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Do you feel a stabbing pain in your heel with your first steps out of bed

in the morning? You’re not alone! Every day, thousands of Americans

suffer from this condition. Plantar fasciitis, more commonly known as

heel pain, is by far the most common complaint patients bring to podiatric


Aching heels can truly affect your lifestyle and disrupt essential activities

and prevent you, to a large extent, from playing sports or simply going for

a walk. An accurate and expedient diagnosis of the cause of your symptoms

will help you receive the appropriate treatment.

There are several causes of heel pain. The most common include:

✿Plantar Fasciitis

– Inflammation of the band of fibrous connective tissue (fascia) running along the bottom (plantar) surface of the foot,


from the heel to the ball of the foot. Both heel pain and heel spurs are

frequently associated with plantar fasciitis.

Heel Spurs

– A bony growth on the underside of the heel bone. The spur, visible by X-ray, appears as a protrusion that can extend forward

as much as half an inch. Heel spurs can result from strain on the ball of

the foot and repeated tearing away of the lining or membrane that covers

the heel bone. Contrary to popular belief, heel spurs are generally

not the cause of pain—the pain you may feel is from inflammation of

the plantar fascia.

✿Excessive Pronation

– Excessive inward motion can create an abnormal amount of stretching and pulling on the ligaments and tendons

that attach to the bottom back part of the heel bone. Excessive pronation

may also contribute to injury to the hip, knee, and lower back.

✿Achilles Tendinitis

– Pain at the back of the heel is associated with

Achilles tendinitis, which is inflammation of the Achilles tendon as it

runs behind the ankle and inserts on the back surface of the heel bone.

Other possible causes of heel pain include

rheumatoid arthritis  and other forms of arthritis (e.g., gout); Haglund’s deformity  (a bone enlargement at

the back of the heel bone in the area where the Achilles tendon attaches to the bone);

inflamed bursa  (“bursitis”), a small, irritated sac of fluid; neuromas (nerve growths) or other soft-tissue growths; and

bruises or contusions

, which involve 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.

Some contributing factors associated with heel pain are age (with increasing

age, often there is decreasing flexibility); any sudden change in activity

(particularly activities that increase weight bearing or pressure on the

foot); flat, pronated feet or high-arched feet; a sudden increase in weight;

pregnancy; stress from an injury; a bruise incurred while walking, running,

or jumping on hard surfaces; or medical conditions such as tarsal

tunnel syndrome.

Seeking medical attention from your podiatric physician is the

first line of defense in treating heel pain. However, there are

several steps you can take to avoid heel pain in the first place:

-Wear shoes that fit well and have shock-absorbent soles,

rigid shanks (the part of the shoe that supports the foot

and helps give a shoe its structure), and a supportive

heel counter (the rear-most part of the shoe, at the

back of the heel above the sole).

-Wear the proper shoes for each activity.

-Do not wear shoes with excessive wear on heels or soles.

-Begin exercises slowly. Consult with your podiatric physician before beginning a new exercise program.

-Wear athletic shoes with good shock support in the heels.


-Purchase shoes that fit.

-Avoid activities that may put constant strain on the foot.

-Avoid going barefoot on all surfaces.

-If obese, lose weight.

A variety of treatment solutions are available to provide

short and long-term pain relief. Begin treating heel pain

by avoiding all sorts of pressure or tension on the inflamed

area, giving your feet ample rest. Applying ice and

heat packs in alternating fashion will greatly accelerate the

process of healing. Another option is the use of custom

insoles created by your podiatric physician. Custom

insoles may assist with treating active conditions of heel

Heel Pain pain and likewise reduce the risk for reoccurrence. The custom insole will

restore body balance and prevent the plantar fascia from experiencing

strain when you walk. If all non-invasive treatment solutions do not work,

surgery is probably the best next option.  Regular exercise for calf muscles and the plantar fascia is necessary to alleviate

pain and improve flexibility of the affected muscle. These exercises

are advised for both legs even if the pain is in one heel only. Some of the

most beneficial exercises are: 

✿Towel stretches

– This exercise should be done every morning before

you leave your bed. Make a loop with a towel and use it to pull your

 toes toward your body, while keeping the knee straight. Stretch each

foot three times, and hold each stretch for 30 seconds, if possible.

✿Stair stretches

– Stand tall on a staircase with the balls of both feet on

the edge of the step. Place hands on the railing or the wall for balance

and support. Slowly lower heels toward the floor until you feel a stretch

in your lower leg and heels. Maintain the stretch for 10 to 15 seconds.

Repeat this exercise six times, and perform the stretches twice every day.

✿Wall-leaning Stretch

– Stand an arm’s length away from a wall,

place both hands on the wall at shoulder height, with the feet

slightly apart and one foot in front of the other. Your front knee

should be bent, but the back knee should be straight while you lean

toward the wall. Hold the position for 10 seconds at a time for up to

15 or 20 repetitions per leg.

If you are unsure of the cause of your symptoms, if pain is severe, or if you

have the following symptoms, call a podiatric physician immediately:

-Inability to bend your foot downward.

 –Inability to rise on your toes.

 –Inability to walk comfortably on the affected side.

 –Swelling or discoloration of the back of the foot.

 –Heel pain that occurs at night or while resting.

 –Heel pain that persists beyond a few days.

 Heel pain does not always subside quickly after medical attention is

received. Unfortunately, it may take several months before the pain is actually

gone. In most cases, heel pain can be treated at home under a podiatric

physician’s supervision. 


Fungus Got Your Toes? Zap It!

Do you have thick, yellowish, brittle, and easily cracked or broken toenails without having

injured them? They are likely discolored due to a fungal infection called onychomycosis,

which is the most common disease of the nails.

The nail weakens as fungi continue to grow through the nail tissue. Since fungus grows

faster than the nail, damage increases and the nail becomes more and more unsightly,

with the infection spreading to the root or base of the nail.

Yeast and molds are also suspected to cause toenail fungus. These types of fungi exist

in warm and moist environments, like shower areas, locker rooms, swimming pools,

and even your shoes (as toes are usually encased in shoes). People with circulatory

problems, weak immune systems, or diabetes are at greater risk of developing fungal

infections as well.

Nail fungus has been difficult to treat with success. The only options in the past have

been topical or oral medications, which provide limited benefit. In addition, oral medication

may cause liver damage. Now there is a safe, effective laser treatment for nail fungus.

The laser destroys the fungus that causes onychomycosis with very little effect on the

surrounding tissues. Treatment normally takes fewer than 20 minutes and there

is no pain, although sometimes you may experience a warm or tingling

sensation. There are no age or health restrictions for laser treatments.

Laser toenail treatment is considered aesthetic (cosmetic). Therefore,

most health insurance plans do not cover treatment, and it can be costly.

Consult with your podiatric physician to determine if this course of

treatment is right for you.

Doctors of podiatric medicine are podiatric physicians and surgeons, also known as podiatrists, qualified by their education,

training, and experience to diagnose and treat conditions affecting the foot, ankle, and related structures of the leg


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