Plantar refers to the sole, while fascia is a fibrous band of elastic tissue connected from the heel to all five joints (metatarsal heads) behind the toes. The inflammation of this tissue is plantar fasciitis which causes heel and arch pain.

Shoe Recommendations:

Running: 1226, 1225, 1123, 1012, 993, 760, 587

Walking: 927, 846, 811

Cross-Training: 855

Stabilizer Insole, Ultra Arch Insole

Additional, the Pro-Stretch.

HEEL PAIN CAN BE CURED
Heel pain among weekend sports participants, runners, and those beginning exercise programs is reaching epidemic proportions. Furthermore, heel pain is one of the most common and persistent foot problems affecting men and women. It originates deep within the foot, directly on the heel bone, or within the foot’s connective tissue — the fascia. The plantar fascia is a very thick band of tissue that covers the bones on the bottom of the foot. Pain results in the heel or arch when these tissues become irritated or inflamed or when small spurs grow on the heel bone itself.

It is estimated that 15 percent of all adult foot complaints involve plantar fasciitis, the type of heel pain caused by chronic inflammation of the connective tissue extending from the heel bone to the toes.

Plantar fasciitis occurs most frequently in adults 40 years and older, especially women. Being overweight and wearing inappropriate footwear are common contributing factors. The pain is most noticeable after getting out of bed in the morning, and it tends to decrease after a few minutes and returns during the day as time on the feet increases.

Many patients attempt self remedies for heel pain, such as anti-inflammatory medications and over-the-counter heel pads, before seeking medical advice. To help diagnose the origin of heel pain, physicians take a thorough history to learn the time of day when the heel pain occurs, types of shoes worn most frequently, activity levels at work or during recreation, and if there has been any recent trauma to the area. X-rays often are taken to check for heel spurs, which indicate that the condition has been present for 6 to 12 months. Generally, the longer that heel pain persists, the longer it takes to cure it.

Not all heel pain, however, is caused by plantar fasciitis. It also can occur from inflammation of the Achilles tendon, bursitis, arthritis, gout, stress fractures, or irritation of one or more of the nerves in the region. Sometimes in such cases, heel pain could be a symptom of a serious medical condition that should be diagnosed and treated separately.

Conservative Treatment Works
Initial treatment options for heel pain caused by plantar fasciitis include the following:

• Stretching the calf muscles regularly
• Wearing the proper shoes. Shoes that do well to help with plantar fasciitis include those with strong arch support (This is different than high arch support). To determine whether or not a shoe has strong arch support, a torsion test is required. During the torsion test look for shoes that are stiff in the arch area and do not bend/flex in that area. If an athletic shoe bends in the middle, it may not provide the required stability and protection against heel pain. A shoe should bend in the area in which the toes bend and not at the arch.
• Using over-the-counter orthotics by New Balance, Spenco, Powerstep or Lynco (these orthotics are firm/hard through the arch; they are not soft, cushioned all-purpose inserts like Dr. Scholl’s).
• Taking anti-inflammatory medications
• Padding and strapping of the foot around the arch
• Injections of corticosterioids.Most patients with plantar fasciitis respond to conservative treatment within six weeks. If improvement occurs, initial therapy is continued until the heel pain is resolved. But if heel pain persists, the patient should be referred to a podiatric foot and ankle surgeon for further evaluation and more specialized treatment.

Treatments for Persistent Heel Pain

When conservative treatment fails to remedy heel pain, surgical options that may be considered are removal of a heel spur and separation of the fascial tissue from the heel bone (plantar fasciotomy). During surgery to separate fascial tissue, the podiatric foot and ankle surgeon makes a small incision on the inside of the heel and gently cuts away the tissue. During this procedure, if heel spurs are present they may removed after the fascial tissue is detached from the heel bone.

Heel pain surgery normally is performed on an outpatient basis. A cast might be needed to immobilize the foot for two or three weeks after surgery and about a month of physical therapy is recommended after that. With no complications, recovery is complete in six to eight weeks.

A relatively new non-invasive technique, extracorporeal shock wave therapy, also is effective for treating severe, chronic heel pain in adults. This new procedure uses a lithotriptor device — similar to those used to eliminate kidney stones — to generate shock waves aimed at the treatment site. The shock waves achieve therapeutic results by increasing blood flow to trigger a healing response. This eases inflammation in the heel and relieves chronic pain.

With several surgical and non-surgical treatment alternatives available, heel pain should not be tolerated as a consequence of aging, injury, disease or regular physical activity. Sometimes a simple modification of daily activities to reduce stress on the feet can help relieve it. But for those with persistent heel pain, podiatric foot and ankle surgeons are the experts to consult for determining the most appropriate treatments.