Patient Education

Heel Pain (Plantar Fasciitis)


Knee Pain (Patella-Femoral Syndrome)


Tennis Elbow (Lateral Epicondylitis)


Heel Pain (Plantar Fasciitis)

Overview

Impact on the heel and arch increases stress in the plantar fascia, which stretches from the heel to the base of the toes. Inflammation at the heel or along the band of the plantar fascia causes pain.

Decrease activity which aggravates the condition

  • Avoid running or jumping
  • Slow walking is better than fast walking
  • Non-impact aerobic exercise is best. Examples include swimming, bicycling, NordicTrack and rowing.

Wear light, impact absorbing shoes

  • Running shoes, walking shoes or dress shoes with crepe soles (Rockport, Easy Spirit, Florsheim, New Balance, etc.)
  • Avoid shoes with thin soles and hard heels that transmit impact to the foot.

Heel cup and arch supports

  • There are several types of heel cups that fit into shoes and redistribute force about the heel.
  • TULI's absorb impact; polypropylene cups mold the heel to spread out pressure.
  • Soft or specially molded arch supports decrease strain along the arch and decrease tension.
  • Over the counter insole replacements can be added to shoes. Be sure to shoes are roomy enough to accommodate an arch support without crowding the foot.

Heat and ice

  • Soak the heel in warm water for 10 to 15 minutes, 2 to 3 times daily
  • If you have diabetes, water temperature must be less than 95 degrees.
  • Follow the soak with some gentle stretching exercises
  • Massage the heel and sole with an ice pack or a bag of frozen rice or beans.

Therapeutic exercises

Stretching: Stretch the heel cord (Achilles tendon) for 30 seconds. Rise on the ball of the foot, stretching the toes back. 4 to 5 repetitions 4 to 5 times daily, especially before and after sitting for long periods and before sleeping.

Strengthening: Stand on the ball of the foot at the edge of a stair or footstool. Balance with a hand against the wall or a counter. Rise on the ball of the foot and descend until the heel is below the level of the toes. Repeat on both sides. Do 4 to 5 repetitions 4 to 5 time a day.

Medications

Over the counter non-steriodal anti-inflammatory drugs (NSAIDs) may be taken with meals. Ibuprofen, 2-3 200 mg. tablets, 3 times daily; Naproxen, 2 200 mg. tablets, 2 times daily; or Aspirin, 2 300 mg. tablets, 3-4 times daily are reasonable programs. Avoid dehydration; take the medication after a meal or snack. Read the directions carefully. If there is any history of liver or kidney disease, ulcers, dyspepsia, or you take regular medication for other medical problems, consult your primary care physician before taking NSAIDs. Tylenol, acetaminophen, may be taken with NSAIDs or by itself for relief of pain. If the combination is needed for more than two weeks, consult your physician.