As promised, I’ll be posting at least once a week. I hope to address issues that are important and/or meaningful to you. My first updated post will answer a question posted by one of our readers:
“My daughter works on her feet for 8 hrs. Once she sits for a while or when she wakes in the mornings she has to hop for a while bc she says her heel hurts so bad just on one foot. What do you suggest?” – Bonnie
Hi Bonnie! Thanks for checking in. Sorry to hear that your daughter is in pain. Hopefully we can help getting her back to feeling better! I must preface with saying that unfortunately because she is not directly my patient, I caution you to take this as my educated opinion, but not strict medical advice because I do not have all the details…*see page on medical disclaimer*.
But, to me, it seems she may have what’s called “PLANTAR FASCIITIS“. “Itis” – means inflammation. The “plantar fascia” is an area along the bottom of your foot that contains thick, white pearly fibers attached to your skin. It helps to support your foot as it pushes off the ground.
If this area is inflamed, it is called “plantar fasciitis.” This is one of the most common causes of heel and foot pain and often presents with pain when you’re first getting up in the morning (first step out of the bed) or when initiating walking.
Plantar fasciitis is most common in ages 40-60, but can also present earlier in younger people who walk/stand often in inappropriate shoe wear or in runners.
We don’t fully understand the cause, but so far, research has shown that the following factors may contribute:
- Prolonged standing or jumping
- Flat feet
In runners, it’s thought that plantar fasciitis could be due to the repetitive actions that cause “micro trauma”. It is also common among ballet dancers for similar reasons.
As stated above, someone with plantar fasciitis usually has heel pain that is usually worse with their first step in the morning, or after a prolonged period of not walking/standing. The pain usually improves throughout the day, but often worsens towards the end of the day.
Your doctor, when checking for plantar fasciitis, may perform a test wherein they bend your ankle with one hand to tighten the plantar fascia, and then press along the area of your plantar fascia with the other hand to see if you are in pain.
Your doctor may perform the test mentioned above, which could often be an indicator that you have plantar fasciitis.
They will also listen to you describe your history and go from there.
Usually you do not need any testing (labs or imaging/x-rays) to diagnose plantar fasciitis. However, if your doctor is concerned it could be something else, such as a fracture or arthritis, then they may order testing.
The good news is that treatment of plantar fasciitis is often not invasive and usually improves with the right conservative measures! These include the following:
- Avoiding wearing flat foot shoes and barefoot walking. (Your first step out of bed should be made with a supportive shoe or sandal).
- Using over-the-counter arch support and/or heel cups (This could help).
- Decreasing physical activity that could further aggravate the condition (such as excessive running, jumping, or dancing).
- Performing home stretching exercises for the plantar fascia and calf muscles. Here are some exercises that could help.
- Applying ice to the painful area.
Your doctor may also recommend “NSAIDS” (non-steroidal anti inflammatory drugs…such as Ibuprofen or Naproxen). They may recommend you take this for 2-3 weeks.
If there’s no improvement with the above measures, your doctor may even recommend an injection of the painful area with a steroid and/or anesthetic (numbing medicine). This can sometimes be done by your primary care doctor, or you may be referred to a specialist at that point (orthopedist or podiatrist).
We used to recommend foot orthoses aka “orthotics” (specially designed shoe inserts for plantar fasciitis), but a study performed in April 2018 says they really aren’t very helpful…Foot orthoses study. Whomp whomp…
Most people do quite well with the measures described above. There’s about 5 percent of people, however, that may need surgery for improvement. Don’t worry about that, though, unless it’s you! And you won’t know until you try what we’ve already mentioned.
If you’re concerned you may be dealing with plantar fasciitis, try some of these stretches, ice, etc.
See your doctor if you’re concerned. We’re here to help!
And, until next time, be well!
P.s.: If you have more topics you’d like me to discuss or questions you’d like answered, post below or fill out the form on my “About me” page.