Is Your Heel Pain Plantar Fasciitis?

You would think that staying home this past year due to COVID-19 would have given most people’s feet a good rest, especially those who often navigate the world in high heels. 

Apparently not! We’ve been walking around the house barefoot or in socks and slippers and this is causing problems. “Without proper shoes and arch support, people are more likely to strain their arch, leading to plantar fasciitis,” says Dr. Weissman, a podiatrist at Cedars-Sinai Hospital. Some of us are even doing high-impact exercises at home not wearing shoes.

But, plantar fasciitis (PLAN-tar fash-ee-I-tis) has long been a common cause of heel pain. It involves inflammation and micro-tears in your plantar fascia, which is the long band of ligament tissue that runs across the bottom of your foot connecting your heel bone to your toes. It supports the arch and acts as a shock absorber and stabilizer for your foot. Overuse, repetitive motion, strain, walking barefoot on hard floors, wearing shoes with little support and pressure all lead to injury which you may not feel until the inflammation and pain become more pronounced.

People usually notice the stabbing heel pain when they first get out of bed in the morning. It can improve as you move around, but then returns after more time on your feet. 

Pain from plantar fasciitis develops gradually over time, and usually affects just one foot. The pain can be dull or sharp. Some people experience a burning or aching on the bottom of the foot spreading outward from the heel.

Some Risk Factors

Even though the cause of plantar fasciitis often can’t be explained, there are factors that can increase your risk of developing this condition. They include:

• Age – plantar fasciitis is most common between the ages of 40 and 60.
• Certain types of exercise and sports – running, aerobic exercises, dance, soccer, tennis, basketball.
• Foot Types – flat feet, a high arch, and body mechanics while walking can affect the way weight is distributed.
• Obesity – extra pounds put stress on your plantar fascia.
• Pregnancy – weight gain puts pressure on arches, your gait and center of gravity have changed.
• Occupations that keep you on your feet – cashiers, factory workers, teachers, healthcare workers, anyone who is on their feet all day especially on concrete surfaces.
• Tight calf muscles – restrict motion in the ankle joint, and this lack of flexibility puts an extra strain on the fascia. 
• Too much too soon – suddenly throwing yourself into a new sport or activity, especially without the correct shoes
• The wrong shoes – new shoes are not always the right shoes, consult your podiatrist and find a knowledgeable salesperson. 

Treatments:

It may take time and patience, but most can improve or eliminate heel pain with consistent home treatment.

• Rest your foot – Stop or reduce your activity or sport. Don’t do what hurts.
• Ice – Rolling your foot over a frozen water bottle for 20 minutes is effective. This can be done 3 to 4 times a day.
• Use nonsteroidal anti-inflammatory medication – Ibuprofen or naproxen reduce pain and inflammation; consult your healthcare provider about how long you should use these.
• Exercises and Stretching – Plantar fasciitis is aggravated by tight muscles in your feet and calves. Stretching your calves and plantar fascia is the most effective way to relieve the pain that comes with this condition. Here and here are videos for a variety of therapies you can do at home.
• Massage – Here are massage suggestions that can help. 
• Night Splints – A night splint is a brace you wear on your foot that holds it in a flexed position while you sleep, this lengthens the plantar fascia and Achilles’ tendon aiding flexibility. 
• Removable Boot – A boot cast may be worn during the day to immobilize your foot reducing strain and allowing your plantar fascia to heal. 
• Anti-inflammatory injection – If progress is too slow and pain too great, your healthcare provider may choose to give you a shot of cortisone to reduce swelling and inflammation. 

Last Resort – Surgery

There are two surgeries used to treat plantar fasciitis; this is a serious last option as surgery can result in nerve damage and chronic weakness. 

• Gastrocnemius Recession – Tight gastrocnemius muscles can strain the plantar fascia. To release this stress, your surgeon will surgically lengthen the calf muscle, and increase the motion of the ankle.
• Plantar Fascia Release – This operation involves a partial detachment of the plantar fascia from the heel bone. This reduces tension but weakens the arch of the foot.