I published this article in our patient newsletter Aches & Joints [AchesAndJoints.org].
If you are a runner, you probably worried about Plantar Fasciitis. Early in the summer when researching this article, I got a mild case of heel pain that left me distraught. My training for the Boston Half Marathon (Oct 7th 2007) was guarded and I am still tentative with my heel. But doing all the exercises linked at the end, I am good to go.
What you can do to reduce heel pain
Heel Pain Can Be Debilitating
“Getting out of bed each morning was painful,” recalls a patient of her yearlong experience with heel pain. “As I place my foot on the floor, I could feel a sharp pain in my heel and could only shuffle about the room. It would loosen up after a few minutes, but my foot would continue to hurt as I went through the day.”
Heel pain with the first steps getting out of bed in the morning, or when standing from a seated position, are the most characteristic symptoms of plantar fasciitis (fashee-eye-tiss). Pain can also occur with prolonged standing and walking. The sharp pain is usually on the bottom inside part of the heel. While it most often occurs in only one foot, it can affect both feet.
Plantar Fasciitis Causes Heel Pain
The plantar fascia is a tough, fibrous tissue band running under the soles of your feet, and connects the heel bone (calcaneus) to the base of the toes. It also helps support the arch of the foot in its role as a shock absorber. An injury or continuous irritation of this tissue causes plantar fasciitis and the resulting heel pain.
Multiple factors likely cause plantar fasciitis. It tends to affect people between 40 and 70 years of age, more likely in women, people who are overweight, or have jobs that require a lot of walking or standing on hard surfaces. Runners may be at a higher risk. People with flat feet or high arches are also more prone to plantar fasciitis.
Marathoner, Professor, Author, Citizen Journalist, Fitness Nut, Foodie, Meera's father, Hindu, Scientist, Photographer.
i ve been suffering from plantar fasciitis for the last four months and would like to visit you in Mumbai. Can i please have your physical adress and phone number so that i can get in touch with you.
Many Thanx
Upen Shah
Hi Upen:
Sorry to hear about your plantar fasciitis. It is best for you to follow the exercises and stretches mentioned in the article and the related links. That is the best I can do.
I am also preparing another summary article on plantar fasciitis, and will post that sometime in March. So please do sign-up for email notifications.
Wishing you the best.
Arun
I’ve enjoyed reading your great blog for a few years now and am so glad to have come across this article for plantar fascia. You have explained it so well, and all those photos & sketches make it easy to understand. The first paragraph describes exactly what I’ve been suffering for the last 6 months.
I had been walking regularly for the last 2 years and was worried I might not be able to continue due to heel pain.
The podiatrist gave me orthotics to wear in my winter shoes but they were not suitable to put into my summer footwear.
The stretches you recommend were a miracle cure for me! I got relief on the first day!! I will not forget to do those 3 exercises regularly because the results are definitely worth it!
Now I am so grateful to be able to resume walking without pain. I have sent links of this article to friends I know who have been dealing with similar foot pain.
Thanks again Arun!
Thank you Jo for sharing your experiences;
I know it works coz, I suffered from plantar fasciitis and have to stretch every day. no problem, it has become a routine.
BTW, you don’t need ‘custom’ insoles, any regular comfy /gel soles you find, provide cushioning.
And thank you for spreading the word. Best Wishes in all that you do.
Arun
Yeah i did a lot of stretching and moderate walking.
Feel much better now. There are no tender spots on the ankle now. I try not to run now coz a slight pain returns. But I do go for walks everyday.
Thanks for the suggestions.
Michael.
Glad to hear the ankle is better; continue the stretching and walking.
Hi Arun,
Im 25 and about 3 months back I started running since my job is of a sedentary nature. What I did was ran on really hard cemented ground and with the wrong footwear. I kind of overdid it (ran an hour from day 1). By the end of the week, i was in a lot of ankle and calf pain, hence i stopped. The pain subsided, but that pain came back again everytime i ran or played badminton (this had never happened before). I also practice salsa and im sure this has also contributed to the pain. This pain has come on a regular basis since the past 3 weeks. It is mostly around the ankle area and it is worse with the first few steps in the morning. After the pain goes down, but it is still there the entire day with walking. I have noticed a very slight limp in my gait. Havent yet visited a doc. What should I do???
Also could you plz tell me where i could buy an exercise ball in Kolkata.
Thanks a lot.
Michael.
Yikes! you definitely overdid it;
I recommend:
rest, stretch and do short runs. stop when it hurts and ice it.
next day, do a little bit less.
If it hurts more than 2 days, take 2 days off – but continue to stretch and walk.
btw, is there a tender spot on the ankle? ie. if you poke around, is there something which hurts? if so, definitely see a doc. Otherwise, just rest, stretch and do in moderation.
Sorry, am not in Kolkatta and cannot help with the exercise ball.
Best Wishes
Arun
Dear Sir
I have heel pain since two years
kindly give me your clinic address and number
for treatment
Siddharth
Hi Siddharth,
I am located in boston.
There is sufficient info here and exercises in the included links that you should be able to take care of it yourself. And besides, the doctor is going to tell you the same thing.
The most important treatment is regular exercise.
Best Wishes.
Arun
Hello,
I am a gymnast who trains 25 hours a week. i have severe pains in my heel. i have tried taping my foot, stretching, a day splint and a night splint. Nothing has worked and it has been 5 months now. My doctor has suggested a cast and crutches. is this the way forward? please help !
Jaclyn x
Hi Jaclyn:
I ran your comment by Dr R DeAsla, Orthopaedic Surgeon mentioned in the article above; he replied:
“Sounds like she needs to be seen by (an orthopaedic surgeon). Plantar fasciitis is not the only cause of heel pain… .”
Thank you very much for this info.
i had an mri which revealed it is severe tendons, tissue and ligament damage.
now he is talking about a steroid injection. is this the right way ?
thanks again
Jaclyn xx
I think he means that your doctor who is treating you, has a better sense of your overall health and activities; Steroid is an obvious next step, but you can NEVER do more than two! The question I have for you is: Why are your tissues still inflammed? Are you still working on your Gymnastics. Realistically you may need to take a break and let the healing take place; Steroids are NOT a substitute for rest!
Also, try placing you heel on an icepack whenever you get to sit. That worked for me; but I still stretch my heels every morning. Best Wishes
Thank you for this
i am no longer getting the injection
the pain has not reduced and it has been almost 5 months now
i am on crutches and have been told that insoles will now help… any ideas?
also how long do you suspect i will be on crutches
thanks
jaclyn xx
Jaclyn:
Sorry for the long delay!
Insoles absolutely! I had heel pain and have insoles for ALL my shoes. There are several varieties of ‘heel cup’ made of a silicone elastomer and available at a CVS or Walgreen. Try those.
Also, at night, or when sitting at a desk, I place my heel on a ice-pack. Even when I go to bed, I sleep with my heel on a ice pack and kick it off after 30 minutes.
All this, aggressive stretching AND rest should do it!
Looks like you have been suffering for ages, hope some of this works for you.
Best Wishes
Arun
Dear Arun,
I am suffering from Plantar Fasciitis for almost 2.5 years. I tried many doctors (Allopathic, Ayurverdic and Homeopethic). I work in a company where i have to spend more than 8 hours a day.. there is no physical exercise and due to eating junkie food i have put on some weight!! Due to this hectic work and the pain in the heel i could not walk & run properly. So no physical exercise is possible….I am really frustrated with this heel pain..My legs are almost turned black and there is a tingling and numbness feeling whenever i sit on the floor for more than 30minutes..I have waisted lots of money to find a cure..so please help me out…..I also tried the streching exercises, brought cushion chappals and cushion for the shoe sole…none of them worked!!!!!
One of the Doc said it is a “Vath”(Hindi) problem and it will come and go and will remain for your lifetime….
The consultant doc fees are Rs.300-400 per visit which is costly in this recession period….Also they are not in clinic on sundays which is a major problem.. i have to take a leave and visit them…Also they ask us to conduct tests bood tests, urine tests xrays etc which is far more expensive….
So please suggest me what to do… I will buy the night splints but where are they available in mumbai i do not know..but i will definetly find out…
Awaiting your prompt response…….
Thanking you,
Pradeep Surve.
Hi Prakash:
Sorry to hear of your plight. I am not sure what exercises that you have done, but I have not linked some relevant exercises above. In our clinical experience, these do help to alleviate the pain.
In very severe cases, the doctors can inject steroids at the site of inflammation; or in worst cases, there is surgery. So please check a foot & Ankle surgeon, or any orthopaedic surgeon.
Wishing you the best.
Arun
Where can I get the day splint as shown above. Plantar Fasciitis is a killer. I have had three rounds of shots with only minimal relief for 1 week. Will try anything
Hi Andy:
Sorry for the difficulties you have.
Exercise is one way to reduce the pain;
The splints that you mention should be available in any medical supply store. In our hospital, we have a in-house store which fits the splints for the patients. Many dedicated running shoe stores carry the splints.
In our area, I know this running store carries some of the splints. You can call the owner directly – Mike
http://www.bostonrunningcompany.com/
Hope this helps.
Arun
Hi Arun,
thanks for the quick response….
but would you say that there is no permanent cure for this?
now a days i am getting more frustrated due to this…. as i am not able to keep the exercise schedule on daily basis…
its becoming more and more painful and irritating….
also can it become a heridetary thing?
Regards,
Nikhil
I am not sure if you can just give up exercise; Also, it might be the type of shoes that you are wearing on a daily basis.
Exercises do help, but our lifestyle, plus our choice of footwear do aggravate heel pain. I think a quick 2-3 minutes of targeted exercises while having breakfast can provide lifelong relief.
Genetics may have a role in heel pain.
Good luck
Arun
Hi Arun,
I am experiencing this pain for now more then 2 years….it decreases whenever i do a bit of Exercise but then again it increases… over last month, the pain has increased tremendously. please tell me what should i do now….
to quite an extent, i kept on ignoring it…..
please let me know the solutions for the same….
Hi Nikhil,
Sorry to hear of your heel pain;
It appears you already know the answer – exercise!
Do the heel stretches every morning; I suffered from heel pain about three years ago and i still exercise – if I don’t I can feel the aches and pains creeping up.
Also consider night splints discussed in the article and in the comments – those help a lot.
Best Wishes
Arun
we need a night splinter we stay at hyderabad, Andhrapradesh can you help us where we can get the above mentioned article as i am suffering with heavy pains your quick response on the same is appreciable. Thaks
hi Roopakal,
perhaps you could try to locate these night splints in any medical supply shops. If not in Hyderabad, I am sure they are available in Mumbai.
Wishing you the best.
Hi Roopakal,
I am also looking for Night Splint. Could you please tell me the place fir buying if you already got one?
I think there is a strong need to develop a night splint, which will be more effective AND inexpensive for the indian market. Will look into it. Arun
Hi Adhi:
Here in the US, these are available in any medical supply shop and even in some good running shoes shops.
In Mumbai, try some of the Medical Supply Stores; I know there are several near Metro cinema; They have all kinds of stuff.
If you don’t have some close by, try going to a local hospital, they usually have a store;
or, some pharmacies may be able to get it for you as well.
Hope this helps;
In the meantime, please continue to do the stretches religiously!
Best Wishes
Arun
want to buy Treating Heel Pain or Plantar Fasciitis – Night Spints
Hi Khusru
:
Sorry to hear of your plantar fasciitis. It can be very frustrating.
I have started to post stretches and the first one is here -pb with pic
http://arunshanbhag.com/2007/09/25/achilles-tendon-stretch/
Other stretches are coming up.
Considering you have had it for 6 months, I think you need Physical therapy for the heel pain. I am not familiar with the outlets for the day and night splints in Mumbai. Very likely that the PT folks will guide you, or check with a medical supply company. I remember there are several near Lohar chawl near crawford market.
In the meantime, see if you can use tapes or soft ropes to keep the ball of the feet pulled towards the shins when you sleep. That helps a lot.
Good luck!
I have been havinng plantar fascitis pain for the last 6 months, in fact it has been getting worse. I have flat feet, there is a length discrepancy in my legs. Will try the exercises. Thanks for the information. Would like to know where the boot and night splints are available in Mumbai.
Khushru
Ellen:
Thank you for sharing your thoughts. I agree with the boot. When I was struggling with heel pain, I had seen the boot and was itching to use it – but did not! I like the stretches.
BTW, I will be posting the Heel Pain Stretches next.
Hope you are enjoying the book.
Arun, this is so helpful — particularly the illustrations and details of treatment and recovery paths.
I lost a whole year of running while recovering from plantar fasciitis and wish I’d had this post to look at during that time.
The boot worn at night was the thing that finally worked for me, but the physician did not want to give it to me at first. I really recommend asking for ‘the boot’ from the beginning!
Ellen
Asha – you are absolutely right!
The heel sees greater than 7 times the body weight during walking. So a 10 lbs extra weight, translates to a 70 force at the heel. So reducing weight would also alleviate the problem. Even switching to well cushioned shoes helps.
Thanks Asha
Very informative post Arun.!:)
Losing some weight for some people helps too unless it’s chronic and needs medical help.
Thank you Rachna -
Indian dancers are also prone to heel pain, so it makes sense to take precautions (like placing the heel on ice, after a hard practice). Do you have to practice a lot?
wow…great info here…Arun