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Dr Mark Nelson Foot & Ankle Specialist
Clinic Home Page
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Dr. Nelson's "Top 10 Tips" for Treating Plantar Fasciitis (aka - "Heel Spurs")1) Wear a
custom-made prescription orthotic (best treatment) or a
high quality pre-made type
arch support, like Orthofeet BioSole.
- *very important* You don't have to suffer with heel pain. You can get rid of your heel pain if you follow each of the top 5 suggestions listed above. If you do each of the top 5 suggestions on a daily basis, you have over a 90% chance of eliminating your pain due to plantar fasciitis (heel spurs). Successfully relieving plantar fasciitis heel pain requires using a variety of synergistic treatment modalities. The goal is to stop the activities which are irritating the plantar fascia, position the foot into the correct anatomical alignment, reduce strain on the plantar fascia while standing/walking, calm down the inflammation and stretch out the plantar fascia, so that it can heal properly in an elongated position. The longer you let heel pain go untreated, the harder it becomes to eliminate the pain. For most people, using a combination of arch supports/orthotics, a night splint while sleeping or sitting down, stretching twice daily and modifying their activities is sufficient to make their plantar fasciitis heel pain progressively resolve. Fortunately, surgery is rarely needed. Keep a positive attitude and remember that, yes, you can usually eliminate your heel pain by using these treatment suggestions. Heel Pain Information
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Rheumatoid arthritis and other forms of arthritis,
including gout, which usually manifests itself in the big toe joint, can
cause heel discomfort in some cases.
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Heel pain may also be the result of an inflamed bursa (bursitis),
a small, irritated sack of fluid; a neuroma (a nerve
growth); or other soft-tissue growth. Such heel pain may be associated
with a heel spur, or may mimic the pain of a heel spur.
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Haglund's deformity ("pump bump") is a bone enlargement at
the back of the heel bone, in the area where the Achilles tendon
attaches to the bone. This sometimes painful deformity generally is the
result of bursitis caused by pressure against the shoe, and can be
aggravated by the height or stitchng of a heel counter of a particular
shoe.
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Pain at the back of the heel is associated with inflammation of the
achilles tendon as it runs behind the ankle and inserts on the back
surface of the heel bone. The inflammation is called achilles
tendonitis. It is common among people who run and walk a lot and
have tight tendons. The condition occurs when the tendon is strained
over time, causing the fibers to tear or stretch along its length, or at
its insertion on to the heel bone. This leads to inflammation, pain, and
the possible growth of a bone spur on the back of the heel bone. The
inflammation is aggravated by the chronic irritation that sometimes
accompanies an active lifestyle and certain activities that strain an
already tight tendon.
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Bone bruises are common heel injuries. A bone bruise
(also called "stone bruise") or
contusion is an inflammation of the tissues that cover the heel bone. A
bone bruise is a sharply painful injury caused by the direct impact of a
hard object or surface on the foot.
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Stress fractures of the heel bone also can occur, but
these are less frequent.
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Wear shoes that fit well — front, back, and sides — and have
shock-absorbent soles, rigid shanks, and supportive heel counters.
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Wear the proper shoes for each activity.
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Do not wear shoes with excessive wear on heels or soles.
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Prepare properly before exercising. Warm up and do stretching exercises
before and after running.
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Pace yourself when you participate in athletic activities.
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Don’t underestimate your body's need for rest and good nutrition.
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If obese, lose weight.
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If pain and other symptoms of inflammation—redness, swelling, heat—persist, you should limit normal daily activities and contact a doctor of podiatric medicine.
The podiatric physician will examine the area and may perform diagnostic X rays to rule out problems of the bone.
Early treatment might involve oral or injectable anti-inflammatory medication, exercise, stretching, shoe recommendations, taping or strapping, night splints, or use of shoe inserts or orthotic devices. Taping or strapping supports the foot, placing stressed muscles and tendons in a physiologically restful state. Physical therapy may be used in conjunction with such treatments. The most successful plantar fasciitis treatments involve a combination of arch supports, anti-inflammatory medication, stretching, rest and night splints.
A functional custom-made orthotic device may be prescribed for correcting biomechanical imbalance, controlling excessive pronation, and supporting of the ligaments and tendons attaching to the heel bone. It will effectively treat the majority of heel and arch pain without the need for surgery.
Only a relatively few cases of heel pain require more advanced treatments or surgery. If surgery is necessary, it may involve the release of the plantar fascia, removal of a spur, removal of a bursa, or removal of a neuroma or other soft-tissue growth.
Heel Pain Tips From The APMA |
If the pain persists longer then one month you should visit a podiatrist for evaluation and treatment. Your feet should not hurt and it may require professional podiatric care to help relieve your discomfort.
To avoid heel pain, the APMA recommends
the following tips:
If you have not exercised in a long time,
consult your podiatric physician before starting a new exercise program.
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Begin an exercise program slowly, don't go
too far or too fast.
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Purchase and maintain good shoes and
replace them regularly.
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Stretch each foot and achilles tendon
before and after exercise.
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Avoid uneven walking surfaces or stepping
on rocks as much as possible.
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Avoid going barefoot on hard surfaces.
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Vary the incline on a treadmill during
exercise. Nobody walks uphill all the time.
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If it hurts, stop. Don't try to "work
through the pain."
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Reprinted with permission from the American Podiatric Medical Association.
The Strassburg Sock night splint treats plantar fasciitis heel pain while your sitting or at night while you sleep in comfort. Plantar fasciitis is also commonly called "heel spur syndrome" or "heel spurs". This style of night splint is much more comfortable to wear while sleeping than traditional hard plastic back (or front) style night splints. Plus, the Strassburg Sock night splint is much less expensive than most other styles of night splints.
Visit our Foot Care Store. We offer a variety of different models from SuperFeet, OrthoFeet, PowerStep, WalkFit and more.
Dr Nelson's comments:
The best fitting and functioning type of arch support is a custom made
prescription orthotic, which can be made by your podiatrist. Generally,
for most people, I recommend trying a pre-made arch support before progressing
to an expensive pair of custom made orthotics. Finding a comfortable and
effective pre-made arch support can be difficult. There are hundreds of
varieties on the market and that can make it confusing for customers. Due
to the variations in people's foot shapes, foot problems and style variations in
different products, there is no "one type fits all" arch support available.
That's why DrNelsonClinic offers different brands and models like
OrthoFeet, SuperFeet,
WalkFit and PowerStep to
choose among. Fortunately, for most people, I've found that the
OrthoFeet BioSole gel self-molding orthotics work the best and fit almost everybody.
Among the hundreds of pre-made arch supports I've seen and used, the
OrthoFeet
BioSole models give the best support and pain relief for people with
plantar fasciitis and heel pain. It's by far my favorite model for
people with heel pain, due in part to the higher arch and shock absorbing
gel under the heel. Be aware that the standard OrthoFeet BioSole "sport"
model is rather thick through the arch and it fits into athletic, work boots and
walking shoes, but may not fit into a shallow shoe, like a dress shoe. If
you want to use the OrthoFeet in a shallow shoe, like a dress shoe, then use the
"thin-line" or "high heel dress" models. The "sport" model may also be too
high in the arch area for people with very flat feet. For elderly or
arthritic people and those that want extra cushioning and softness under the
foot, while still getting extra support under the arch, try the OrthoFeet
BioSole "soft" model. If you don't need extra arch support or heel pain
relief and only want shock absorption and cushioning under the foot, try
the OrthoFeet "ThermoFit" model. After you start using any brand of arch supports,
remember to break them in gradually, because is will take some time for the orthotic and your feet to adjust to each other. I personally use the
OrthoFeet BioSole sport model in my athletic shoes and have found them to be as
effective and comfortable as my expensive custom prescription orthotics.
But, it did take longer to "break-in" the OrthoFeet supports than my custom
orthotics. If you don't have plantar fasciitis or heel pain or if you have
a flat foot and can't tolerate an arch support with a higher arch, but still
want great foot support to relieve foot fatigue and strain, you should also
consider SuperFeet Synergizer orthotics, which are
our most popular arch supports. SuperFeet Synergizer orthotics have
been highly recommended by sports and outdoor publications such as Backpacker™
magazine.