Have you ever felt that stabbing pain to the bottom of your heel when taking the first few steps after getting out of bed or sitting for a long time? You probably have plantar fasciitis or heel spur syndrome.
Plantar fasciitis is inflammation of a dense band of tissue that runs across the bottom of your foot and connects the heel bone to the toes. It is one of the most common causes of heel pain and it is usually seen in female, overweight individuals, jobs that require long standing and walking on hard surfaces. It is also related to running on hard, unyielding surfaces; overtraining; improper conditioning, especially failure to stretch the Achilles tendon and hamstrings; and excessive shoe wear or improper shoes with lack of foot support or shock attenuation. People with very flat feet and also high arches also are more prone to plantar fasciitis.
The condition occurs when the plantar fascia is strained over time beyond its normal extension, causing the soft tissue fibers of the fascia to tear or stretch at points along its length; this leads to inflammation, pain, and possibly the growth of a bone spur where the plantar fascia attaches to the heel bone.
- A variety of steps can be taken to avoid heel pain and accompanying afflictions:
- Wear shoes that fit well—front, back, and sides—and have shock-absorbent soles, rigid shanks, and supportive heel counters
- Wear the proper shoes for each activity
- Do not wear shoes with excessive wear on heels or soles
- Prepare properly before exercising. Warm up and do stretching exercises before and after running.
- Pace yourself when you participate in athletic activities
- Don’t underestimate your body’s need for rest and good nutrition
- If obese, lose weight
Early treatment might involve oral or injectable anti-inflammatory medication, exercise and shoe recommendations, taping or strapping, or use of shoe inserts or orthotic devices. Taping or strapping supports the foot, placing stressed muscles and tendons in a physiologically restful state. Physical therapy may be used in conjunction with such treatments.
Stretching of the Achilles tendon and plantar fascia is the best treatment for plantar fasciitis. If after about 6 months of conservative treatment, you do not return to a previous comfortable level of function, your physician might consider surgical intervention. If surgery is necessary, it may involve the release of the plantar fascia, removal of a spur, removal of a bursa, or removal of a neuroma or other soft-tissue growth.
Most patients do not require surgery, which is only performed in less than 8% of all heel pain cases.
I treat most of my patients conservatively, which includes, but not limited to:
- PRICE protocol (Protection, Rest, Ice, Compression, Elevation)
- Taping of the foot
- Stretching exercises of the lower leg and foot (most important)
- Night splint for continuous stretching
- Orthotics and other accommodative
- Ice massage
- Injection, depending on the level of discomfort
- Patient education
Just remember that not every heel pain is plantar fasciitis or heel spur syndrome. Contact your doctor or my office for an evaluation.
If you don’t treat plantar fasciitis, it may become a chronic condition. You may not be able to keep up your level of activity, and you may develop symptoms of foot, knee, hip and back problems because plantar fasciitis can change the way you walk.