bone, at the point where the ligaments insert into the heel bone.

Over-pronation of the feet (fallen arches + rolling inward of the feet and ankles), tight calf muscles, as well as ageing and being overweight are the main causes for the plantar fascia being overly stretched.

There are many ways to treat heel pain, heel spurs and Plantar Fasciitis, including cortisone injections and surgery. However, in most cases Plantar Fasciitis relief can be achieved through self-help by following a number of easy, simple steps, most of which are aimed at reducing the pulling of the plantar fascia:

1. Rest, reduced activity:

When you have Plantar Fasciitis avoid any activity that can further aggravate the problem. This includes walking for long distances, walking up or down stairs, running, sports etc. If you want to keep fit swimming is the safest activity, until your heel pain has been treated properly. Or you can ride a bike or a stationary exercise bike. Basically, try to be as little on your feet as possible, allowing the plantar fascia to heal itself.

2. Ice (can be combined with heat)

Use an ice pack and apply it onto the sore heel for 5-10 mins at a time, 3 to 4 times per day. The ice will reduce the Plantar Fasciitis inflammation in the heel area. To help reduce any chronic inflammation, you can try alternating between ice and heat. Place an ice pack on the heel for 5 minutes and then switch to a hot pack (or hot water foot bath) for another 5 minutes. Do this for about 20-30 minutes per day and you’ll notice some considerable heel pain relief.

3. Roll a tennis ball (or rolling pin) under the foot

Many people with Plantar Fasciitis experience a sharp heel pain in the morning, when taking the first steps after getting out of bed. This pain comes from the tightening of the plantar fascia that occurs during sleep. Stretching and massaging the plantar fascia before standing up will help reduce heel pain for the rest of your day! Massaging the plantar fascia can be done simply by rolling a tennisball (or rolling pin) under the foot, all the way from the heel to the toes. You may do this sitting down, applying a fair amount of pressure onto the arch, or even standing up as long this causes not too much discomfort. Keep rolling the ball or pin under the foot for about 5 minutes.

4. Towel stretch

Your next Plantar Fasciitis exercise is stretching of the plantar fascia using a bath towel. Put a rolled up towel under the ball of one foot, holding both ends of the towel with your left and right hand. Next, slowly pull the towel towards you, while keeping your knee straight (the other knee may be bent). Hold this position for 15 to 20 seconds. Repeat 4 times and change to the other foot, if necessary. (It’s always good to do these exercises on both feet, even if you only experience heel pain in one foot, as this will help prevent the heel problem to come back in your other foot!)

5. Stretch your calf muscles

Tight calf muscles is a major contributing factor to Plantar Fasciitis. Therefore this particular heel pain exercise is very important. Stand facing a wall with your hands on the wall at about eye level. Put one leg about a step behind your other leg, keeping your back heel flat on the floor. Make sure this leg stays straight at all times. Now bend the knee of the front leg slowly, lowering your body until you feel a stretch in the calf of the back leg. Hold the stretch for 15 to 20 seconds. Repeat 4 times. Do the same for the other leg.

Now you’re ready to face the day! Please make sure you don’t walk barefoot at home in the morning, as this will undo all the hard work and aggravate your plantar fasciitis. Wear shoes or supportive sandals as soon as you have done the heel pain exercises.

You can repeat any of these heel pain exercises during the day, if you wish. For example the tennis ball rolling can be done as you watch TV or read the paper.

There’s one more plantar fasciitis exercise you may want to do which is called the Achilles Tendon stretch. Stand on a step with both feet on the same step and slowly let your heels down over the edge of the step as you relax your calf muscles. Hold this stretch for about 15 to 20 seconds, then tighten your calf muscle a little to bring your heel back up to the level of the step. Repeat 4 times.

Please note that stretching exercises should create a pulling feeling, they should never cause pain!

6. Take an anti-inflammatory drug, like Ibuprofen

To ease Plantar Fasciitis and heel pain you can take an anti-inflammatory that contains Ibuprofen, like Nurofen or Advil. This is a short term fix that will help decrease the inflammation of the plantar fascia. You still need to do take all the other measures such as stretching, ice, orthotics etc to achieve long term pain relief from your heel problem. For many people Ibuprofen is pretty heavy on the stomach and therefore these drugs should be taken in moderation.

7. Lose some weight

As we get older we tend to put in a bit of extra weight. The combination of weight gain and ageing means we put a lot of extra tension on our muscles and ligaments in the feet, legs and back. Most people tend to over-pronate because of weight gain. Over-pronation (fallen arches) is the main cause of Plantar Fasciitis and heel pain. Therefore by losing weight you will decrease the tension on the plantar fascia.

8. Wear the right footwear

Supportive footwear is paramount, especially as we get older. Floppy footwear causes ankle instability during walking and contributes to the problem of over-pronation, leading to heel pain and other foot problems. A good supportive shoe should only bend at the sole in the forefoot area and should be firm elsewhere, especially the back section of the shoe (heel counter) should be firm. Many footwear companies advertise shock-absorption and cushioning as the major benefits of their (sports) shoes. Stability is far more important than cushioning!

9. Use a Plantar Fasciitis night splint

A night splint holds the foot at 90 degrees during your sleep. The aim of the splints is to keep your foot and calf muscles stretched during the night. Normally during rest the plantar fascia and calves tend to tighten and shorten. So when you wake up in the morning and take your first steps, the fascia are being pulled all of a sudden, causing the sharp pain in the heel.

The problem with night splints is that they can be quite uncomfortable. This is why they are so-called sock night splints on the market which are more bearable than rigid night splints.

10. Wear orthotics in your shoes

Research has shown that by far the most effective way to treat heel pain, plantar fasciitis and heel spurs is wearing a corrective device inside the shoe. Orthotics are designed to correct the problem of over-pronation, the major cause of plantar fasciitis and heel pain. Orthotics support the arches and control abnormal motion of the feet, thereby greatly reducing the tension in the plantar fascia band. Especially when combined with daily exercises, orthotics will provide relief to the majority of heel pain sufferers.

Orthotics can be obtained from a foot specialist (podiatrist). These are called custom orthotics and they usually quite hard. Nowadays there are softer orthotics on the market, which are made of EVA and which mold themselves to the wearer’s foot shape because of body heat and body weight. These softer orthotics are pre-made and can be very effective in the treatment of Plantar Fasciitis. They are available without a prescription from pharmacies and specialty websites.

Runners often complain about heel pain. Actually, most people have endured heel pain at some point in their lives. 40% of all visits to U.S. podiatrists are due to heel pain. Of all the different causes of heel pain, the majority is due to a condition known as plantar fasciitis, which is an inflammation in the band of tissue, known as the plantar fascia, that runs from the heel to the toes. Plantar faciitis is most often caused by a tight Achilles tendon or poor foot structure, such as overly flat feet or high arches. Wearing non-supportive footwear on hard surfaces, spending long hours on your feet, and obesity are also causes of plantar faciitis.

The pain from plantar fasciitis is usually a sharp, stabbing pain on the inside of the bottom of the heel that can feel like a knife sticking into your heel. Pain from plantar fasciitis is usually most severe when you first stand on your feet in the morning. Many people complain that the first step out of bed is the worst. Many also have pain as they get up and start to walk after sitting for a period of time while working at a desk or computer. This heel pain will usually subside as you walk, but can return with prolonged standing, walking or running.

For runners, the plantar fascia may become inflamed after a period of running hilly courses or running in excessively worn shoes or the wrong type of shoe for your foot type. Once this happens, a cycle of inflammation ensues. There is a nerve (called the medial calcaneal nerve) that runs along on the inside of the heel bone and actually curves down around the bottom of the heel between the bone and the plantar fascia. As you walk and place stress on the plantar fascia, the tugging of this ligament where it attaches to the heel bone stimulates inflammation. The inflammation results in fluid being collected around the nerve between the bone and the plantar fascia. When you get up and step on the heel, the nerve gets compressed by the collection of fluid. This causes the sharp pain. By stepping on the heel, some of the fluid is pushed out of the area and away from the nerve. Each consecutive step may hurt less and less as even more fluid is pushed away from the space around the nerve. Once you get moving, the pain then usually subsides. Once you go to sleep the whole cycle begins again.

Plantar fasciitis is a combination of two separate problems. If your Achilles tendon is too tight, that leads to abnormal tension on the plantar fascia when you run or walk. Second, there is inflammation from all of the tissue damage as the plantar fascia is tearing away at its attachment to the heel bone. You must address both.

The main question I get from patients about treating plantar fasciitis is “will I need surgery?” The answer to this is almost certainly not. Most heel pain sufferers could effectively self-treat their heel pain and get permanent relief without ever visiting a doctor. The reason I know this to be true is that I have tracked the progress of those patients that have been seen in my office. I see several patients with heel pain every single day in my office. In 2007 I only performed surgery on four patients for plantar fasciitis.

My treatment philosophy and practice style is simple. I firmly believe that simple, reliable, cost-effective treatments should always be attempted before expensive and evasive treatments like surgery. Although I am an award winning foot and ankle surgeon (and admittedly love doing surgery) I truly believe that surgery is just a bad idea if any other treatment will work.

The main question I get from runners is “can I run with plantar fasciitis?” The answer is yes, provided it has been diagnosed as plantar fasciitis. As I said earlier, plantar fasciitis is by far the most common form of heel pain, however there are other causes. Stress fractures of the heel bone, bone cysts (weak areas) and bone tumors can all mimic the symptoms of plantar fasciitis. The difference is that they are usually more painful when you run and will not subside (but instead get worse) while you are walking or running. These can also lead to serious problems such as a fracture of the heel bone. A fractured heel bone will definitely interrupt your training schedule.

Provided that it is plantar fasciitis, the most often effective treatments for plantar fasciitis include stretching, icing, and anti-inflammatory medications. A program of home exercises to stretch your Achilles tendon and plantar fascia are the mainstay of treating the condition and lessening the chance of recurrence. Achilles tendon stretches are essential to eliminate heel pain. Perform the Achilles tendon stretches morning and evening. This will only take 1 minute in the morning and 1 minute at night.

Stand upright one large pace away from the wall with your feet parallel and about hip width apart. Place your hands against the wall, at shoulder height. Move your right leg half a pace forward. Try lunging forward on your right leg so that the knee is aligned over the ankle. Stretch your left leg back as far as is comfortable with the foot and heel remaining flat on the floor. Slowly lean forward to stretch the left leg calf muscles and tendon. Hold the stretch for 10 seconds, relax, and repeat on the other leg. Perform each stretch three times per side.

Icing your heel will decrease inflammation that accumulates while you walk during the day, and to prevent more inflammation while you sleep. Apply ice to the sore area for 20 minutes two or three times a day to relieve your symptoms. Do not go barefoot or wear flip-flops. Only wear shoes with a moderate heel that do not bend through the arch. Always wear shoes when walking, even in the home. If you have custom orthotics, or over-the-counter inserts, wear them in your shoes at all times. The majority of people with plantar fasciitis improve tremendously after just two months of initial treatment.

Keep on running, but seek help if your heel pain gets worse while you run or if the heel pain just won’t go away after trying the treatments described above. Once you get rid of the heel pain, keep stretching your Achilles tendon periodically and you can prevent your heel pain from coming back. No more limping out of bed before your morning run!

What is Plantar Fasciitis?

Plantar fasciitis is a common foot problem in sports participants and people that stand/walk for extended periods during the day.  It starts as dull occasional pain in the heel which may progress to a sharp persistent pain.  Classically, it is worse in the morning with the first few steps, or at the beginning of a sporting activity. The plantar fascia is a thick fibrous band running the length of the arch from the heel bone to the ball of the foot.  It is responsible for helping maintain the arch of the foot.  It stretches to help absorb shock as the arch flattens with body weight. With repetitive stress, such as prolonged standing, walking or running, the fascia becomes strained resulting in micro tears, most often where the fascia attaches to the heel bone. Since it is difficult to rest, a vicious cycle is set up where the situation is aggravated with each step.  In severe cases, the heel may become swollen.  The problem progresses rapidly and is much easier to treat when it has just begun, rather then when it has become a chronic problem. However, when the fascia is properly supported by an orthotic the tears are minimized and healing may begin. When the fascia is pulled away from the bone the body reacts over time by filling in the space with new bone.  This causes the classic “heel spur”.  This heel spur is usually a secondary x-ray finding and is not the cause of the problem but rather a result of the problem.

What Causes Plantar Fasciitis:

Flat over-pronated feet or high arched rigid feet Overuse/training errors – too much too soon Standing/walking more than 6 hours a day Inappropriate, improper or worn out shoes Soft terrain (ie running in sand) Inflexibility of the Achilles tendon Increasing age

Treatment:

Orthotics:  They support the arch which controls overstretching of the plantar fascia and reduces tearing.  Orthotics also help align your feet to keep your weight centered on your heel instead of on the inside edge.  The heel cup in the orthotic redistributes pressure over a larger area, thereby reducing pressure on the centre of the heel. Avoid walking barefoot, even at home.  Ideally you would want to wear your custom orthotics as much as possible to keep the stress off the plantar fascia. Muscle/Fascia Therapy: Plantar fascia stripping by having one leg crossed over the other so that you can see the bottom of the affected foot.  With one hand pull your toes back to stretch out the plantar fascia.  Apply some moisturizing cream to the bottom of your foot.  Use the knuckles of your fingers (the middle joints) and apply firm pressure in a downward motion from the ball of your foot to the heel.  It should feel like popping bubble wrap when you do this.  Repeat the motion around 40 times and do this several times per day.  This procedure is painful if done correctly, but the result will be well worth it. Shoes:  It is possible for shoes to cause the problem.  You may need different or new shoes.  Wear supportive and shock-absorbing footwear at all times. 

Modified Activity: Use pain as your guide.  Avoid prolonged standing, excessive walking on hard or rough surfaces, and other weight bearing activities.

Ice: Place ice on your heel for 15 minutes several times a day to reduce the inflammation.  You can also roll your foot over a frozen can as shown, or frozen bottle of water. Exercises: Your chiropractor will show you how to strengthen the small muscles of your feet and improve the flexibility of your plantar fascia and Achilles tendon.  This will support the arch and put less stress on the weakened inflamed plantar fascia.

Soak your feet each night in a warm (not hot) Epsom salts bath. 

Go back into the weight bearing sports slowly.  If you have a lot of pain either during the activity or the following morning, you’re doing too much.

Plantar fasciitis is a very painful condition that affects a majority of the population.  Conservative management of this condition works well if done in combination with orthotics, fascia stripping and ice.  Remember that you should treat this condition as soon as possible.  Living with pain is not a sensible option, and delaying treatment will likely result in increased, prolonged and recurring pain.