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A
common foot complaint is pain in the bottom of the heel.
This is often referred to as heel spurs or plantar
fasciitis. It commonly is painful the first few
steps in the morning or after rest. It tends to get
worse the longer one stands during the day. It is caused
by subtle changes in foot structure that occurs over
time. These changes result in the gradual flattening of
the arch. As this occurs a thick ligament (the plantar
fascia) that is attached to the bottom of the heel and
fans out into the ball of the foot is stretched
excessively. This ligament acts as a shock absorber
while walking. As the foot flattens it stretches. If it
stretches too much it gets inflamed and causes pain.
Over time the pull of the ligament creates a spur on the
heel bone. It is important to realize that it is not the
spur that causes the pain and therefore the spur does
not need to be removed in most cases. This condition may
also cause generalized arch pain called plantar
fasciitis. This is an inflammation of the plantar
fascial ligament.
A common factor that contributes to
this condition is tightness of the calf muscles. Women
who wear high heels and people who walk for exercise
will often develop this problem because of the tightness
that results in the calf muscle as a result of these
activities. A non-supportive shoe also contributes to
this problem. Weight gain is another factor in
developing heel pain.
Home Treatments
Stretching
Calf muscle stretching is very
useful. The typical runners stretch by leaning into a
wall is helpful. An alternative method of stretching is
to stand approximately two feet from a wall. Facing the
wall turn your feet inward so you are pigeon toed. Lean
forward into the wall keeping your heels on the floor
and the knees extended. Also keep your back straight and
do not bend at the hips. Hold the stretch for 10 seconds
and do the stretch ten times in a row. Do the stretching
three times each day. Always stretch the calf
muscles following any form of exercise.
Over the Counter Arch Supports
Wear a supportive sport or walking
shoe. This can be supplemented with a good over the
counter arch support.
Oral Anti-inflammatory Medications
Medications like Advil, Tylenol, or
Aleve may be of some benefit. Always read the
medications directions and warnings before use.
Professional Care
If the heel pain persists your foot
doctor may suggest a cortisone injection, taping the
foot to support the arch, night splints to stretch the
calf muscles at night while you are sleeping or
functional foot orthotics. On occasion surgery may be
required to cure this condition. Orthotics should be
tried before surgery and should be used following the
surgical procedure.
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