© SKI Publishing
Tips for Treating Heel Pain
By Christine Dobrowolski,
The most common cause
of heel pain is plantar fasciitis (plan*tar _fash*ee*i*tis).
If you experience a sharp pain in your heel when you first step down
in the morning, it is most likely due
fasciitis. This type of heel pain may also occur as achiness at
the end of the day in the heel or even burning pain in the arch.
can be associated with a heel spur, but this is not the cause of
the pain. When the long ligament like structure (plantar fascia)
on the bottom
of the foot pulls on the heel bone over a period of time, a spur
is formed. Only 50% of individuals with plantar fasciitis have
a bone spur in their
heel. The spur will never go away, but the plantar fasciitis will.
Plantar fasciitis is typically caused by a new activity, a new
pair of shoes,
a worn out pair of shoes, a change of routine or change in job.
Individuals with flatfeet or abnormal motion in the feet may
have a higher chance
of developing plantar fasciitis. Once you develop plantar fasciitis,
you may find it very difficult to treat.
the cause. There is typically a reason for the development of plantar fasciitis,
but since the condition is not typically
associated with an acute
injury it may be hard to remember. Once the cause is identified, try
to stop or modify the activity.
aggravating activities. Climbing up and down stairs, walking or running on hills,
heavy items and walking on uneven
terrain all place
excess stress through the feet. Decrease these activities by asking
your spouse, significant other or friend for help with the kids or
heavy items. Avoid
multiple trips up and down the stairs at work and home. Limit gardening
to flatter more even terrain. Stop running and walking for exercise
and try biking or swimming.
Avoid the stair stepper, the treadmill and the elliptical machine at
- Stop running
or walking. Keeping up aerobic activity is important and cross training
can help. Try biking or swimming. Most
at the gym, but this isn't forever. Don't drop your heel when you
bike and try to avoid standing and climbing steep hills if you cycle
If you participate
in spin classes, you may need to modify the class to avoid further
injury to the foot. The recumbent stationary bike may place excess
because of the position. The classic stationary bike may be more
- Try using
an ice massage. Freeze a sports water bottle and place it on the floor.
To decrease inflammation and pain in your
foot over the
water bottle for at least 20 minutes twice a day. Alternate between
the frozen water bottle and a heating pad, at 5 minute increments,
minutes a day,
three to four times a week.
your calf. Before you get out of bed, wrap the towel or belt around the ball
of your foot. Pull
the foot towards you,
You should feel a stretch in the back of the calf, and this will
also stretch the bottom of the foot. Stretch your calf throughout
with the runner's
stretch and spend 5-10 minutes every evening stretching your
- Take anti-inflammatory
Anti-inflammatory medications will help decrease the
inflammation that occurs in the fascia
as a result of
and tearing. Make sure you decrease your activity level and
stretch and ice as much as possible during the time you are taking
you may end up only masking the pain. Take the medication with
stop taking the medication if you experience stomach discomfort.
- Wear supportive
shoes. A supportive shoe will only bend at the toes. This step may
seem logical, but many individuals
shoes lack support and may be contributing to their pain.
Test your shoe by taking it, flipping it over and grabbing the toe
Attempt to fold
the shoe in half. If the shoe bends in half, then the shoe
is not supportive. Don't go barefoot. See the American Podiatric
(APMA) list of approved shoes at www.apma.org/ seal/sealaccategory.html.
the muscles in your feet.
Place a small towel on the floor and
curl your toes on the towel as you bring
on the floor and pick them up with your toes and place
them in a bowl.
- Wear orthotics. Prefabricated orthotics are inserts that fit into the shoe to help
control motion in your feet.
can decrease the stress and help the plantar fascia heal.
Soft inserts available at the drug store may be comfortable,
help control abnormal
motion. Make sure the orthotics you buy are rigid or
stiff from the heel to the ball of the foot.
- See a
podiatrist. If your symptoms persist, make an appointment with your podiatrist.
steroid injections, night splints, physical therapy,
cast boots, shock wave therapy and surgery. Luckily,
is a podiatrist, runner, and author of "Those Aching Feet:
Your Guide To Diagnosis and Treatment of Common Foot Problems," available
via her publisher, SKI Publishing, and at Barnes & Noble and Amazon.com.
by Dr. Christine Dobrowolski, DPM
Products at Northcoast
Heel Pain Kit