How Can I Heal My Heels?

By Jason B. O'Dell, MD

Pee Dee Orthopaedic Associates

Introduction:

There are various reasons why people don’t want to get out of bed in the morning, but pain in the heel can be a significant one. This pain can either be in the posterior aspect of the heel or under the bottom of the foot. Typically, this pain is present when one starts walking after periods of rest, or the first few steps in the morning. In this article, we will focus on plantar fasciitis, the common source of this pain when it’s present in the bottom of the foot.

The plantar fascia is a normal structure in the bottom of the foot and runs the length the entire bottom of the foot, connecting the heel to the toes. When it becomes inflamed from repetitive trauma, the condition develops.

Diagnosis:

The history is an important part of the diagnosis. Pain when starting activity after rest or sleep is the primary symptom of this condition. The patient often has tenderness in the region of the fascia attachment to the calcaneus (red area). X-rays can also give information about the alignment of the foot and the presence of any bone spurs.

Treatment:

The primary treatment for this condition is nonsurgical. Nearly all patients with this condition have some degree of contracture of the Achilles tendon. Achilles stretching and plantar fascia stretching are the mainstays of treatment. Icing the area and anti-inflammatory medications are also recommended. Symptoms are also improved by increasing padding of the heels using padded cups, which improve cushioning. More invasive treatments such as steroid injections can be considered in more prolonged cases. Rarely, surgery is considered to improve chronic contractures of the Achilles or release the plantar fascia, but this often can have less than reliable results.

Plantar Fascia Stretch

Plantar Fascia Stretch

Achilles Tendon Stretch

Achilles Tendon Stretch

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