What Is Heel Discomfort

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Feet Pain

Overview

The plantar fascia is a strong, relatively inflexible, fibrous ligament band that runs through the bottom of the foot. That band helps to keep the complex arch system of the foot, absorb shock, plays a role in body balance and in the various phases of gait. The band transmits your weight across the bottom of the foot with each step you take. When the heel of the trailing leg starts to get off the ground, the band bears tension that is approximately twice the body weight. The tension on the band at this moment is even greater if the calf muscles are not flexible enough.




Causes

Plantar fasciitis occurs when the ligament in your foot arch is strained repeatedly, which causes tiny tears and significant pain. There are several possible causes for this condition. Excessive pronation, or overpronation, which happens when your feet roll excessively inward as you walk. Flat feet or high arches. Walking, standing, or running for long periods of time, particularly on hard surfaces (a common problem for athletes). Excess weight, such as overweight or obesity. Shoes that are worn out or don’t fit well. Tight calf muscles or Achilles tendons.




Symptoms

Symptoms of plantar fasciitis can occur suddenly or gradually. When they occur suddenly, there is usually intense heel pain on taking the first morning steps, known as first-step pain. This heel pain will often subside as you begin to walk around, but it may return in the late afternoon or evening. When symptoms occur gradually, a more long-lasting form of heel pain will cause you to shorten your stride while running or walking. You also may shift your weight toward the front of the foot, away from the heel.




Diagnosis

A thorough subjective and objective examination from a physiotherapist is usually sufficient to diagnose plantar fasciitis. Occasionally, further investigations such as an X-ray, ultrasound or MRI may be required to assist with diagnosis and assess the severity of the condition.




Non Surgical Treatment

Rest the foot as much as you can, especially during the beginning of the treatment. Try to avoid unnecessary foot activity like running, or excess standing. Instead, perform exercises that do not put stress on the injured foot, like bicycling or swimming. Apply ice to the painful area a few times a day to reduce inflammation. Try rolling the arch of the foot over a tennis ball or a baseball. A good treatment is rolling the arch of the foot over a frozen soft drink can. This exercise cools and stretches the affected area. You can use over-the-counter pain relievers (ibuprofen, naproxen) to reduce pain and inflammation. Use an over-the-counter arch support or heel support. Avoid walking barefoot, because it may add stress on the plantar fascia. Exercise your feet to make the muscles, ligaments, tendons and other parts stronger. Stronger foot muscles give better support to the plantar fascia preventing it from another injury. Stretching the foot, the plantar fascia and the calf muscles a few times a day is an essential part of treatment and prevention.

Feet Pain




Surgical Treatment

Surgery is rarely used in the treatment of plantar fasciitis. However it may be recommended when conservative treatment has been tried for several months but does not bring adequate relief of symptoms. Surgery usually involves the partial release of the plantar fascia from the heel bone. In approximately 75% of cases symptoms are fully resolved within six months. In a small percentage of cases, symptoms may take up to 12 months to fully resolve.

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