Heel Attack

 Plantar fasciits


"The bottom of my heel really hurts in the morning when I first step, what could it be and how can I treat this?"

What is it?

If your first few steps out of bed in the morning cause severe pain in the heel of your foot, you may have plantar fasciitis, an overuse injury that affects the sole of the foot. A diagnosis of plantar fasciitis means you have inflamed the tough, fibrous band of tissue (fascia) connecting your heel bone to the base of your toes. The good news is plantar fasciitis can be treated without surgery a vast majority of the time!





 How can I treat it?

Plantar fasciitis can be treated with these basic but important ideas. However the mistake most patients make is not doing these AT THE SAME TIME!

1) Anti-inflammation: Ice, NSAIDs(eg Ibuprofuen), local corticosteroid injection. Treatment generally consists of Icing for no more than 20 minutes at a time. Some good ideas are to use a pepsi bottle or water bottle and fill it up 1/2 way with water. Put the bottle in the freezer and at night while sitting on the couch, keep your knee at 90 degrees and roll the bottle on the bottom of your foot. You can also try styrofoam or paper cup and directly apply the ice to the hurt area.
NSAIDs should be used at the discretion of your doctor. Ibuprofuen is a NSAID that can be used for occasional breakout pain.
Corticosteroid injections are typically used if the patient is in extreme pain. These steroids can be injected directly into the painful area of the heel. These injections can last several days to months. Patients are generally allowed 3 in  one year. These aren't the most pleasant but generally have good pain relief.

2) Stretching: This is essential to keep the plantar fasciitis from coming back in the long term. Some simple stretch ideas include but are limited to;  figure 4 stretch, wall stretches, and using a towel in bed in the morning. The figure 4 stretch is easy and can be done multiple times throughout the day. While sitting down cross your hurt foot and pull your toes with your hand. See below for wall stretches. Also use a towel and put it under your forefoot and pull it towards you head.

3) Arch Support: Some patients will only need shock absorbing inserts for their shoes. Others may need a functional orthotic custom made for their feet. A functional orthotic is created to be specific for a patients foot. This allows the foot to function properly with the orthotic supporting the foot. An over the counter shock absorbing insert can also be used. These may not be suitable for some patients and custom made orthotics may be desirable. Check with podiatrist and insurance company to see if they are covered. If insurance doesn't cover them, they can go around $250 per pair. However, the hard shell of the orthotic can last up to 7-10 years without being replaced. Remember, if the custom orthotics are not comfortable at first, try them for 1 hour a day and gradually work into them. If they are still painful, bring them back to the podiatrist and have them modified! Don't just throw them away or not use them! Custom orthotics can also be made for dress shoes including high heels.


Any questions, please email zbeth02@gmail.com
If pain persists please seek medical advice immediately.

footandanklesolution.com

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