My Aching Foot

Ever woken up, got out of bed and felt like you were 90 years old? Where did that pain in your heel and foot come from?  Yesterday's workout was no different than before.  You walked with your kids all day but that was easy. Maybe the new shoes that you bought last week did something. Don't despair you are not alone. I too lived and conquered this foe. This is how it all starts. Overuse injuries occur not from one single event but from a series of overload stresses to our tissues. Collagen, which is the major constituent of our tendons, ligaments, and fascial tissues, fails under this type of stress. The dreaded injury called, Plantar Fasciitis is one such condition that affects all too many people. Plantar fasciitis or heel pain can be the bane of ones active existence.

This overuse injury occurs to the bottom layer of tissue that covers the muscles of the foot as it inserts into the heel. This layer of tissue inserts like a flattened cable into the bone. From repetitive stress, unfortunately like running, micro tears occur which lead to pain and stiffness around the foot and ankle. Pain can be mild and actually get better as we walk around. However, sometimes it can stop you from walking, and playing sports. This condition left unrecognized and untreated can be devastating to an active person.

We usually don't see swelling, bruising or other obvious signs of injury. It Just Hurts! Early recognition that something is not right is the best medicine to get you on the road to recovery.

With all the modern advances in medicine, no one has found the cure for this. No one single treatment is better than the next; it is usually a combination of multiple treatments that get rid of this unwelcomed visitor.

So how to we get rid of this " Pain in the Foot"? Here are some of the treatments most commonly recommended to my patients as well as those that I used to treat my own Plantar Fasciitis.

1.                  Activity modification: I know you don't want to hear it, but changing your running routine can be a start. Try another activity like biking, swimming, elliptical trainer, or rowing machine. Avoid hills or speed work.  Don't become a couch potato!

2.                  Shoe modifications: Change your old sneakers. They have a limited life, 300-500 miles or 3- 6 months. I date my shoes to know when I bought them. Heels or the use of gels pads can relieve stress on the fascia. Orthotics can be used but tend to be very expensive.

3.                  Ice Massage: 5 -10 minutes after activity and 2-3 times a day help reduce pain and inflammation. Easier to do than putting your foot in an ice bath.

4.                  Flexibility: Stretching the calf and foot a few times during the day helps maintain flexibility. Be gentle and slow with each stretch. Hold for 20-30 seconds.

5.                  Night splints: Sleeping with a night splint has been shown to have very good results in making Plantar Fasciitis go away. Hard to get used to while sleeping but helps to maintain a stretched position during the night. This will help reduce morning pain. When first using it, keep the straps loose and make sure not to kick your significant other with it.

6.                  Professional Intervention: I don't mean a psychiatrist but a physical therapist and possibly an orthopedic surgeon to make sure there is not some other injury going on, like a stress fracture of the heel. The proper use of oral anti-inflammatory medication and possibly a cortisone injection can help make this better. Surgery is reserved only for the most chronic cases, like me.

Early injury recognition and aggressive treatment using some or all of the points above can get you back on track. Good luck

Mark Klion MD