arch pain – Mike Ryan Sports Medicine

Tame Heel Pain Flareups From Plantar Fasciitis

Understanding Plantar Fascia Strains

Plantar fasciitis causes localized pain in the backside portion of the arch that attaches to the underside of the heel bone, or calcaneus. It often results from overstretching, overloading or tearing in the arch origin that runs from the heel to the front portion of the foot, under the toes.

This band of tissue helps stabilize and propel the foot forward during movement and stretches each time weight is applied when standing or walking. Plantar fascia strains occur when the band experiences excessive trauma or if the arch is exposed to persistent stress. A plantar fascia strain usually gives rise to sustained inflammation in the front of the heel and back portion of the arch. This creates a high level of localized pain, particularly after a prolonged period of rest during non-weight bearing activities such as sleeping and sitting. The band simply tightens when not in use, and if left untreated, a plantar fascia strain can become a chronic and troubling ailment.

Causes: The most common cause of plantar fasciitis is wearing inadequate footwear while running, walking and/or jumping. Additionally, beginners who go overboard doing new physical activities may inadvertently overstretch the band. Additional factors include obesity, sudden weight gain, flat feet, and excessive exercise with insufficient levels of progression. Heel bone spurs may also result as the band continues to pull on the heel bone, causing chronic arch pain.

Signs & Symptoms of Heel Pain From Plantar Fasciitis

Burning, stabbing, or dull aching pain in the front of the heel and along the tissue band in the backside of the arch
Difficulty placing weight on the foot while barefoot
Arch pain that occurs with heel raises or flat-footed squatting
Localized swelling and tenderness under the heel and arch

Professional Treatment for Plantar Fasciitis

Plantar fascia strains usually respond well to conservative treatment methods. However, recovery time does vary from individual to individual. Be sure to:

Rest and avoid weight-bearing activities to lessen heel pain.
Utilize the latest physical therapy modalities and rehab devices to reduce swelling and decrease pain.
Ice the arch and toe flexor tendons in a stretched position on a consistent basis to reduce inflammation and pain while elongating the sore plantar fascia tendon.
Always wear the proper footwear for your sport(s).
Tape the foot to assist in arch support, reduce inflammation and decrease the risk of further injury.
Massage the posterior arch with progressive, aggressive transverse-friction, applying more moderate pressure to the ankle and lower shin.
Perform strengthening and stretching exercises for the neighboring arch and calf muscle.
Buy arch support shoe inserts.
Properly tape the arch to provide effective support and reduce heel pain when performing weight-bearing activities.
Minimize weight-bearing activities.
Work to shed excess pounds, if overweight or obese.

Ask the Right Questions like a Pro

Here’s what smart pro athletes would ask their sports medicine specialist to ensure a fast and safe return to their beloved game or sport:

1) Is this heel pain related in any way to my pelvis, lower extremity or foot alignment?

2) Which types of physical therapy are best to quickly resolve this problem so I can get back to my sport(s), pain-free?

3) Are non-surgical treatment options available?

4) Can this problem cause any long-term complications?

5) Will anti-inflammatory medicines provide relief?

6) Is my painful heel a result of some other biomechanical abnormality that must be addressed?

Elite Sports Medicine Tips from Mike Ryan

Fast Treatment=Fast Recovery: The sooner you address plantar fascia strains, the sooner they resolve. Seek treatment quickly to avoid a chronic problem.
Defy Sir Isaac Newton: Aggressive weight-bearing activities prolong recovery time and increase the risk of long-term complications.
Embrace that Après Workout Life: Immediately following your workout (or related treatment):
- Elevate your foot for 3 minutes
- Stretch for 5 minutes
- Ice your arch and heel for 7 minutes
Unleash Your Inner Gumby: Aggressively stretching your calves, arches, big toe and toe flexor tendons will go a long way toward maintaining healthy tissue in the entire foot.
Eat and Drink Right: It’s easier and safer to control inflammation and promote healing by staying well hydrated and maintaining a healthy diet rather than popping pills to manage the problem.

How To Eliminate Heel Pain

In order to eliminate heel pain, it is important to understand its underlying cause(s). Although the term “heel pain” is somewhat generic, you can testify to its significance if you suffer from this condition. Sources of the pain, which is located in the arch area on the underside of the foot, can vary.

Heel pain may be caused by trauma such as a forceful strike of the heel against a hard surface, but an overuse injury such as plantar fasciitis is also a potential culprit.

The underside of the heel, or calcaneus, bone has a thick layer of fat and protective fascia that provides padding as the heel makes contact with the ground. Excessive forces or repetitive pounding can cause this fat pad to move or become inflamed. When the protective layer under the heel bone loses efficiency in this manner, heel pain and burning feet are painful side effects.

Common Sources of Heel Pain

Plantar Fasciitis – A common source of arch pain, this inflammatory condition involves the plantar fascia in the back of the arch.
Heel Bone Spur – This problem occurs when excessive bone forms underneath the calcaneus (heel).
Heel Contusion – Simply put, this is a bruised heel bone.
Calcaneal Stress Fracture – This represents either a preliminary or significant fracture of the calcaneus bone.
Tarsal Tunnel Syndrome – This painful condition occurs when nerves encroach upon the back of the foot and arch.
Calcaneal Bursitis – This manifests itself as inflammation that occurs within the sack of fluid that sits under the heel.

Heel Pain Signs & Symptoms

Tenderness associated with the surface of the heel bone
Increased warmth and potential swelling of the underside of the heel bone
Arch pain that originates on the heel and can extend into the underside of the foot, towards the toes
Posterior heel pain trigged by bearing weight on the foot, which may worsen with active toe flexion

Professional Treatment for Heel Pain

Ice the entire heel bone with an ice bag, ice massage or, ideally, with an ice bucket.
Rest the area to minimize pressure on the calcaneus.
Gently massage the arch and toes.
Wear appropriate shoes that bolster padding for the heel bone and help absorb shocks.
Stretch the calf to foster pain-free movement of the ankle joint.
Consider utilizing orthotics or arch supports, depending on the anatomical alignment and biomechanics of your lower extremities.

The treatments noted above may improve heel bone spur symptoms and help avoid surgery.

Ask The Best Questions to Receive the Best Care

To ensure you receive the best possible care for your injured foot, ask questions like smart professional athletes would as they seek a quick, safe return to the sport they love. Specifically, here’s what a pro athlete would ask his or her sports medicine specialist:

1. Are you 100% certain of the diagnosis provided?

2. Do I need an X-ray to determine the extent of this injury?

3. What are my injury treatment options?

4. What can I expect when dealing with this injury over the next 2-6 weeks?

5. Can you recommend any expert heel pain rehab specialists in this area?

6. Will you provide me and my therapist with a detailed protocol to direct my rehab regimen?

Tips for a Speedy Recovery

Act Fast – Arch pain and heel pain are not injuries to ignore. By prioritizing treatment, it is possible to resolve this injury quickly with minimal downtime.
Do Some Sole Searching – Shoes are typically the source of the problem. Old, improper shoes and worn shoe soles are common factors that lead to arch pain and burning feet.
Remember That Ice is Your Friend – Yes, it’s a reality check: Ice hurts, but it’s exactly what you need for this injury. Professional athletes will tell you that ice is their best teammate. Stop complaining and do what is needed….ICE, and lots of it.
Know What to Expect – Heel pain typically dictates minimal recovery time. Provided there is no stress fracture, large bone spur or significant plantar fasciitis, the downtime required for this injury can range from a couple of days to a few weeks. Quickly determine the source(s) of the problem and seek the appropriate treatment, and you’ll be back in the game before anyone even knew you were cooling your heels!