Do you dread those first steps in the morning when you get out of bed to go to the bathroom? Does it feel like something is stabbing into the bottom of your heel? If you have heel pain, especially bad first thing in the morning or when you start walking after sitting or resting, you probably have one of these conditions: Plantar Fasciitis and/or Heel spur. These conditions are closely interconnected and can lead to other potentially serious conditions, but if you take the proper steps, they can be corrected and the pain and dysfunction can subside.
How do I know if I have it?
Plantar fasciitis and heel spur usually begins with dull aching pain in the heel that comes and goes. Standing for long periods of time, stretching the leg and foot, and the first steps after rest all tend to make the pain start or get worse. Runners may develop this condition, as well as those who are on their feet at work, people with collapsed arches or even high arches, heavy people, and those with tight calf muscles.
What exactly is it?
There is a broad tendon-like fascia that runs along the bottom or sole of the foot. This fascia extends from the front of the heel bone to the ball of the foot. When the foot arch collapses or compresses, it over-stretches the plantar fascia causing it to become inflamed. Sometimes the plantar fascia starts getting rips or tears, similar to tendonitis. Often the fascia, where it connects to the heel, begins to pull away from the bone, or avulse. This causes a massive inflammatory response and is why this spot is the most common point of pain.
What’s the difference between Plantar Fasciitis and Heel Spur?
If the body starts to pack calcium into the torn fascia where it is pulling away from the heel, the plantar fasciitis becomes a heel spur. Heel spur is just a further progression of plantar fasciitis. It’s really the same condition and therefore the treatment is the same.
Besides the heel pain, what else could go wrong?
The inflammation and tears on the fascia that result in your experiencing heel pain are actually the end result of structural problems with your foot. The foot, with its 26 bones, dozens of muscles, tendons and ligaments, and its two important arches, functions like a shock absorber as we walk or run. This shock absorbing function of the foot minimizes the impact on our knees, hips and lower back. Heel pain is an alarm signal that the foot is no longer functioning as a shock absorber protecting the other weight bearing joints. Additionally, the longer you have the condition and have to limp or favor the symptomatic leg and foot, the greater the stress that is imparted to the knee, hip or low back. Left untreated, plantar fasciitis can result in damage to these other important joints.
Is there anything else that could be causing my foot pain?
There are, of course, other conditions that can cause foot pain. If you are a runner, athlete or obese, there could be a stress fracture, especially if the pain is elsewhere in the foot and not at the front of the heel bone. If the pain is in the center of the front pad or ball of the foot, you could have a Morton’s neuroma. X-rays would reveal these alternate causes of foot pain.
The eight critical steps to fix Plantar Fasciitis
All eight steps are critical for successful resolution of plantar fasciitis or heel spur. If after three weeks of religiously following this protocol you have not neared resolution, seek professional advice. Many chiropractors can assist your recovery by adjusting your foot, prescribing custom orthotics, as well as ordering imaging like x-rays or MRI. Medical doctors may want to do steroid shots or surgery.
- Use herbal anti-Inflammatories. Anti-inflammatories will take down the inflammation and swelling of the fascia. These will aid the healing process while helping with the pain. Herbal anti-inflammatories are actually healthy for the body, rather than the very negative health side effects of NSAIDs (Non Steroidal Anti-inflammatory Drugs)*. NSAIDs are ibuprofen, aspirin, naproxen, Aleve and Advil. For best results, take the herbal throughout the day regardless of the level of pain. Turmeric, boswellia, ginger, white willow, devil’s claw, licorice and bromelain are excellent anti-inflammatories.
- Get arch supports. Put over the counter orthotics (arch supports) into your shoes to support you arches. There are two main arches in the foot, the long arch at the inside of the foot that we all know about, and another smaller one perpendicular to this one in the ball of the foot. For best results, get an arch support orthotic with a metatarsal pad that supports the smaller front arch as well. (powersteps.com see powerstep pinnacle plus orthotic)
- Ice your heel. Ice at least once a day on the point of pain on the heel. For best results, soak your foot in hot water with Epsom salt or sea salt for 15 minutes then ice the point of pain on the heel. The best way to ice is an ice massage. [freeze water in a small paper cup, peel away some of the paper at the top of the cup to reveal the ice. Place the exposed ice right on the point of pain. Move the cup of ice in a small circle the size of a dime for three minutes. There will be a large red circular patch the size of the ice cup on your heel with a smaller white circular center]
- Mobilize your foot. With both hands, twist and turn your foot to loosen up any fixations in between the many bones of your foot. For best results, soak your foot in the hot water first, then take a couple of minutes to mobilize your foot, then do the ice massage. You may also use a roller and roll the sole of your foot over the roller. You can make one by taking a small plastic water bottle, fill with water and freeze. Roll the foot from toes to heel. Tapping the heel vigorously below the Achilles tendon in a heel-to-toe / back-to-front direction is another excellent mobilization.
- Stretch your calf muscle. One way is to stand on a step, gripping the step with only the front of your foot so that your heel can drop down toward the step below. You should feel a pulling in the calf muscle. Hold for 20 seconds, rest for 10 seconds and then stretch again. Continue for five minutes. This calf muscle must be stretched at least three times a day initially.
- Replace your shoes! If you stand at work or run for exercise, replace your shoes every 6 months. They may not look worn, but their support and cushioning wears out much faster than it takes for the shoe to look worn or tattered.
- Take Magnesium citrate and Vitamin D. If you are already taking magnesium and Vitamin D, you may need to increase your dose. Discontinue any calcium supplements unless you are taking them for active parathyroid disease. This step is critical for those that already have a heel spur seen on an x-ray, but should also be done if there is no known spur to prevent spur formation.
- REST. If you are a runner, walker or aerobics exerciser, switch to swimming, biking or yoga. Stay off your feet as much as possible if you stand at work. Sometimes a high stool can be used rather than standing.
- If you know from an x-ray that there is an actual spur, use the homeopathic heel spur formula along with this protocol. (5 drops directly into the mouth 3 times a day, away from any food or drink for 15 minutes)
- If your heel pain first thing in the morning is not responding, you may try a night sock or night splint. ( powersteps.com)