Age, constant pounding can cause heel pain

By Dr. Paul G. Donohue

DEAR DR. DONOHUE: I am a 47-year-old woman who has been physically active for the past 28 years. I walk, run, cycle and use an elliptical machine. Last summer I suffered with plantar fasciitis, and it took six months to recover from. Now the plantar fasciitis is back. It’s worse after sitting for some time, and the tops of my feet hurt. What can I do? — D.J.

A: I am not sure why the tops of your feet hurt. Could it be too-tight shoes? I can help with the plantar fasciitis, though.

The plantar fascia is a band of tough tissue that stretches from the front, bottom of the heel to the bottom of the toes. It provides support for the feet. Constant pounding on hard surfaces inflames the fascia — plantar fasciitis. It happens to many athletes. It also happens to older people whose plantar fascia has lost its elasticity.

The first step out of bed in the morning is a thing of great pain. People with plantar fasciitis feel like a knife has penetrated their heels. The same thing happens after sitting for a prolonged time.

In the early stages of inflammation, resting the heel by not running or jumping is essential. Resting does not mean total inactivity. Complete inactivity will make the fascia stiff and compound the problem. Icing the heel for 10 to 15 minutes, three times a day, helps. Nonsteroidal antiinflammatory drugs — Aleve, Advil, Motrin — ease pain and reduce inflammation.

Heel pads, silicone heel cushions, silicone shoe inserts and shoes with soft soles like crepe soles protect the fascia. Orthotics — specially made shoe inserts — are especially useful. A splint that keeps the foot pointed upward during the night speeds healing. Sometimes a shot of cortisone into the heel will be needed.

Stretching is the way to stop recurrences. While sitting, put the right foot on the left knee. Grab hold of the toes with the right hand and bend the foot toward the shin. Hold the bend for 10 seconds. Repeat 10 times, and do the exercise three times a day. This exercise should keep you free from plantar fasciitis.

c. North America Syndicate