Heel Pain / Plantar Fasciitis
Heel pain can occur after prolonged periods of walking or strenuous exercise,
especially on hard surfaces without shoes or with poor support.
However, plantar fasciitis is more often a wear-and-tear-type injury.
Within the arches of our feet, there is a thick band of tissue called the plantar fascia.
This tissue is attached to the bottom of our heels, which bears much of our body weight.
With time this tissue becomes chronically inflamed, leading to heel pain.
One often under-recognized cause of plantar fasciitis is tight calves.
As we move down the leg, our calf muscles become the Achilles tendon,
which attaches to the heel bone, and continues into the foot as the plantar fascia.
When our calves are chronically tight, it makes the Achilles tendon and plantar
fascia more prone to injury or chronic inflammation.
Some of the more common symptoms may include pain under the heel after prolonged
walking or standing. The pain may be especially worse upon awakening in the morning
or after prolonged sitting.
The treatment of plantar fasciitis rarely involves surgery.
However it is important to know that heel pain rarely completely “goes away.”
With the treatments I discuss, our goal is to help minimize the pain to a level
that does not interfere with our daily activities or our quality of life.
The mainstay of treatment is stretching of the calf or Achilles.
This helps to keep the plantar fascia “loose” and less prone to inflammation.
Stretching should be done at least two to three times a day.
Calf Stretch Against the Wall
- Stand about 3 feet from the wall
- Step forward with your left foot
- Put your hands on the wall. Keep your elbows slightly bent. Make sure your shoulders, hips and feet are pointed towards the wall.
- While keeping your right knee(back leg) straight, slowly bend your left knee to increase the amount of stretch you feel in your right calf muscle. Both heels should stay flat on the ground at all times.
- Hold this position for 15 seconds (NO bouncing)
- Slowly push yourself back to the starting position
- To stretch the other side, switch legs and repeat the above steps
Seated Calf Stretch
- Use a rope or something similar
- Sit with both legs straight
- Loop the rope around the ball of one foot while grasping each end of the rope
- Flex your foot back toward your ankle (your toes toward your knee)
- Hold for 15 seconds
I also recommend wearing supportive shoes or sneakers.
You can also add a cushioned heel pad to your shoe.
This may come in the form of an orthotic, but you can also purchase heel
pads from most pharmacies or supermarkets in the foot care section.
Another solution may be a night splint that keeps your ankle bent up towards
your head thereby keeping your Achilles and plantar fascia in a stretched
On some occasions after these modalities have failed, a formal physical therapy program
may be initiated. Injections into the heel are also a common form of treatment.
Repeated injections are not recommended in the heel as the cortisone can cause
thinning of the fat pad of the heel and increase the risk of plantar fascia rupture,
which can lead to other problems.