If you’ve been wanting to lace up your running shoes and hit the lake path — or have just been looking forward to enjoying the many outdoor events in our area — but heel pain is slowing you down, read on!
A common cause of heel pain is plantar fasciitis. If you feel a sharp pain or ache in your heel or the bottom of your foot when you step down, it’s likely plantar fasciitis.
The plantar fascia is a ligament that runs along the bottom of your foot, connecting the front of your foot with your heel. When this ligament is injured, either over time or suddenly, it becomes inflamed, resulting in pain centered around your heel.
Causes of plantar fasciitis Plantar fasciitis is caused by things like overuse and repeated stress and strain, wearing the wrong shoes, doing a new activity, a misstep or just landing heavily on your heel. Plantar fasciitis pain is often the worst during your first steps getting out of bed. The pain may be reduced or completely go away after walking for a few minutes but may then come back during the day with increased activity.
Plantar fasciitis can be caused by:
- Repeated wear and tear
- Overuse and repeated stress and strain
- Wearing the wrong shoes
- Starting a new activity
- Missteps or landing heavily on your heel
All of these things contribute to flattening of the arch, either suddenly or repetitively, causing the plantar fascia to stretch and pull on the heel bone where it attaches leading to inflammation and pain in that area.
What to expect if you have planter fasciitis Most of the time, plantar fasciitis resolves on its own and will improve with rest, stretching and strengthening without needing surgery or other invasive treatments. However, it can take many months to completely heal. You may need to switch to low-impact activities like swimming or bike riding and avoid activities that involve your heels hitting hard surfaces.
Preventing and relieving plantar fasciitis Roll, stretch, strengthen, and give your feet the right support.
Stretching and strengthening the plantar fascia ligament and supporting muscles can help prevent plantar fasciitis or decrease inflammation and pain if it occurs.
Things to try:
- Use a tennis ball: While seated, roll the ball under the arch of your foot while applying gentle pressure. Do this for a few minutes a couple of times a day. Rolling your foot over a frozen water bottle can also provide some relief.
- Do toe extensions: Seated on the floor or in a chair, use one hand to pull the toes and ankle of your affected foot up as far as you can. You’ll want to feel a stretch in the arch of your foot and in your calf. Use your other hand to massage the arch of your foot. Another way to do this stretch is to use a towel. Holding both ends of the towel, loop it around your foot – or both feet – to pull your toes back and ankle up so you feel that stretch. Hold it for about 10 seconds, release and repeat for a few minutes. Do these stretches two to four times a day. Another way to stretch your calves and plantar fascia ligament is to stand on a step. Holding onto the railing with the front of your foot on the step, raise your heels, standing on your toes, then lower your heels so they drop below the step. You should feel the stretch in your feet and calves — this is especially important to do if you are experiencing significant pain when first standing up in the morning or after long periods of sitting.
- Choose the right shoes: The right shoes can help protect and prevent plantar fasciitis. Your shoes should provide good cushioning to absorb the pressure put on your heels. They should have arch support and, of course, fit well. Pro tip: Shop for shoes at the end of the day as feet tend to swell, so they are a little larger after you’ve been on them for a while. There should be about the tip of a thumb’s space between your longest toe and the end of the shoe. Try on several pairs, and you’re sure to feel a difference between what feels okay and what feels great. But remember that even the best walking shoes do not provide great support so consider coupling a firm arch support with good shoes.
If you’re having heel or any type of foot pain, you may want to schedule an exam with a podiatrist. We’re here to answer your questions, suggest options for relief, and help you determine the best treatment for your situation. This may include at-home exercises, wearing a protective boot, or getting a referral to physical therapy. There are also options like inserts, over-the-counter NSAIDs, rest, icing, cortisone injections and, in some cases, surgery.
Michael Donnenwerth, MD, FACFAS
Thomas Nachtigal, DPM
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