Most cases of Heel Pain
are caused when a band of tissue in the foot, known as the plantar fascia, becomes
damaged and thickens. Plantar fasciitis is the medical term for the thickening of the plantar fascia. The plantar fascia is a tough and flexible band of tissue that runs under the sole of the foot.
It connects the heel bone with the bones of the foot, and acts as a kind of shock absorber to the foot. Sudden damage, or damage that occurs over many months or years, can cause tiny tears
(microtears) to develop inside the tissue of the plantar fascia. This can cause the plantar fascia to thicken, resulting in heel pain. The surrounding tissue and the heel bone can also sometimes
Heel pain is most often the result of overuse. Rarely, it may be caused by an injury. Your heel may become tender or swollen from shoes with poor support or shock absorption, running on hard
surfaces, like concrete, running too often, tightness in your calf muscle or the Achilles tendon. Sudden inward or outward turning of your heel, landing hard or awkwardly on the heel. Conditions that
may cause heel pain include when the tendon that connects the back of your leg to your heel becomes swollen and painful near the bottom of the foot, swelling of the fluid-filled sac (bursa) at the
back of the heel bone under the Achilles tendon (bursitis). Bone spurs in the heel. Swelling of the thick band of tissue on the bottom of your foot (plantar fasciitis). Fracture of the heel bone that
is related to landing very hard on your heel from a fall (calcaneus fracture).
Plantar fasciitis is a condition of irritation to the plantar fascia, the thick ligament on the bottom of your foot. It classically causes pain and stiffness on the bottom of your heel and feels
worse in the morning with the first steps out of bed and also in the beginning of an activity after a period of rest. For instance, after driving a car, people feel pain when they first get out, or
runners will feel discomfort for the first few minutes of their run. This occurs because the plantar fascia is not well supplied by blood, which makes this condition slow in healing, and a certain
amount of activity is needed to get the area to warm up. Plantar fasciitis can occur for various reasons: use of improper, non-supportive shoes; over-training in sports; lack of flexibility; weight
gain; prolonged standing; and, interestingly, prolonged bed rest.
A biomechanical exam by your podiatrist will help reveal these abnormalities and in turn resolve the cause of plantar fasciitis. By addressing this cause, the patient can be offered a podiatric
long-term solution to his problem.
Non Surgical Treatment
Treatment includes resting from the activities that caused the problem, doing certain stretching exercises, using pain medication and wearing open-back shoes. Your doctor may want you to use a 3/8"
or 1/2" heel insert. Stretch your Achilles tendon by leaning forward against a wall with your foot flat on the floor and heel elevated with the insert. Use nonsteroidal anti-inflammatory medications
for pain and swelling. Consider placing ice on the back of the heel to reduce inflammation.
Surgery to correct heel pain is generally only recommended if orthotic treatment has failed. There are some exceptions to this course of treatment and it is up to you and your doctor to determine the
most appropriate course of treatment. Following surgical treatment to correct heel pain the patient will generally have to continue the use of orthotics. The surgery does not correct the cause of the
heel pain. The surgery will eliminate the pain but the process that caused the pain will continue without the use of orthotics. If orthotics have been prescribed prior to surgery they generally do
not have to be remade.
Flexibility is key when it comes to staving off the pain associated with these heel conditions. The body is designed to work in harmony, so stretching shouldn?t be concentrated solely on the foot
itself. The sympathetic tendons and muscles that move the foot should also be stretched and gently exercised to ensure the best results for your heel stretches. Take the time to stretch thighs,
calves and ankles to encourage healthy blood flow and relaxed muscle tension that will keep pain to a minimum. If ice is recommended by a doctor, try freezing a half bottle of water and slowly
rolling your bare foot back and forth over it for as long as is comfortable. The use of elastic or canvas straps to facilitate stretching of an extended leg can also be helpful when stretching
without an assistant handy. Once cleared by a doctor, a daily regimen of over-the-counter anti-inflammatory medication like Naproxen Sodium will keep pain at bay and increase flexibility in those
afflicted by heel pain. While this medication is not intended to act as a substitute for medical assessments, orthopedics or stretching, it can nonetheless be helpful in keeping discomfort muted
enough to enjoy daily life. When taking any medication for your heel pain, be sure to follow directions regarding food and drink, and ask your pharmacist about possible interactions with existing
medications or frequent activities.