Let’s say you took a long hike yesterday along a rather strenuous trail in the mountains, enjoying the fresh air, wildlife, and interesting scenery. This morning when you got up, a lancing pain under your foot almost had you flopping back down on the bed. You limped along to the bathroom and gradually the pain lessened as you moved about. You’ve just experienced the classic symptoms of plantar fasciitis.
Parsing the Term
Some medical terminology can be difficult to understand, so let’s break it down into its parts. The word plantar refers to the bottom surface of your foot—the sole. Fasciitis comes from two words: fascia, which is a sheet or band of tissue that holds things together in your body. The word “-itis,” refers to inflammation. Combine them and you have an inflammation of connective tissue in the sole of your foot.
Why Your Heel Hurts
Plantar fasciitis is usually defined as an overuse injury. When the ligament that connects your heel bone to your toe bones is stressed by repeated movement—such as from long hikes, running, or standing on the job—it can be damaged over time. The tissue is overstretched and eventually develops tiny tears in the fibers. Over time, the plantar fascia becomes inflamed and swollen, pressing painfully on other soft tissues.
While you sleep, the ligament shrinks back to its original length and tightens. In the morning, the stiff tissue is too tight to expand when you put weight on your foot. It pulls on the bone where it is attached, causing heel pain with those first steps. The same thing can happen if you sit for a long period of time and then get up and walk. Eventually, the condition can worsen until it hurts nearly every time you put weight on it.
Best Treatments for Plantar Fasciitis
According to the American Orthopaedic Foot & Ankle Society, stretching the tight band of tissue is the best way to relieve the pain. Since tight Achilles tendon or calf muscles can contribute to this condition, they should be stretched as well. Use the following regimen:
- Sit down and lift your right leg over the left, so the ankle rests on your left thigh.
- Use your right hand to gently pull the toes of the foot up towards your shin, using your left thumb to check that the plantar fascia is taut.
- Hold 10 seconds, release, and repeat 10 times. Then do the opposite leg.
- Now stand facing a wall, with your right foot a step back. Making sure the right knee stays straight and the heel stays firmly on the ground, bend the left leg and lean forward to get a gentle stretch in the right calf muscles. Hold 10 seconds, relax and lean back, then repeat 10 times. Repeat with the left leg.
- Finally, hold onto a counter top or heavy table or desk. Move your right foot ahead slightly, then gently squat, keeping your heels on the ground to get a good stretch in the Achilles tendon and arch of the foot. Hold 10 seconds, relax and straighten your knees, and repeat 20 times.
Repeat this sequence three times a day for several weeks and the pain should subside. Try icing your heel and arch a few times a day as well, to reduce inflammation and swelling.
Help for Chronic Plantar Fasciitis
This home care regimen is often effective, but sometimes the pain continues. That’s when you need to get expert help from Dr. Matthew Paden, Dr. Brett D. Sachs, and Dr. Dustin Kruse at Rocky Mountain Foot & Ankle Center. There are many other treatments we can try, including pain medication, physical therapy, night splints, steroid shots, or shock wave therapy. Custom orthotics can also be used to address the underlying problems such as flat feet, high arches, and tight tendons that contribute to this debilitating heel pain. In severe cases that don’t respond to conservative treatments, surgical procedures are an option.
If you are tired of dealing with morning heel pain, call (303) 423-2520 to set up an appointment in our Wheat Ridge, CO, office or one of our other locations. You can also schedule one online.
Photo Credit: Alexis VIA pixabay.com