HEEL
PAIN (PLANTAR
FACIITIS)
BY G. STEPHEN CLEVES,
MD
Plantar
fasciitis,
pronounced as "plantar fash-ee-eye-tis",
is an
inflammation of the plantar fascia, a band of connective
tissue on the bottom of the foot that runs from the heel to
the base of the toes. Plantar
means
"Foot", Fasciitis
means
"Inflammation of the facia." The
plantar fascia becomes inflamed when too much pounding or
stress is applied. This resulting inflammation causes pain
along the bottom of the foot especially at the heel. Most
people describe plantar fasciitis as severe pain especially
in the morning when getting out of bed or at the start of
running. This occurs as the result of tightening of the
plantar fascia with either sleeping or inactivity. Often,
an x-ray will show bone spurs at the heel, and many people
mistakenly feel that the bone spurs are the cause of the
pain. However, the bone spur is actually the result of the
inflammation and not the cause of the inflammation. On many
occasions, individuals have had bone spurs removed only to
have continuation of the pain from the plantar fasciitis.
What is the Treatment?
The best treatment for plantar fasciitis is actually to
stretch the plantar fascia in order to relieve the
inflammation. Stretching is best accomplished by standing
on a step on your toes with the heels of the feet hanging
over the edge of the step. While holding on to prevent
falling, the heels are slowly lowered so that they are
below the level of the toes. It is very important when
doing this stretching exercise to go down very slowly and
not to bounce up and down thereby causing further
inflammation in the bottom of the foot. This exercise is
best done for a total of 10 to 15 repetitions 2 or 3 times
a day. Patients are encouraged to begin this stretching
exercise very slowly to avoid aggravating the calves or
other muscles of the legs. With improved strength and
balance a backpack with some books for additional weight
can be worn during this exercise to maximize the benefit of
the stretching. This problem may require several weeks of
stretching. In
addition, using ice along the bottom of the foot can be
helpful. A frozen can placed under the foot and rolled back
and forth from the toes to the heel is a effective way to
apply ice to this area. Shoe inserts, such as Dr.Scholl's
are very helpful to cushion the foot during activities.
Occasionally, cortisone injections may be necessary to
treat the pain of plantar fasciitis.
