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Becoming well-heeled

How to combat plantar fasciitis


Is your heel painful when you step out of your rig after driving a few hours, or when you first get out of bed? If so, you may have plantar fasciitis. Four to 7% of North Americans experience heel pain at any given time – 80% caused by plantar fasciitis. Ten per cent of the population will be affected by plantar fasciitis, especially between the ages of 40 and 60.

Plantar fasciitis is inflammation of the thick band of tissue (plantar fascia) that runs along the bottom of your sole, connecting your toes to your heel bone. Stabbing heel pain caused by this inflammation usually occurs with your first steps after sleeping or prolonged sitting, and often decreases after walking.

Because the plantar fascia supports the arch in your foot by acting like a shock-absorbing bowstring, when its bowstring tension becomes too great, small tears form. Repeated stretching and tearing causing irritation and inflammation, leads to plantar fasciitis pain, which feels worse after exercise, but not during exercise.

Although runners commonly get plantar fasciitis, other factors can increase your risk, such as improper foot movement and mechanics. Being flat-footed, having a high or fallen arch, or using an abnormal pattern of walking can impact weight distribution while standing, walking or exercising – putting extra stress on the plantar fascia, especially if you carry a bit of extra weight.

Standing for hours on hard surfaces can also be damaging. Even regularly jumping out of your rig or trailer can place a lot of stress on your heel, causing you to develop plantar fasciitis at a younger age.

People with plantar fasciitis who continue with their regular activities by adopting an irregular gait to minimize the pain may develop problems with their feet, knees, hips or back as a result.

To avoid these issues, try following a conservative, self-treatment plan, consisting of: rest; icing the painful area to reduce inflammation and pain; massage; and gently stretching the foot’s sole by placing the toes against a wall three to six inches above the floor and gently leaning forward a few times a day. As well, take ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), as needed. By following this plan, usually 90% of cases are resolved within six months.

However, when more focused therapy is required, a physical therapist could guide you though exercises to stretch the plantar fascia and the Achilles tendon, and to strengthen your lower leg muscles and stabilize your heel and ankle, and could also show you how to support the bottom of your foot with athletic tape.

A therapist or doctor may recommend that you stretch your calf and support the arch of your foot overnight while sleeping using a foot splint, or you might be prescribed custom-fitted or off-the-shelf orthotics (arch supports) to help equally distribute pressure across your feet during the day.

If your pain continues, more extreme treatments might include having steroids injected into the painful area for temporary pain relief. However, ongoing injections should be avoided since they can weaken the plantar fascia and lead to a rupture. As well, shock wave therapy, where soundwaves are directed toward the painful area, may be used to stimulate healing for chronic plantar fasciitis, but possible side-effects include bruising, swelling, pain, tingling, and numbness.

You can take the following steps to avoid or reduce the pain of plantar fasciitis: maintain an appropriate weight to minimize the stress on your feet; and wear supportive work boots and shoes with a low to moderate heel, and with good shock absorbency and arch support. When exercising, wear supportive, cushioning athletic shoes.

Participate in low-impact sports like bicycling and swimming. Keep your arches and plantar fascia limber by stretching your feet – point your toes and flex your heels a few times before you jump out of your rig or out of bed.
Don’t allow painful feet to impact your day – stay well-heeled.

Karen Bowen is a professional health and nutrition consultant. She can be reached at karen_bowen@yahoo.com 


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