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Heel pain is one of the most common conditions I treat in my office on a regular basis. The pain can occur at the side, back or bottom of the heel. Runners are especially susceptible to heel pain from overuse. It occurs as a result of pulling or tearing of the ligament that spans from the heel to the forefoot called the plantar fascia.
The plantar fascia ligament pulls from it’s origin at the heel, resulting in inflammation and swelling. This inflammation then causes heel pain. Plantar fasciitis can occur in either one or both feet, and it is sometimes also associated with a heel spur.
The spur develops as a result of the constant pulling of the ligament from the heel, but it does not directly cause pain. Many people with plantar fasciitis can resolve their symptoms even if they have a heel spur.
Heel pain is generally associated with too much pressure on the heel and abnormal walking or running mechanics that place excessive stress on the ligaments. The stress can also result from an injury, poor shoe gear that is flimsy or has a lack of arch support, or from being overweight. People with arches that are either flat or too high can be susceptible, and it can occur in people of all ages. Those with tight calf muscles or Achilles tendon may also be at risk. People with jobs that require a lot of walking or standing on hard surfaces or athletes that run on irregular surfaces are also susceptible
People sometimes report a stabbing pain early in the morning when they first get out of bed and taking their first few steps. They may also experience pain after standing or sitting for a long time. The pain may get better after moving around a bit, but progressively gets worse as the day progresses. This may also occur when exercising or running where the pain comes back after the activity.
Taping or strapping the foot. I can apply kinesio tape, such as Rocktape, to support and reduce painful symptoms
I may recommend a night splint. These are very useful to prevent the pain people experience from getting out of bed by keeping a constant passive stretch to loosen up the ligament at night.
Physical therapy is something I can write a prescription for if home stretches are not enough. Physical therapists offer a wide range of modalities to treat this condition.
I also give steroid injections or prescribe stronger anti-inflammatory medication.
Podiatry recommended arch supports called Powersteps can be used in sneakers, and they even have a line of arch supports for more narrow dress shoes to make them more supportive for your feet.
Custom molded orthotics can also be made, and they are great because I take an exact mold of your feet to create devices for your specific arch height
Additional treatment options including surgery may even be discussed. If you are experiencing heel pain that is unbearable please make an appointment to see me and let’s discuss your treatment options and find the best solution.