Every time we take a step, our feet coordinate a complex network of bones, muscles, tendons and ligaments to give us momentum. If your feet are aching in pain when you go for a run and it is an intense, sharp pain in the heel and arch, you are not alone. The heel is the largest bone in the foot. Heel pain, or plantar fasciitis, is the most common foot problem and affects 2 million Americans every year. It can occur in the front, back, or bottom of the heel.
The plantar fascia is a connective tissue band similar to a ligament that connects the heel to the front of the foot to absorb stress and shock we place on our feet. The direct result of straining the plantar fascia is pain, swelling, weakness and irritation.
Symptoms: The symptoms are generally noted as intense sharp heel pain in the first few steps of activity. Sometimes there is occasional relief from pain after a few minutes. There can be pain when pressing on the inside of the heel and sometimes along the arch. The pain is usually worse first thing in the morning because the fascia tightens up overnight. After a few minutes the fascia eases as the foot gets warmed up but the feet will hurt more as the day goes on if activity and weight-bearing pressure continues.
Causes: Plantar fasciitis is caused by stress in the foot’s arch, and it can affect anyone. It accounts for more than 1 million physician visits yearly. Those who are most at risk are athletes, soldiers and overweight individuals who stand frequently, placing heavy strain on their feet. Plantar fasciitis is common in sports involving running, dancing or jumping. The most common cause is very tight calf muscles which lead to prolonged pronation of the foot. This produces repetitive over-stretching of the plantar fascia leading to possible inflammation and thickening of the tendon. As the fascia thickens it loses flexibility and strength. Excessive walking in footwear which does not provide adequate arch support has been attributed.
Relief: Plantar fasciitis is sometimes difficult to eliminate completely. But treatment is generally nonsurgical and conservative in nature. Some initial treatments include:
• Rest- Take a few days off of jogging or prolonged standing/walking. Just resting can allow the inflammation to begin to cool down.
• Apply Ice Packs- Icing will help to diminish some of the symptoms and control the heel pain.
• Exercises and Stretches- Simple and quick exercises often help to relieve pain quickly. They are designed to relax the tissues surrounding the heel bone. It also helps to do preventative calf stretches several times a day, especially when waking up and beginning daily exercises.
• Footwear- Footwear for plantar fasciitis should be lace-up with good arch support and cushioning.
• Shoe Inserts- Shoe inserts are often the key to successful treatment of heel pain. The shoes inserts can permit you to continue daily routine activities without heel pain.
If your pain is severe or if you are unsure of your diagnosis, you should seek medical advice before beginning any treatment plan. You will likely have x-rays to evaluate for other potential causes of heel pain. Further treatments may include: steroid injection in the heel, NSAIDS, physical therapy, custom molded orthotics, night splints, walking cast boot or surgery.