04/04/2024
Why do my heels suddenly hurt?
When you wake up and step out of bed, do your heels really hurt? Does it take a while before the pain eventually subsides and later in the day or in the evening when you relax, the pain returns? There’s a chance you are suffering from a condition known as plantar fasciitis. You can be 20 to over 60 years of age and develope plantar fasciitis (PF).
So how did I get this pain in the first place?
The most common reasons are walking barefoot on hard flat surfaces like tile or concrete for a prolonged period of time. Oh, you’ve been wearing flip flops? Even worse! A good old fashioned flip flop has the ability to exasperate PF. How about your shoes and sneakers? You might be wearing sketchers, Nike’s, adidas, Jordan’s, or you might be wearing what the medical community called good sneakers like new balance, Brooks, Hooka, or ASICS. Yet you still have that annoying heel pain.
Here’s an easy anatomy lesson:
There is a tendon on the bottom of your foot called the plantar fascia. It’s a wide tendon attached at the base of your calcaneus, or heel bone. It runs underneath your arch and splits into 5 segments that attach to your toes. There are 32 muscles and tendons, 107 ligaments, and 38 joints in each foot. Of the entire skeletal structure throughout your body, your feet are the Rolex of your physical structure! Imagine if one gear was not in alignment in a Rolex watch, would the watch work efficiently or at all? Probably not. Your feet, like a Rolex watch, needs to be maintained for proper efficiency and effectiveness. And if your not caring for your feet as you should, you might develop more than heel pain. You might experience conditions such as knee pain, hip pain, back pain, even neck pain. You can also start feeling tiredness & fatigue, making it more difficult to exercise, walk the mall, or going on vacation. All because of foot pain!
Your feet are three dimensional, tile and sidewalks are not.
Your feet were designed to adapt to softer uneven surfaces, not hard flat ones. Therefore as you take a step your heel strikes the ground first. As your foot comes to mid-stance different parts of your arch might or might not come into contact with the ground. As you roll forward the ball of your foot acts like a spring to propel you in a forward motion. Most of the pressure, impact, and contact with the ground is on your heel and the ball of your foot. Your feet are supporting all your body weight. That’s a lot of pressure. What about the arch? The Plantar fascia, along with all the other muscles , tendons, and ligaments, is trying to do its job of supporting your foot structure and keep you stabilized so you don’t fall over. What’s supporting your arch then? The answer is not much. Our feet are designed to come into total contact with the ground. With the advent of concrete and tile, we’ve created a 2 dimensional flat hard surface for our 3 dimensional feet. (Unless you are very flat footed but that leads to a whole other article ).
Arch support for heel pain
Our goal is to bring our three dimensional feet in total contact with the two dimensional ground. We want to use properly fitted arch supports to give you total contact which will support and alleviate pressure on the heel, arch, and ball of your feet. In turn arch support will help your knees, hips, and back. Even make you stand up straight if you have a tendency to slouch.
Side note: I love when I put the correct sneaker and arch supports on patients and they visibly stand up straighter, are taller, and feel better! It’s almost mind blowing to be able to have an instant outcome in improving someone’s life on the spot.
Selecting the proper arch for your foot is important. Unfortunately there are just a few experienced people who can assist you in your selection of the proper support. If you have a Pedorthist in your area, you might be in luck. A Pedorthist is trained in foot biomechanics, arch supports, and footwear. In my experience I’ve evaluated and worked with and have worn hundreds of various brands of arch supports. I’ve so far referred to over the counter (OTC) arch supports. There are custom arch supports as well. Custom arch supports are made from a mold or cast of your foot. They are more expensive since they take quite a bit of work to make. Not all custom arch supports will work properly for you since they are made different ways by different health care professionals. I will have another article just on custom arch supports coming soon.
Shoes, sneakers, and sandals:
For the sake of the length of this article, I will give a short overview. I will be discussing footwear in another article due to the intricacies of shoe selection. Matching your foot and ankle type to the correct style of shoe or sandal is as vital as selecting the proper arch support. They work together with your feet to achieve the right support for your feet and body. The number one question I get asked is “what is the best brand?’ It does not matter. There are great brands but if you have flat feet or pronation and you buy a style designed for a high arch, it will be uncomfortable pretty quickly and add to your pain. Most good brands have styles designed for high arches,flat feet, and in between. So how would you know which style within the brand is right for you? Most footwear retailers will not know. Their employees are not trained for that. Many stores are self help so it’s up to you to choose your own footwear. I often go on line and look up key words for shoe selection. I will typically get over one million searches on a subject, such as PF. The first and second page on a google search will bring up the most popular brands, top 10 lists, or many ads to capture your attention first. After reading these articles I can say a good deal of them have incorrect information. Marketing is crucial and every company wants to make a sale. I am unaware of how they come to their conclusions but it is often incorrect.
Other products designed for PF
There are many other products available for treatment of plantar fasciitis at home. Do they work or are they necessary? They all help, some more than others. You should not be using them in place of proper arch supports and footwear. Rather they should be used in addition to them.
Night splints:
There are many to choose from. Some are cumbersome and bulky, others cheap and flimsy. There are dorsal night splints. I have found these easiest to wear for my patients and they are effective.
PF sock or support:
These socks have zoned elastic compression. It targets extra support to the plantar fascia and arch. You can wear it with your shoes and arch supports or with sandals and even barefoot.
Heel cups:
In general, heel cups absorb shock from impact. Your calcaneus is one of the softer bones in your body, believe it or not. We have natural fat pads in our feet to absorb impact and protect them. However, when we walk on those hard flat surfaces, several hundred pounds of pressure per square inch is exerted on heels and vibrates into our skeletal structure. Heel cups and heel cushions help absorb and dampen that impact. Heel cups also help by pushing our natural fat pads back under the calcaneus increasing the effects of shock absorbency. They are awesome for back pain! I don’t typically recommend them for healing from PF. They do relieve the pain though. You might consider using them intermittently if you choose to do so.
Prostretch:
looks like a semi circle and it positions the toes in an upright position also known as the windlass effect. You place your foot on it while standing and stretch your tendons, muscles, and ligaments.
Stretch rite rope:
unique in that it has handles throughout the length of the rope making much more effective and easier to use than a belt or towel.
PressWrap 2”:
PressWrap is a thin double lined neoprene comPRESSion support that you wrap around the arch and the ankle. It lifts and supports the plantar fascia and arch thereby relieving pain almost instantly. It can be worn in most sneakers, with sandals or flip flops and even barefoot. It can be worn in water making it the most ideal product for water parks, at the beach, or in the pool. I don’t suggest wearing it with an existing arch support because it might cause too much bulk on your foot and make yourself shoes tight.
Creams, lotions, ointments:
There are creams and lotions are advertised for PF. I cannot tell you if they all work. In most cases they might help and if not, they can’t hurt. Unless you have a known allergy to any of the ingredients creams and lotions can help as well.
Cortisone shots from your podiatrist or Orthopedic Doctor
Podiatrists and orthopedic physicians might give you a Cortisone shot to help alleviate the pain of PF. While they help alleviate the pain it’s not usually long lived. Most patients say it helped for 1-3 months. That is unless you take other measures to correct the problem such as the proper arch supports, sneakers, shoes, and sandals.
How long will it take for my pain to get better?
It depends on how long you’ve had it. The longer you’ve been suffering with it, the longer it can take to go away. If you take the proper steps to heel it (pun intended) it will be the fastest way to get rid of it. If you’ve had the problem for a few weeks to a few moths, it can take anywhere from 1- 2 weeks up to 1 month to resolve the problem. If you’ve had it for 6 months to a year, it could take 1 to 3 months to resolve. Look for the weak link in your daily routine. For instance, if your wearing the proper arch support and sneaker, do you take them off and walk barefoot in the house? Or do you put on flip flops? Most common brands of flip flops from Havana’s, Tory Birch, to dollar store flip flops, provide no support at all. Brands such as Powerstep, Revere, Vionic, Spenco, & Dr. Comfort, do have arch support and feel amazing by the way.
“Time wounds all heels”
The more attention you pay to your Plantar Fasciitis and take CONSISTENT proper steps to healing it, the faster it will go away. You may use a few modalities or all of them. The sooner you recognize and take care of the condition the better off you will be. Consulting with a Pedorthist, Physician, or Physical Therapist for advice will help you choose the proper method for you. As soon as my new website is up you will be able to get assistance from me, as well as some of the aforementioned products.
I’ve been helping patients and customers with foot conditions for almost 30 years. I hope this article has opened your mind to new modalities for treating your Plantar Fasciitis.
STUART PRESSMAN, CO, C.Ped
You can find me on Facebook under the page(s):
Sole-lutions footwear ; Dr. Foot ; or PressWrap. Also on Instagram under “Sole_Lutions” and .
