• Do You Understand Heel Ache?

    Overview



    The heel is the first bone to contact the ground when walking and takes the full force of impact and the resulting shock of bearing weight during motion. The primary symptom is pain in the heel area that varies in severity and location. The pain is commonly intense when getting out of bed or a chair. The pain often lessens when walking. The most common cause of Heel Pain is plantar fasciitis. Plantar fasciitis is a stretching of the plantar fascia, a ligament that runs from the ball of foot through the arch and is attached to the heel. It is that attachment which becomes aggravated and typically causes pain after being on your feet for lengths of time. Abnormal motion of the foot (pronation) is one cause of plantar fasciitis. Heel spurs, which are abnormal bone growths coming off the heel, can also cause heel pain. Other causes include repetitive stress or shock to the heel, standing for prolonged periods or osteoarthritis. To prevent heel pain, always wear properly fitting shoes, place insoles or inserts in your shoes to help control abnormal foot motion, maintain a healthy weight, exercise and do foot stretches as they have been shown to decrease the incidence of heel pain.

    Causes

    Heel pain is often the result of the plantar fascia being overstretched or overused. Risk factors include. Obesity or sudden weight gain. Long distance running. Tight Achilles tendons. Shoes with poor arch support or soft soles. Foot arch problems (both high arches and flat feet).

    Symptoms

    Plantar fascia usually causes pain and stiffness on the bottom of your heel although some people have heel spurs and suffer no symptoms at all. Occasionally, heel pain is also associated with other medical disorders such as arthritis (inflammation of the joint), bursitis (inflammation of the tissues around the joint). Those who have symptoms may experience ?First step? pain (stone bruise sensation) after getting out of bed or sitting for a period of time. Pain after driving. Pain on the bottom of your heel. Deep aching pain. Pain can be worse when barefoot.

    Diagnosis

    The diagnosis of heel pain and heel spurs is made by a through history of the course of the condition and by physical exam. Weight bearing x-rays are useful in determining if a heel spur is present and to rule out rare causes of heel pain such as a stress fracture of the heel bone, the presence of bone tumors or evidence of soft tissue damage caused by certain connective tissue disorders.

    Non Surgical Treatment

    Shoes, orthoses, splinting and/or immobilization form the cornerstone for successful functional management of plantar fasciitis.When you take the overuse nature of plantar fasciitis into account and attempt to re-establish the windlass mechanism of the foot, there is an enhanced potential for success. Unfortunately, too little attention has been directed to appropriately managing the shoes worn during treatment for plantar fasciitis. Emphasising motion control and stability type athletic shoes (that provide a firm heel cup, instep rigidity, longitudinal integrity and a well-integrated shoe upper) can help decrease excess eccentric tissue strain. The shoe also serves as a vital and functional link between an orthotic and the foot. Orthoses have long been considered to be a reliable method for treating plantar fasciitis. Considerable debate has been waged over the benefits of over-the-counter (OTC), prefabricated and prescription foot and/or ankle orthoses. Heel cushions, heel cups and cushioning pads appear to provide immediate pain relief for many people who have plantar fasciitis.This relief is frequently short-lived and requires other treatment modalities for success.Neutral position taping and strapping of the foot provides temporary symptomatic relief of pain caused by plantar fasciitis. Although the functional benefits are temporary and likely do not last longer than 10 minutes with exercise, the soft tissue compression and symptomatic relief afforded by the strapping can last for nearly a week.

    Surgical Treatment

    Although most patients with plantar fasciitis respond to non-surgical treatment, a small percentage of patients may require surgery. If, after several months of non-surgical treatment, you continue to have heel pain, surgery will be considered. Your foot and ankle surgeon will discuss the surgical options with you and determine which approach would be most beneficial for you. No matter what kind of treatment you undergo for plantar fasciitis, the underlying causes that led to this condition may remain. Therefore, you will need to continue with preventive measures. Wearing supportive shoes, stretching, and using custom orthotic devices are the mainstay of long-term treatment for plantar fasciitis.

    Prevention



    Wearing real good, supportive shoes are a great way to avoid heel pain. Usually, New Balance is a good shoe to wear, just for everyday shoe gear. By wearing proper footwear and performing thorough stretches, athletes can help prevent frequent heel pain. If you are starting to get a little discomfort or pain in the feet or heel, know that pain is not normal. So if you are having pain, you should be proactive and visit our office. If you let heel pain get out of control you could run into several other problems. It is always suggested to visit a podiatrist whenever you are experiencing pain.

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