Heal Your Heel Pain
The average person takes about 9,000 steps per day. Within that day of walking, the forces that are exerted on the feet can total to hundreds of tons, being equivalent to a fully loaded cement truck! When a person is running, these pressures are as much as four times as great.
If you are experiencing some type of heel pain, you are not alone. Seventy-five percent of Canadians will experience some type of foot health problem at some time in their life. There are a range of different diagnoses that may be contributing to the discomfort in your feet and more specifically in your heels. This blog will discuss some of the most common conditions that frequently result in heel pain, as well as some treatment options.
What is it?
This is the most common foot condition that is treated at physiotherapy clinics. These patients find that their heel pain is normally the worst when they first get out of bed in the morning. Plantar fasciitis is caused by irritation and inflammation of the tissue that lines the bottom of your foot. The tissue, known as the “plantar fascia”, starts at the toes and connects at the heel. As this fascia is stretched day to day during walking, running and jumping, the tissue gets pulled away from where it connects to the heel and brings on discomfort.
- Gentle Stretching. In a seated position, cross the injured foot over the opposite leg and grab your toes on the injured side. Now pull your toes backwards towards your face until you feel a gentle stretch in the arch of the foot. The stretch should feel tight and uncomfortable but not painful. Hold this position for at least 30 seconds.
- Massage. A massage technique requires rolling a tennis or lacrosse ball across the bottom of your foot from the toes to the heel. With strong pressure, run the ball along the entire length of the plantar fascia. This myofascial technique will help to release some tension in the fascia.
- Foot Orthotics. A common reason why individuals develop plantar fasciitis is from walking over-top their longitudinal arch as they step. These individuals are called pronators. Pronators are very bad at protecting their plantar fascia and are constantly stretching and irritating it. To prevent this poor gait pattern, custom-made or prefabricated orthotics can be inserted into shoes to prevent constant over pronation of the feet and irritation of the fascia.
- Taping and Compression. A great way to stabilize the plantar fascia is to use either sports tape or k-tape. When the foot is taped properly, the movements of the foot are slightly limited and prevent the plantar fascia from being excessively stretched and progressing any minor tears that have developed. This added protection will give the fascia the much-needed time to heal and will help to reduce painful symptoms. Added compression using some type of sleeve can also help to improve circulation of blood to the area and assist in healing.
- Radial Shockwave Therapy. This type of therapy has gained popularity over the past decade, though it has been around since the 1980’s. Shockwave therapy uses a physically generated soundwave that is produced when an object reaches the speed of sound. We utilize this technology by generating the shockwaves and transmitting them into scarred or calcified soft tissue. This treatment shows very promising results for individuals with chronic plantar fasciitis who received no relief from more conservative treatments.
What is it?
A heel spur is a foot condition that produces a bony-like structure on the bottom of the heel due to a buildup of calcium. Although it is somewhat common for heel spurs to develop, they do not always produce painful symptoms. Many times, as muscles and the fascia of the feet tighten, they begin to become irritated by the rough and uneven surface of the new deposited bone. Normally, heel spurs are only about a quarter of an inch long and will attach to the centralized area of the heel.
- Ice. A cold compress, especially after exercising can help to reduce inflammation and produce therapeutic benefits.
- Rest. It is important to reduce high impact activity and rest your feet after long periods of activity.
- Foot Orthotics. There are many modifications that can be added to an orthotic to help prevent and treat conditions that originate from the feet. Orthotics geared to those suffering with heel spurs will require a small cutout in the central area of the heel with some added cushion. This central hole will allow the spur to comfortably sit in a cushioned space without being constantly compressed and irritated.
- Radial Shockwave Therapy. Similar to plantar fasciitis, shockwave therapy uses high-energy pulses to breakdown the excess deposited calcium (also known as the heel spur).
What is it?
The Achilles tendon connects the calf muscle to the back of the heel and is the biggest and strongest tendon throughout the body. It allows us to walk, run, jump, climb stairs. With overuse and large amounts of stress, this tendon can become chronically tight and pull away from where it inserts on the heel. This micro trauma to the tendon causes inflammation and sometimes degeneration of the Achilles.
- Modifying Activity. Since this condition is known to be an overuse injury, modifying the physicalactivity that you are involved in may be the only treatment you will require. Try to limit activities that require quick stops and starts. Be sure to warm up before activity and stretch the muscles after. As well, it is encouraged to not increase your activity level by more than 20% each week. This will allow muscles to properly adapt to the stresses of physical activity.
- Dry Needling and Stretching. In some cases, the Achilles tendon may be pulling away from the heel insertion point due to tightness in the calf. Dry needling techniques such as Intramuscular Stimulation (IMS) can help to alleviate pain in the Achilles by lengthening shortened calf muscles. Similar to acupuncture, the fine needles are inserted into the muscles and produce a contraction, allowing the muscle to then enter a relaxed state. Another way to help release the tension of the calf muscles is by stretching each day. Complete both gastrocnemius and soleus stretches daily to maintain lengthened muscles.
- Radial Shockwave Therapy. Research has found that shockwave therapy increases blood flow to the area, creating an inflammatory response that contributes to healing. As we can see, shockwave therapy is a very effective treatment for many different conditions of the feet!
- Foot Orthotics. If you think about your Achilles tendon as a loaded spring, the easiest way to release some of the tension in that spring would be to allow one of the ends to release closer to the other. By inserting an orthotic with a slight heel lift, this is essentially what you are doing. A slight lift of the heel, even a couple millimeters can instantly take some pressure off the tendon and relieve painful symptoms.
It is important to note that this is not a holistic list. There are many more conditions that produce painful symptoms of the heel and beneficial treatments that are not listed above. If you are experiencing painful symptoms in your feet, visit us at Leduc Physio for an assessment to find out more about how your feet are moving and the things you can do to prevent and treat your pain.
At Leduc Physio, we have a variety of staff that can assist you with the range of treatment options listed above. Whether you require a new pair of custom orthotics, a plantar fascia compression sleeve, are interested in radial shockwave therapy or would like to have your foot taped for plantar fasciitis, there is someone at Leduc Physio that would be happy to assist you! Book online at www.leducphysio.janeapp.com or call the clinic at (780) 980-5443 today!