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5 Steps to help treat heel pain
5 Step Guide for Treating
Plantar Fasciitis and Heel Pain
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Plantar fasciitis or inflammation of the plantar
fascia comes about when the ligament suffers
very small tears where it inserts into the heel
bone, or along its length. With poor foot
mechanics, too much use or the presence of other
triggers, the pressure on the plantar fascia during
the process of walking and running can tear the
fascia from where it joins to the heel and develop
microscopic tears. This can lead to heel spurs
which are easily detected with x-rays.
The most common complaint of heel pain is that it is usually worst in the morning and
may improve throughout the day. By the end of the day the pain may be replaced by a
dull aching that improves with rest.
If you have seen your doctor about this he or she may
prescribe rest and anti-inflammatory medication for the
first part of treatment but there are some very
conservative and non-invasive treatment methods to
manage and eliminate this heel pain.
If you have not seen your doctor but answer YES to
any of the following questions then you might be
suffering from Plantar Fasciitis or Heel Spur
Syndrome.
1. Do you have heel pain after rest or sitting?
2. First few steps in the morning are painful?
3. Does it feel like you have a stone under your heel?
4. Does your heel hurt when you press on the bottom?
After the end of the initial rest and recovery stage, treatment can begin, tackling the
problem with multiple techniques. These may involve icing, taping, specific stretches,
This information provided by Kinetic Konnection is not intended to replace the medical advice of your doctor or health care provider.
Please consult with your health care provider for advice about a specific medical condition.
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5 Steps to help treat heel pain
massage, resting splints, insoles or custom foot orthotics and proper footwear.
It may take several months for symptoms to go away and the plantar fascia to be
completely healed. Remember that a damaged ligament (even microscopic tears) only
comes about after recurring and prolonged stress. The longer someone has been
suffering from plantar fasciitis and the worse the heel pain, the longer the treatment will
take. Using a combination of treatments will shorten the recovery time and get you back
to pain free activities sooner.
Five Step Guide for Treating Plantar Fasciitis
Before you get started with any treatment
plan please speak with your physician or
foot specialist about your condition or
diagnosis. These steps are simple,
effective, non-invasive, and conservative
and work best in combination. Your feet
will soon be happy again!
Step #1 - Icing
Plantar Fasciitis is an inflammatory condition. Often your doctor will prescribe antiinflammatory medication for pain and help control the inflammation. Icing 2 to 4 times a
day will also help with the pain and inflammation. There are several ways to effectively
ice the area.
•
•
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Use a tensor bandage to wrap a bag of ice to your heel. Do not apply too tight
and place a thin cloth barrier between the ice and your skin to avoid skin
damage.
Freeze a 500 ml water bottle. Place the bottle under your foot
and roll it back and fourth. Heel to toes. This will ice and
massage the heel and arch. You may want to use a thin sock if
it is too cold.
Ice Tape. Wrap your foot as if you sprained it. The Ice Tape provides
compression and as it begins to evaporate it will get colder but
not cold enough to cause skin irritations. Ice Tape can be left on
for extended periods of time and is reusable.
This information provided by Kinetic Konnection is not intended to replace the medical advice of your doctor or health care provider.
Please consult with your health care provider for advice about a specific medical condition.
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5 Steps to help treat heel pain
•
Dixie or Styrofoam cups. Fill them with water and freeze. Before
application tear off the top ½ inch of the cup to expose the ice.
Gently rub and massage the pain area. This icing technique is
very specific to the heel area.
Step #2 - Resting and Night Splints
Damage to the plantar fascia usually occurs over a period of time while the tissue is
being stretched too much causing micro tears. When we rest or while we sleep the
micro tears begin to heal but in a shortened relaxed position. We when rise and become
weight bearing we cause the plantar fascia to stretch again and consequently tear what
was trying to heal. A night or resting splint will keep the foot in a neutral position (90
degrees) allowing the tissue to heal at a normal length. This will eliminate the pain in the
first few steps after sleeping or resting. It also breaks down the cycle of healing –
tearing – healing – tearing which creates scar tissue and can lead to heel spur
syndrome.
Types of night splints – there are two types that are most effective, comfortable and
affordable. There are many others available just make sure it keeps your foot at 90
degrees and is comfortable.
•
Dorsal Type Night Splint. This splint goes on top of the foot
and slightly up the shin bone. It is made of rigid material to
help maintain a neutral position. This material is also
adjustable to increase or decrease the angle of the foot.
There are no hard or bulky surfaces to contact the opposing
leg during sleep. Very easy to use and comfortable.
•
Traditional Adjustable Night Splint. The splint goes under
the foot and up the calf area. Adjustable straps allow for
an increase or decrease in the angle of the foot. Front
buckle straps keeps the foot and ankle securely in place
for optimal position.
Both splints are very effective. One might suit you better. Be sure to get fitted properly
by a trained fitter.
This information provided by Kinetic Konnection is not intended to replace the medical advice of your doctor or health care provider.
Please consult with your health care provider for advice about a specific medical condition.
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5 Steps to help treat heel pain
Step #3 - Stretching
It is important to avoid overly aggressive stretching at the start of the treatment as this
can re-injure the plantar fascia. Stretching should be done within a range of motion that
is pain free. The following stretches are basic and easy and should be followed by icing.
For more advanced stretches you can contact us or see your physical therapist who can
give you personalized instruction in a series of stretching exercises.
•
Wall Stretch
A wall stretch can help to stretch the calf and muscles in the foot. Firmly plant
your hands on a wall in front of you with your arms fully extended. Move one foot
in front of the other. The foot with plantar fasciitis should remain in back. Slightly
bend your knee on the leg in back. Hold this position until you feel your calf
muscles stretching. Hold this position for 30 seconds.
•
Stair Stretches
The American Academy of Family Physicians recommends using the stairs in your
home to help stretch. Stand on the stairs and alternate dropping each heel below
the stair level to help loosen the plantar fascia and the Achilles tendon. If you do
not have stairs, you can stand on a block for the same effect.
•
Non-Weight-Bearing Stretches
If your foot is extremely painful, weight-bearing stretches may not
be tolerable. The University of Michigan suggests sitting on the
floor and wrapping a towel around the bottom of your foot so you
can pull your toes toward you. You also can sit in a chair, cross
your legs and use your fingers to pull your toes up. Both of these
exercises will stretch out the bottom of your foot. Make sure you
apply only enough pressure to create a gentle stretch.
•
Foot Roll
This exercise not only stretches the plantar fascia but also provides a
massage for the bottom of your foot. Place a tennis ball, can of soup or other
round object under your foot and roll it from your toes to your heel. It is best
to do this seated. If your foot is painful or inflamed, place the object in the
refrigerator or freezer, so you can give your foot an ice massage as well.
References
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American Academy of Orthopaedic Surgeons: Plantar Fasciitis
American Academy of Family Physicians: Treatment of Plantar Fasciitis
University of Michigan Health System: Plantar Fasciitis Rehabilitation Exercises
This information provided by Kinetic Konnection is not intended to replace the medical advice of your doctor or health care provider.
Please consult with your health care provider for advice about a specific medical condition.
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Kinetic Konnection – www.thebracingexperts.com
5 Steps to help treat heel pain
Step #4 - Proper Footwear
This step is easier than most think. Proper foot wear is important even for those who do
not suffer heel pain. Yes, I know we all have
different shoes that we need for different occasions
and we can’t all wear running shoes to work, but
follow these 3 golden rules for sourcing out proper
footwear and your feet will thank you.
1. Make sure you get sized accurately.
2. Get sized at the end of the day when
your foot is the largest.
3. Don’t lie about your foot size or width.
Here are the top 4 Test to help deciding what shoe you should buy.
1. “Heel-Counter Thumb”
•
In this test, one holds the shoe in one hand, while they use
the thumb of the other hand to push in the back part of the
heel counter. In a shoe not designed to assist over-pronation
problems, this aspect of the shoe will fold very easily. A good
shoe will not fold at all.
2. “Heel Counter Pinch”
•
In this test, one holds the shoe in one hand, while they
squeeze the heel area together with the index finger and
thumb. In a shoe not designed to assist over-pronation
problems, the sides of the upper will fold very easily. A good
shoe will not fold at all.
3. “Dish Rag”
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To do this test, grip the front part of the shoe with one hand
and the back part with the other hand. Then twist the shoe in
opposite directions. A good shoe will be resistant to these
forces. A poor shoe will fold up like a dish rag.
•
A good shoe should be able to fold at the balls of the feet (where the toes connect to the
rest of the foot). This allows for proper toe-of during walking and running. A shoe that
folds in other places such as the middle should be avoided.
4. “Fold”
A shoe that passes these four tests will provide superior support and compliment an orthotic that
is designed to relieve symptoms produced by over pronation. If an orthotic is resting on an
unstable environment, it will not be able to perform its function thus limiting its ability to relieve
the pain and symptoms.
This information provided by Kinetic Konnection is not intended to replace the medical advice of your doctor or health care provider.
Please consult with your health care provider for advice about a specific medical condition.
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Kinetic Konnection – www.thebracingexperts.com
5 Steps to help treat heel pain
Step #5 - Custom or off the shelf foot orthotics
Orthotic insoles are a device placed inside your shoes with the
purpose of correcting faulty foot function. Poor foot biomechanics
can be blamed for many common foot conditions such as Plantar
Fasciitis (heel pain) and Metatarsalgia (ball of foot pain).
The most common display of faulty foot biomechanics is 'over-pronation'. Overpronation is a condition whereby the arches are lowered
and the feet and ankles roll inwards excessively during
walking and running. Over-pronation should not be
confused with flat feet (Pes Planus). Over-pronators do
have an arch present, but the arch will lower significantly
during walking and standing – causing the fascia to become
over stretched.
Orthotics are designed to correct the faulty foot function. In turn this will reduce the
amount stress place on the fascia. By correcting over-pronation orthotics re-align the
feet and ankle bones to their neutral position, restoring our natural foot function.
Therefore, orthotics not only help alleviate problems in the feet but also in other parts of
the body such as the knees and lower back.
There are many types of orthotics available and several casting and measuring
techniques. There are some questions you should ask before getting your foot
orthotics.
1. What are the credentials of the person who will be responsible for
my custom orthotics?
• You want to make sure that they have training in biomechanics,
pathologies and anatomy of the foot. Podiatrists, Chiropodists,
Pedorthists and Kinesiologists are recommended.
2. What are the methods for creating my custom orthotics?
• Metascan dynamic software scans the foot 150 times per second tracking 8 key
points along the plantar surface of the foot. Gait
observations show each of the 8 key points relative to
pressure and time in a color
corresponding to the 2D and 3D
composite image and displays gait
analysis data. This type of orthotic is
typically for those who fall into a normal range of foot
function with mild biomechanical deficiencies.
This information provided by Kinetic Konnection is not intended to replace the medical advice of your doctor or health care provider.
Please consult with your health care provider for advice about a specific medical condition.
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Kinetic Konnection – www.thebracingexperts.com
5 Steps to help treat heel pain
•
Slipper casting is similar to plaster except that it is less messy and time
consuming. It is in a sock not fabric roll format and leaves no
residue on the client's foot since a bag is placed over the foot
first. By capturing the correct foot position (subtalar joint in
neutral) in the cast this technique is great for those who
require additional correction. This is usually taken non-weight
bearing.
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Foam box impressions involve pushing the foot into a foam box (with subtalar
joint in neutral) either from a standing or seated position. This
can be a semi-weight bearing or full-weight bearing technique
often used if someone requires a less aggressive (more
accommodative) shell shape. It is often used for people with
severe arthritics or diabetics (sores on foot).
3. Will these orthotics fit into my shoes?
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Orthotics can be designed for virtually any shoe type but are
usually designed with a particular shoe type in mind. Depending
on your needs they should work well with shoes of similar
style. If an orthotic is designed for running shoes, it will not
fit properly into a heeled shoe. Sandals also restrict orthotic
use, as the orthotic is not secure without a closed shoe.
4. What happens if I need an adjustment or modification?
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Make sure that your provider will allow for adjustments and modifications for the
first year at NO CHARGE. The body’s response to the inserts is sometimes
unpredictable and adjustments may be needed even after you have worn them
for a while.
You can get more information or book a consultation with our Kinesiologists
or Foot Specialists by following the links below.
Would you like to be contacted so you can book
a consultation?
Find a location closest you.
Windsor 519-258-4795
Oakville 905-257-4335
Vaughan 905-850-2030
This information provided by Kinetic Konnection is not intended to replace the medical advice of your doctor or health care provider.
Please consult with your health care provider for advice about a specific medical condition.
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