Wishing you all a Happy Easter.
Take care on the roads.
Heel pain affects a large portion of the population, often resulting in visits to The Podiatrist. Plantar fasciitis is typically the diagnosis the patient receives during the visit; however, plantar fasciitis is only one potential cause of heel pain. The plantar fascia is a strong, dense strip of tissue that runs from the heel to the ball of the foot. Its sole job is to support the arch of the foot. .
It is easy to see how the plantar fascia may be causing all this pain as the foot impacts the ground when you think about how often the full weight of the body is concentrated on the plantar fascia. This forces it to stretch as the arch of the foot flattens from the full weight of the body, possibly leading to stress where the plantar fascia attaches at the heel bone. If this keeps up, the result can be pain caused by small tears of the fascia.
If it is not the plantar fascia then what else could be causing my heel pain?
Calf muscle weakness (muscles on the back of the lower leg) can result in referred pain directly to the heel.This is seen after someone has changed/added a workout program or modified the type of shoes they wear. This adds additional stress to the calf muscles that they may not have been ready for and lead small areas of irritation in the muscles.>
Calf muscle tightness – this causes the connective tissue surrounding the muscle to pull harder on the Achilles tendon leading to tightness at the heel, possibly resulting in the pain you’re feeling.
Sciatic nerve irritation – the nerve that runs from the low back through the hip and down the leg to the foot can get tight or pinched not allowing the nerve to move easily as you walk. This can lead to irritation of the nerve causing pain that is located at the heel. This is very common for anyone with any history of low back pain or hip pain.
Poor Posture – if you sit slumped forward most of the day the muscles and structures from the back of your neck, upper back, lower back, and hips can get tight and shortened, consequently pulling on the heel.>
Weakness of the muscles around the hip can cause muscles in the leg to shorten to help stabilize, consequently pulling on the heel.>
Why is this so confusing?
It may be hard for you to pinpoint the cause of heel pain yourself because the symptoms are the same for all of the above listed causes. No matter what the cause, you will experience pain on or around the heel when weight is placed on the foot. This is usually worse in the morning, especially with the first few steps after getting out of bed. In most cases, there is no pain at night, but this is not a rule as many of our patients report increased pain at night. Pain of typical plantar fasciitis is typically believed to decrease over the course of the day as the tissue warms up; however, patients have also reported increased discomfort as the day progresses, leading on to investigate other areas as the source or cause. Additionally, prolonged standing, walking, or getting up after long periods of sitting are commonly reported with all of the above causes. Again, the reports can be as varied as the potential causes.
Activities that make the pain worse:
Excessive running or jumping
Changing physical activity (especially for athletes)
High arches, flat feet, abnormal gait
Wearing improper shoes while walking or running
The Steps to Relieve Heel Pain
In most cases, heel pain does not require surgery and can be treated conservatively, but the first step is to obtain an evaluation by The Podiatrist who can help pin point the actual cause of the pain that’s specific to you. It is important to not treat the symptom of heel pain, but to isolate and treat the cause.
The Podiatrist may then recommend treatment , depending on the needs of your particular condition. In extremely painful conditions, your doctor may prescribe anti-inflammatory medications, and in severe cases give you a cortisone shot to address excessive inflammation.
Most people with heel pain get better with the help of The Podiatrist, but don’t wait. The longer you “live” with the pain the longer it may take to get rid of it as your body adapts. Most acute cases (less than 30 days) can get better within 6-8 weeks. Additionally, treatment should include activities that directly address the cause of your heel pain and are designed to include you in the healing process, so your participation is critical.
The Podiatrist specializes in the treatment and management of all foot related problems and will assess what is the cause of your foot/heel pain, not the symptom.
For more information or to find out if you are a good candidate for our services contact The Podiatrist
Heel and arch pain are the most common foot complaints of individuals over the age of 40. The group that most commonly experiences heel and arch pain consist of middle-aged women. In addition, active athletes and people working on hard surfaces or walking great distances are susceptible to plantar fascitis and developing heel spurs or sore arches. The pain can progressively get worse so that activities of daily living are adversely affected.
Plantar Fascia Defined
The plantar fascia connects to the calcaneus or heel bone on the undersurface of the foot to the bones of the toes. Its purpose is to support the large arch of the foot. When the fascia becomes injured or inflamed, it’s called plantar fascitis.
What Can Cause Plantar Fascitis?
Plantar fascitis begins with injury to the ligaments and fascia. The fascia helps to maintain the large arch on the inside of the foot. It may affect one or both feet. In most cases, it begins gradually and may be made worse by the following:
- Poorly Fitting Shoes – Shoes lacking firm shanks and counters allow the foot to override the shoe so it appears like the foot has slid off the sole of the shoe. This is commonly called “running over the shoe”.
- Pronation and Pes Planus – “Flat feet” is a rolling inward of the arch.
- Prolonged Standing on Hard Surfaces Such as Concrete
- Walking, Dancing or Running Great Distances – These result in repetitive strain on the bottom of the foot.
- Being Overweight – Extra weight on the arches is stressful.
- Sex – Females over age 40 are more susceptible.
Symptoms of Plantar Fascitis
The presentation of complaints to the doctor includes heel pain upon arising first thing in the morning. The first dozen steps or so are very painful until the fascia loosens up and becomes more flexible. The pain seems to subside only to get worse as the day progresses.
Diagnosis of Plantar Fascitis
The diagnosis of plantar fascitis is arrived at from a combination of
history and physical examination of the foot and lower leg. A classic complaint is heel pain when getting out of bed and beginning to walk. Compression of the calcaneus or heel bone on the sides of the heel is painful. X-rays may be necessary if the doctor suspects a stress fracture to one of the small bones of the foot. Many of the causes of plantar fascitis may contribute to a stress fracture in the foot.
Pain and numbness in the foot at night may also be attributed to a condition called tarsal tunnel sydrome. This is a nerve entrapment in the ankle that may produce similar symptoms as those found with plantar fascitis. Both conditions can bother at night when trying to sleep. Other conditions including arthritis, gout and other systemic problems can also contribute to foot pain.
The immediate treatment goal is to reduce the swelling and inflammation to the soft tissue in the foot. Ice treatment to the foot is initially prescribed. Wearing shoes with a firm counter and shank to prevent bowing of the shoe as well as “running over the side of the shoe” is recommended. Discontinuing running and sports activities reduces stress on the foot. The use of orthotics can be very helpful in restoring the arch (flat foot) and correcting pronation (turning in of the foot). Restoring the arch reduces the stress on the knee, hip and spine. Specific exercises will be given for the foot.
It’s difficult for any one treatment protocol to resolve or control plantar fascitis. The combination of proper footwear, treatment, exercise and modification of activity can be successful. Patient compliance is essential to help in the care and treatment. It may take from a few weeks to several months to resolve the problem. Re-injury and aggravation play a large role in the recovery process. The importance of compliance cannot be stressed enough.
If plantar fascitis is ignored and not treated, it may complicate or contribute to ankle, knee, hip and spinal complaints. The biomechanics of gait may be altered.
The Podiatrist has experience in the care and treatment of plantar fascitis and heel spurs. Call today to make an appointment.
Nowadays, most Podiatists and Doctors would agree that heel pain is a very common malady. However, there are many causes of this pain. One of the most prevalent is the heel spur. A heel spur results from an anatomical change of the heel bone.
What are Heel Spurs?
The heel bone forms one end of the two longitudinal arches of the foot held in place by ligaments and are activated by the muscles of the foot. These muscles and ligaments, like the other supporting tissues of the body, are attached in two places. Where there is undue stress to the heel bone, one’s body automatically calcifies the tissue attachments thus creating a spur.
The pain from heel spurs is a result of inflammation around the tendons where they attach to the heel bone. Most would assume that the pain would dramatically increase as you walk but it is not usually the case. In all actuality, the pain is the most intense when you begin to walk after not being on your feet for a while. After a short period of time, the pain usually dissipates and you adjust.
If excessive strain has been placed on the foot the day before, the pain may also be greater. A sudden strain, as might be produced by leaping or jumping, can also increase the pain. The pain might be localized at first, but continued walking and standing after being stressed will soon cause the entire heel to become tender and painful.
It has been reported that anywhere between 11 and 27% of the population have radiographic evidence of a spur. Furthermore, heel spurs do appear to be associated with obesity, osteoarthritis and a major component of the aging process.
Heal Heel Spurs
To help alleviate the pain, see The Podiatrist to have the condition diagnosed.
Have you experienced heel spurs before? What do you do to alleviate the pain from heel spurs?
See The Podiatrist if you are experiencing problems.