Have you ever stepped out of bed in the morning and thought "what in the world...?!" because you have sudden stabbing pain in your heel? The most common cause is plantar fasciitis, or inflammation of the large ligament on the bottom of your foot. This ligament attaches to your heel bone and when inflamed, can cause anywhere from mild to almost disabling pain. It's no secret that residents of Colorado are among the most fit and active in the country. We often see patients who come in with heel pain after increasing their running mileage when the weather warms up. It's also not uncommon to strain the ligament by walking barefoot on hard surfaces. Occasionally the pain starts suddenly, but often it sneaks up on people, with a mild ache that gradually worsens. If an athlete tries to continue to train and "push through the pain", the condition can become chronic and difficult to resolve quickly.
It seems odd to people that the pain should be most severe in the morning after they've been resting all night. Typically, people rest with their foot in a plantarflexed (toes pointing down) position, which puts the ligament on slack. Also, blood flow to the foot is at its lowest in the morning. When the ligament is inflamed and we step on a tight, cool foot, BOOM! there's a sudden tugging of the ligament on the heel bone, accompanied by pain. If you've experienced this but have no redness, heat or swelling of the heel, and if the problem has only bothered you for a couple of weeks, you may want to try a few things at home first before giving us a call. Gently stretch the foot (pulling the toes "up") for several seconds before stepping out of bed. Keep a pair of good supportive shoes by your bed and put them on right away. So, you look a little silly in your pajamas and running shoes, but trust us, it'll be worth it. Put an ice pack on your heel for 10 minutes every hour in the evening (or at least once) if you have normal circulation to your foot. Avoid any barefooted walking, even around the house, and avoid any high impact activity until you've been pain free for at least two weeks. If these simple steps fail to provide relief, you may want to try an inexpensive over-the-counter arch support for your shoes, and a "night splint" to hold your foot in a stretched position at night. Still hurting? It's time to give us a call. We often prescribe anti-inflammatory medications, custom foot orthotics, physical therapy, steroid ("cortisone") injections, and/or cast immobilization. Rarely, patients require shock wave therapy to the heel, and even more rare, surgical intervention.
The sooner you address your symptoms, either at home or with the help of a professional, the more successful rapid relief will be. There is no one cure, for plantar fasciitis, but we have so many treatments at our disposal, that suffering is needless. And, while plantar fasciitis is the most common cause of heel pain, it's not the only cause. If you have redness, heat, swelling or feel otherwise unwell (fever, chills, for example) you need to seek medical care immediately.
Rocky Mountain Foot and Ankle Center