When Walking Becomes A Pain In The Heel

You wake up ready to start your week. You hop out of bed to begin your morning routine and bam – an excruciating pain radiates from the bottom of your foot and heel and you can hardly put weight on it. You walk it out for a few minutes and then all feels fine.

This is often how plantar fasciitis strikes - after a long period of rest, such as sleeping or after a long car ride. It also may show up suddenly after exercising or doing another activity. If you’ve ever experienced pain in the bottom of your heel, you may have plantar fasciitis.

According to the American Academy of Orthopedic Surgeons, approximately 2 million people are treated for plantar fasciitis each year. It happens when the plantar fascia – the long, thin band of tissue that supports the arch of your foot – becomes inflamed or irritated. It’s the most common cause of heel pain.

The plantar fascia’s function is to absorb the strain and stress we put on our feet as we go about our daily lives. Over time, or when too much pressure is put on the feet, the tissues can become damaged or even tear. This injury causes inflammation, resulting in stiffening of the plantar fascia. Heel pain is the primary symptom.

Risk Factors

Although most cases of plantar fasciitis have no specific cause, there are factors that may make you more likely to develop it.

• Tight calf muscles making it hard to flex your foot up
• High arches
• Obesity
• Participating in sports that involve repetitive impact, such as running
• Doing a new or increased activity

If you experience pain in your heel, an orthopedic surgeon can help determine the cause of the pain. Your orthopaedist will examine your foot and discuss your symptoms and concerns with you. X-rays and other imaging tests are usually ordered to help diagnose plantar fasciitis or determine if the heel pain is caused by a different problem. In some individuals, arthritis or a fracture may be the cause of heel pain. Once a diagnosis is confirmed, your orthopaedist will recommend a treatment plan. Most people with plantar fasciitis see improvement within months of beginning non-surgical treatment methods.

• Rest
• Ice
• Medications
• Exercise and stretches
• Cortisone injections
• Supportive shoes and/or orthotics
• Night splints
• Physical therapy

If the non-surgical treatments do not provide you with effective relief after a year or so, surgery may be considered.

Surgical options for plantar fasciitis include:

• Plantar fascia release: In this procedure, tension is relieved in the tissue by making a partial cut in the plantar fascia ligament. This surgery is appropriate for those who have a normal range of motion in the ankle but continued heel pain.
• Gastrocnemius recession: This procedure consists of lengthening one of the two calf (gastrocnemius) muscles and is recommended for individuals who may still have difficulty flexing their feet after completing a non-surgical regimen of stretches.

Either procedure can be done using a traditional, open incision or a smaller incision and an endoscope. You and your surgeon would decide which method is appropriate for you.

Don’t let plantar fasciitis keep you down. Relief is possible. See your health care provider and get the relief you need to put the spring back in your step.

Dr. Patrick Barousse is a surgeon with North Oaks Orthopedic Specialty Center who specializes in diseases and injuries of the foot and ankle. Click here to learn more about foot and ankle care.