How to “Heal” Heel Pain

Heel pain is a common problem that many runners will experience during their training. Heel pain is more correctly referred to as “plantar fasciitis,” or inflammation of the plantar fascia. This entity goes by many other names, such as heel spurs, heel spur syndrome, and plantar fasciitis to name a few.

The plantar fascia is an elastic band of tissue that spans between the heel and ball of the foot. It actually continues as the plantar part of the Achilles tendon, beginning behind your leg, around the back of your heel bone, and continuing to the bottom of the foot where it inserts onto the bottom of the foot where each toe connects. Normally, this fibrous band of tissue is able to withstand the years of punishment that we put our bodies through daily.

Signs and symptoms that you experience may vary. The most common complaint I hear is, “Doc, my feet hurt as soon as I place them on the floor in the morning.” Other symptoms include specific pin-point pain at the heel, which is easily noted. The pain often worsens as the day continues and is quickly alleviated with rest. Also, the pain may progressively worsen over a period of months. Certain shoes may aggravate the condition as well. Obesity, shoe gear, work conditions, and foot type can all play a role in its development.

Conservative treatment is the mainstay of eliminating heel pain. The most important component is stretching. Take a belt, a towel, or that ugly tie aunt Sallie gave you for your birthday and stretch your feet every day before getting out of bed. Put the towel at the ball of the foot and pull both sides toward you like a horse bridle while keeping your knee straight. You should feel a pulling sensation behind your knee and down your leg. Hold this position for 30 seconds and repeat five times. Make sure you stretch the unaffected side as well.

Another trick is to freeze a bottle of water and roll the bottle with your foot for about 10 minutes on each foot. Over-the-counter anti-inflammatories such as Advil, Aleve, Celebrex, Naprosyn, ibuprofen, Motrin, are readily accessible for all patients. Wear supportive sandals or thick flip flops around the house. Along that same line, I can’t over-emphasize the importance of quality shoe gear. A good supportive shoe will do wonders.

Moving into the doctor’s office, we have a variety of more in-depth treatment options. Any good doctor worth his weight will give you a crash course on the conservative treatment options above. He may also offer to tape your feet, temporarily lifting the arch. Night splints also work wonders. Maintaining the stretch on the plantar fascia during the night while you sleep certainly assists with pain control and condition remedy, but they can be awkward and some people may not be able to tolerate them. Another item that can provide very long-lasting relief is custom orthotics. They are expensive, but ask anyone who has a pair…they are definitely worth it. These address the underlying structural abnormalities that may be contributing to your heel pain. Injections are the mainstay of our treatment regimen because they provide quick relief.

As a last resort, surgery is an enticing option for some. More than 95 percent of patients routinely achieve lasting relief without heel surgery. You should try at least six months of conservative measures before entertaining the idea of surgery. If you are experiencing heel pain and want a professional opinion, please contact our office at 214-366-4600.

Dr. Kennedy Legel
As Featured in “D” Magazine