Plantar Fascitis or Heel Pain

Q. Does anyone have a reliable remedy for Plantar Fascitis? (i.e. Severe pain around the heel area of the foot).

Kevin Webster, St Helens

A. Plantar Fasciitis is an inflammation caused by excessive stretching of the plantar fascia. The plantar fascia is a broad band of fibrous tissue that runs along the bottom surface of the foot, attaching at the bottom of the heel bone and extending to the forefoot. When the plantar fascia is excessively stretched, this can cause plantar fasciitis, which can also lead to heel pain, arch pain, and heel spurs.

Cause: The excessive stretching of the plantar fascia that leads to the inflammation and discomfort can be caused by the following:

Over-pronation (flat feet) which results in the arch collapsing upon weight bearing
A foot with an unusually high arch
A sudden increase in physical activity
Excessive weight on the foot, usually attributed to obesity or pregnancy
Improperly fitting footwear

Over-pronation (flat feet) is the leading cause of plantar fasciitis. Over-pronation occurs in the walking process, when a person's arch collapses upon weight bearing, causing the plantar fascia to be stretched away from the heel bone.

With Plantar Fasciitis, the bottom of your foot usually hurts near the inside of the foot where the heel and arch meet. The pain is often acute either first thing in the morning or after a long rest, because while resting the plantar fascia contracts back to its original shape, and inflammatory fluids build up. As the day progresses and the plantar fascia continues to be stretched, the pain often subsides as the inflammatory fluids dispurse.

Treatment and Prevention: The key for the proper treatment of plantar fasciitis is determining what is causing the excessive stretching of the plantar fascia. When the cause is over-pronation (flat feet), an orthotic with rear foot posting and longitudinal arch support is an effective device to reduce the over-pronation and allow the condition to heel.

If you have usually high arches, which can also lead to plantar fasciitis, cushion the heel, absorb shock and wear proper footwear that will accommodate and comfort the foot.

Other common treatments include stretching exercises, plantar fasciitis night splints, wearing shoes that have a cushioned heel to absorb shock, and elevating the heel with the use of a heel cradle or heel cup. Heel cradles and heel cups provide extra comfort, cushion the heel, and reduce the amount of shock and shearing forces placed during everyday activities.

Every time your foot strikes the ground, the plantar fascia is stretched. You can reduce the strain and stress on the plantar fascia by following these simple instructions: Avoid running on hard or uneven ground, lose any excess weight, and wear shoes and orthotics that support your arch and heel to prevent over-stretching of the plantar fascia.

I would recommend initially that you see a podiatrist for a diagnosis/treatment.

Hope this helps

Martyn Sherman, Sheffield

A. Go to your doctor. [This is} also called policeman's heel. Apparently there is a hardening around the heel bone. Surgery or rest may do it, I don't think anything else works.

Neil Marshall, Manilva, Spain

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