Healing for heels

By Christopher Bock

For The Courier-Herald

Our feet definitely take a beating. Anyone who spends time walking or standing, whether for work or recreation, knows any kind of foot pain can make for an unpleasant day.

Heel pain can be particularly irritating since we bear a good amount of our body weight in that part of the foot. Heel pain typically is not the result of a single injury, but usually comes after repetitive or excessive heel pounding.

Various pain-causing conditions can be at the root of the problem. Among the most common:

Plantar fasciitis. In this condition, the thick, connective tissue on the sole of your foot that attaches to your heel becomes inflamed. You usually feel the pain at the bottom of your heel, and it typically feels worse in the morning because of stiffness that develops through the night while you sleep.

Your risk for plantar fasciitis increases if you:

• Wear shoes with poor arch support or soft soles

• Make quick turns that stress your foot

• Have tight calf muscles

• Experience repetitive pounding on your feet from running, especially downhill or on uneven surfaces

• Pronate, which means to land on the outside of your foot and roll inward when walking or running. (Check your soles—pronators’ shoes tend to wear more quickly along the outer edge of the sole.)

Bursitis. An inflammation in the back of the heel, this condition usually is caused by landing hard or awkwardly on the heel or wearing shoes that place pressure in the heel area.

Achilles tendinitis. When the large tendon that connects your calf muscle to your heel becomes inflamed, it can cause considerable pain. The inflammation may be caused by:

• Running, especially on hard surfaces

• Tightness and lack of flexibility in your calf muscles

• Shoes with inadequate stability or shock absorption

• Sudden inward or outward turning of your heel when you hit the ground

Healing the pain

For many people, heel pain is temporary; rest and home treatment may be all you need.

If you experience heel pain, apply ice to the painful area at least twice a day for 10 or 15 minutes. Stay off your feet as much as possible for at least a week, and take acetaminophen (for pain) or ibuprofen (for pain and swelling). Consider wearing a heel cup or orthotic device inside your shoe.

If your heel still hurts after a week, if your pain is severe, if you have redness or swelling in the area, or if you cannot bear weight on your foot, call your doctor.

If your doctor diagnoses plantar fasciitis or bursitis, and shoe changes and orthotics don’t help, the next step may be cortisone injections to help provide relief from the pain.

If Achilles tendinitis is diagnosed, your doctor will probably prescribe anti-inflammatory medicine and may suggest heel lifts and a regular stretching regimen.

Keep heel pain away

Preventing a medical problem is always better than treating it.

Exercise and stretch to maintain strong, flexible muscles in your calves, ankles and feet. Always warm up before starting a workout or athletic activity. Wear comfortable, properly fitting shoes with good arch support and cushioning.If you pronate, look for athletic shoes with an antipronation device. If your doctor prescribes an orthotic, wear it in all of your shoes.

Podiatrist and foot and ankle surgeon Christopher Bock, DPM, practices at Enumclaw Medical Center-Cole Street, part of Franciscan Medical Group.

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