“HEEL PAIN”
A real show stopper
Heel pain (plantar fasciitis) is one of the most common problems seen in podiatric medical offices throughout the country. Almost everyone has experienced this condition or knows someone who has had it. Plantar fasciitis can result from overuse, training errors, inflexibility or other mechanical foot imbalances. This condition can sneak up slowly starting with a subtle annoyance and eventually result in severe pain. Plantar fasciitis may cause heel as well as arch pain.
Heel pain (arch pain) can also follow a sudden traumatic episode. There are cases where the Plantar fascia is actually torn such as in the case of NFL football player, Peyton Manning . These Problems can sideline a professional sports player. In the military we call these types of medical problems “show stoppers” because they take you out of the game. You can’t perform at the level required. Imagine a Navy SEAL who can’t run or jump, limping up to the target. In a sense everyone is a PROFESSIONAL . Most folks need to ambulate to get to work and perform their required duties.
Typical symptoms include pain in the morning when first getting out of bed and pain may remain throughout the day. The pain usually increases as activity increases and often is noticed most afterward when rising up from sitting. In the everyday worker, pain might be most severe when getting up after lunch break. The pain may start in the heel. This is because the plantar fascia runs across the entire arch of the foot and connects to the heel bone. 
In more advanced cases, it can involve the heel and arch. In the most severe cases, there may even be a partial tear of the plantar fascia. The worst case scenario is a full tear of the fascia. Most cases occur in the everyday person in the absence of an injury. The pain may be best described a dull throbbing sensation or even a sharp burning, stabbing pain.
Heel pain (plantar fasciitis) is one of the most common problems we see at Allentown Family Foot Care but it is also one of the most treatable conditions. The initial treatment is centered around making a patient more comfortable. Rest is always helpful but usually not possible in our present day active population. In runners and other athletes, there is always cross training such as swimming and biking. Ice massage is always helpful for inflammation. This can be done with ice packs or cups. There is even a contoured easy to use arch mold called the Icy Foot that fits right up against the arch of the foot. This is the most convenient way to ice your foot. This is a reusable product that is kept in the freezer. Of course anyone with Diabetes or peripheral vascular disease should consult his or her doctor before using ice.
Stretching is cited throughout the literature. Dr. Joseph Godfrey (founder of the Orthopedic Sports Medicine Society) one of my Navy Mentors felt that plantar fascia problems were a result of lack of flexibility. He emphasized heel cord stretching always.
He was the surgeon for the Buffalo Bills in the old Days. I still hear him saying “ We never had these problems with the Bills because we had a good stretching program”.
i.e. Motrin, Advil, Aleve) have their place for early symptom relieve. Use of the medications should be weighed against the risks. Always remember they address pain and inflammation but not an underlying mechanical cause for the problem. Prolonged use could result in GI bleeding and even renal or liver problems. Physical therapy is beneficial in reducing inflammation and pain.
Most experts believe that supporting the arch is one of the most important initial treatment measures. 
At Allentown Family Foot Care we always tell patients with heel pain to avoid all unsupported ambulation. No barefoot walking. We recommend good supportive footwear to be worn all day long. The shoes are the first line of support. We also recommend an over the counter arch support initially. In chronic cases failing to improve, custom molded orthotics are prescribed. Custom orthotic devices are commonly used for athletes and high action military personal. It is one of the best options for difficult cases. See previous Blog for more information on Custom Orthotics.
Surgery is a last option when everything else fails to give relief. The procedures vary from an open incision
to endoscopic approaches that require two to three sutures. At Allentown Family Foot Care, there is also the option of a non incisional procedure using extracorporeal waves. Remember surgery is almost never considered for this problem. A thorough evaluation is always the best first step to determine a good conservative care approach. Other studies can be considered in determining the extent of the problem,
. These include X-rays. Other studies such as ultrasound and MRI’s may be considered if indicated. In the age of High deductibles and copays, every effort is taken to avoid unnecessary costs. An MRI could result in costs ranging in the thousand vs. a diagnostic ultrasound study for at least a one tenth the cost.
Bottom Line if you suffer from heel pain, Have an evaluation early on before symptoms get worse. DR Fritz best quote “I can get a Navy Seal back in action, I can return our patients to work and their desired activities”.
Allentown Family Foot Care is now celebrating their 25-year. There is a Team six doctors as well as a specialty staff all ready to serve the residents of the Lehigh Valley and beyond. The Practice includes multiple locations and offers same day evening and Saturday appointments are available. Our main number is 610-434-7000. The new state of the art facility is located at 2414 Walbert Avenue, Allentown , PA 18104
