Heel pain is one of the most common issues that we treat of the foot and ankle. Something we are seeing in our office is a significant increase in the amount of heel pain over the last few months. We believe this has to do with a couple of different factors.
First, with many of us working and spending more time at home, people are more prone to walk barefoot or in unsupportive shoes. Second, people are also looking for new ways to get out of the house more by picking up activities such as running and hiking without the necessary preparation. Today we will focus on the most common cause of this pain, plantar fasciitis.
Plantar fasciitis is defined as inflammation to a ligament in the bottom of the foot known as the plantar fascia. This ligament attaches at the heel bone and expands outward, supporting the arch of the foot. Inflammation occurs when this ligament is abnormally pulled or stretched, creating small tears that become inflamed.
When walking, the inflammation is unable to settle; however, when the person is non-weight bearing for a period of time, like when in bed or sitting in a chair, the first step is extremely painful as they are stepping on large amounts of inflammation. This is the hallmark sign of plantar fasciitis known as post-static dyskinesia.
Diagnosis of plantar fasciitis is based on a thorough history from the patient as well as physical exam. Imaging studies such as X-rays and ultrasound are also useful.
Once diagnosed, a treatment regimen is set in place. The goal is to immediately treat the pain as well as prevent the pain from recurring, which is a common occurrence with plantar fasciitis. The following five-step plan may be the first line of action in treatment:
Stretching exercises/Ice: We will provide you with some simple at-home exercises and stretches to decrease the tightness of the plantar fascia. An ice massage to the area will decrease inflammation.
Proper shoe selection: Not all tennis shoes are made the same. Furthermore, a higher priced shoe does not equal a higher quality shoe if the type of shoe selected is incorrect for your foot type. Your Resonance Podiatrist will guide you based on your physical exam to the appropriate type of shoes that should be worn based on your foot type and daily activities.
While this treatment regimen is typically successful, treating a part of the body that is under constant stress from walking can be difficult. There are occasions where additional treatment, as well as advanced treatment options, are necessary, including the following.
Physical therapy: Sometimes additional stretching and exercises are needed at the guidance of the physical therapist. Their specialty allows them to directly manipulate the plantar fascia with different modalities to improve the current pain as well as preventing long-term pain.
Custom orthotics: Over-the-counter inserts do not provide enough support, your Resonance Podiatrist will arrange a pair of custom orthotics. These are made from taking a mould of your foot in the office which is then sent to a lab and a personalized pair of inserts are made specifically for your foot.
While plantar fasciitis is the most common cause of heel pain, there are still a number of other conditions that can cause the same symptoms, some more significant than others. If you or someone in your family is experiencing heel pain, please call us today to resolve all your foot pain.
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