Taming the Fire of a Painful Heel From Plantar Fasciitis

Understanding a Plantar Fascia Strain

Plantar fasciitis is a painful condition with localized pain in the backside of the arch where it attaches to the underside of the heel bone or calcaneus.  It is often the result of overstretching, overloading or tearing of the origin of the arch, which runs from the heel to the front of the foot under the toes.

This band of tissue stretches every time weight is applied to the foot with standing and walking.  It helps to stabilize and propel the foot forward in movement. Plantar fascia strains can result excessive trauma to the band or the result of culminated effect of repetitive stress placed on arch over time. A plantar fascia strain usually gives rise to sustained inflammation of the front of the heel and back of the arch.  This results in excessive pain in this location, especially after prolonged non-weight bearing inactivity such as sleeping and sitting.  This is based on the simple fact that the band tightens when you don’t move it. If left untreated, a plantar fascia strain can become a chronic and troubling ailment.

Causes: The most common cause of plantar fasciitis is doing too much running, walking and/or jumping in poor footwear. Also, beginners attempting to go overboard in their chosen physical activities are likely to stretch the band too much the first time.   Additional predisposing factors include obesity, rapid weight gain, flat feet, and excessive exercise with insufficient progression.  With some chronic arch pain conditions, as the band of tissue continues to pull on the heel bone, it can result in a heel bone spur.

Signs & Symptoms of Heel Pain From Plantar Fasciitis

  • Perception of burning, stabbing, or dull aching pain at the front of the heel and along the band of tissue in the backside of the arch.
  • Difficulty bearing weight on the foot without shoes.
  • Arch pain with heel raises and with flat foot 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 times do vary from individual to individual.

  • Rest in the form of avoiding weight-bearing will help improve heel pain.
  • Utilize the latest physical therapy modalities and rehab devices to reduce swelling and decrease pain.
  • Repetitive icing with the arch and toe flexor tendons in a stretched position will reduce inflammation and pain while helping to elongate the sore plantar fascia tendon.
  • Proper footwear for your sports.
  • Taping the foot will assist in supporting of the arch, to reduce inflammation and decrease the risk of further injury.
  • Progressively aggressive transverse friction massage to the posterior arch along with a moderate massage for the ankle and lower shin.
  • Strengthening and stretching exercises for the arch and calf muscles will help a painful heel.
  • Arch support inserts can be helpful.
  • Arch taping, if done properly, can effectively support the arch and reduce the amount of heel pain with weight-bearing.
  • Minimize weight-bearing activities.
  • Weight loss, if overweight or obese.

Asking the Right Questions like a Pro

Here’s what a smart pro athlete would ask his/her sports medicine specialists to ensure a fast and safe return to sports:

1)   Does this heel pain have anything to do with my pelvis, lower extremity or foot alignment?

2)   What forms of physical therapy do I need to do to quickly resolve this injury so I can get back to my sport(s) pain-free?

3)   What are my options besides surgery?

4)   Are there any long-term complications from a sprain?

5)   Will I benefit from the use of anti-inflammatory medicine?

6)   Is this painful heel a result of some other biomechanical abnormality that needs to be addressed?

Elite Sports Medicine Tips from Mike Ryan

  • Fast Treatment/Fast Recovery: The sooner you address plantar fascia sprains the quicker they resolve.  Don’t let it become chronic.
  • Minimize Newton’s Laws: Aggressive weight-bearing activities will prolong the time for recovery and increase the risk of long-term complications.
  • Template for Post-Workout Therapy:Immediately after all of your workouts or treatments do the following:
    • Elevate your foot for 3 minutes.
    • Stretch for 5 minutes
    • Ice the arch and heel for 7 minutes.
  • Stretch: Aggressive stretches for the calves, arches, big toe and toe flexor tendons will go a long way in maintaining healthy tissue involving the entire foot.
  • Eat and Drink Right: It’s easier and safer to control inflammation and promote healing by being well hydrated and with a healthy diet compared to taking all sorts of pain pills.
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