Plantar Fasciitis – Oh My Aching Heel!

I have been in pain for weeks.  Possibly for months.  I don’t recall when the pain started, it’s been so long.  The pain in the bottom of my left heel has ranged from a twinge to severe enough to make me limp badly.  I have plantar fasciitis.

Credit: drmoy.com

What is plantar fasciitis?

Plantar fasciitis is a mechanical problem that happens where the plantar fascia attaches to the front of the heel bone.  The plantar fascia is a tough band of tissue that supports the arch of the foot and acts as a shock absorber when we walk.  It runs from the ball of the foot to the front of the heel bone.

When the mechanics of the foot don’t work right, that attachment place gets inflamed and painful.  Typically the pain is worst first thing in the morning.  In fact if someone tells me their foot hurts on the bottom and the first step out of bed in the morning is the worst pain they feel all day, I know it’s plantar fasciitis.  Nothing else does that!

What causes plantar fasciitis?

The most common cause of plantar fasciitis is wearing the wrong shoes.  Flip-flops and other shoes with no arch support are the most common cause.  I bought some super cute Converse sneakers some months ago, and I think that’s when the pain started.  Tight calf muscles and Achilles tendons also contribute to the mechanical problems that start and maintain the problem.

What can be done about plantar fasciitis?

The first thing is to start wearing proper footwear.  If you have a high arch (like me) you are especially prone to this problem and should be very careful to wear supportive shoes.  Several people have advised me to never go barefoot, even in the house, especially on wood or tile floors.  I’m working on that!  It’s hard for me to wear shoes in the house, and most house slippers have no arch support.

Aggressive calf stretching is important to keep the calf muscles and Achilles tendons loose and limber.  My personal favorite stretch is to stand on the edge of a stair step on the balls of my feet and let my body weight pull me down into my heels.  Be sure to do calf stretches both with the knee straight and with the knee bent.  There are two big strong muscles in the calf and to stretch them both you need to stretch both ways.

Another measure to help heal the pain is ice.  Ice, ice, ice, and then when you’re done  ice some more.  A frozen water bottle is a good way to both stretch and massage the bottom of the foot while applying cold therapy.

What if it doesn’t work?

If I have a patient that comes in with persistent pain in spite of doing all the above simple things, it is usually time for a cortisone injection.  I haven’t done that yet, because I’m chicken, LOL!  It might be time for it soon, though.

In extremely resistant cases patients usually need to see the podiatrist (foot doctor).  Splinting, injections, massage, physical therapy, and sometimes even surgery may be needed.

Trust me when I tell you, good supportive quality shoes are definitely worth the expense!  It’s an investment in good pain-free foot health!

QUESTION: Have you ever had plantar fasciitis?  What did it take to get rid of it?

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