When Stabbing Heel Pain Strikes, Stretching Can Bring Relief

Prolonged walking or standing and an increase in body weight are two leading causes of plantar fasciitis [fashee-i-tis], a painful overuse injury affecting the sole of the foot, according to the American Orthopaedic Foot & Ankle Society.

Plantar fasciitis, which affects millions of people every year, involves inflammation of the fibrous plantar fascia ligament that runs from the heel bone to the toes and is meant to stretch with every step. Typically the problem starts gradually with mild heel pain, which classically occurs with the first step in the morning.

• Basic treatment options include modifying your activities until the initial inflammation goes away.

• Ice application to the sore area for 20 minutes three or four times a day may also relieve symptoms.

• An orthopedic professional may also prescribe a non-steroidal anti-inflammatory medication.

• But your best course of action is a routine of home exercises to stretch the Achilles tendon and plantar fascia.

Benedict DiGiovanni, MD, Associate Professor, Department of Orthopaedics at the University of Rochester (NY) Medical Center, treats many patients with plantar fasciitis. 

He offers the following suggestions on treatment options: “A key component of a plantar fascia specific stretching program is when it is performed, and how often,” he says. 

Based on findings from our research work, I instruct patients to perform the stretch prior to the first step in the morning and prior to weight bearing after periods of inactivity, such as sitting for lunch or driving in the car. Most patients will perform the stretch 4 to 5 times per day for the first month of treatment, and then as needed based on symptoms. Patients are also instructed to stretch the Achilles tendon twice a day, morning and evening.

In addition to stretching exercises, we suggest ice, over-the-counter antiinflammatory medicine, and inexpensive over-the-counter soft arch supports.”

Plantar fasciitis has been known to sideline major league athletes such as the recent case with New York Giants quarterback Eli Manning. Ninety percent of people with plantar fasciitis improve significantly after two months of initial treatment.

• Shoes with shock-absorbing soles or over-the-counter arch supporting inserts may help alleviate pain. Another treatment protocol is taping the foot to support the arch and plantar fascia.

• If heel pain continues after a few months of conservative treatment, your orthopaedic surgeon may suggest heel injections with steroidal anti-inflammatory medications.

• Walking casts or positional splints are other options for treatment of plantar fasciitis.

Treatment of plantar fasciitis is important because it has the potential of turning into a chronic condition. Plantar fasciitis may prevent you from keeping up with your current level of activity and you may also develop symptoms of foot, knee, hip and back problems because of the way plantar fasciitis changes the way you walk.

Source: American Orthopaedic Foot & Ankle Society news release, Dec 21, 2009

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