Monday, August 30, 2010


Just started a new exercise program, and now your feet hurt? Ouch! Could be plantar fasciitis, which often is triggered by a sudden increase in activity, or by new shoes. What are the symptoms? Classically, there is intense heel pain that is WORSE after rest. If you wake up to go to the bathroom and those first few steps hurt like crazy, then gradually ease up, chances are that this is your diagnosis.

Whatever you do, do NOT ignore this one! The worst thing you can do for this is to grin and bear it, and simply “work through” the pain. That approach can extend the natural course of this problem from weeks to many months. The problem is small tears and inflammation within the long ligament on the bottom of the foot. There may or may not be a heel spur on the bone, but the real problem is the inflammation in the ligament. The goals of treatment are to decrease that reaction.

Solutions? Ill –fitting shoes often cause or exacerbate this problem. Put aside your high heels and pointy toes, and temporarily switch to shoes with a strong, less flexible support. I recommend buying heel donuts or heel cups (which are nonprescription) first, and if you are upright out of bed, you are WEARING SHOES WITH THESE INSERTS. This is not a time for bare feet or flip-flops! Icing the heel after activity and anti-inflammatory medications may help as well, though in practice, I have not seen a great deal of improvement with those modalities alone.

Here are a couple exercises that might help:
1. In bare feet, sitting down, using your big toe (one leg at a time) write out the alphabet, first in lower case, and then in upper. Repeat with other foot, even if it is pain-free (for prevention!)
2. Set a towel in front of a chair, and use your toes to steadily scrunch the towel, pulling it towards you. Again, repeat with other foot.

It may take a few weeks to see results, and consistency is the key! Please see your family doc if you are not improving.
BOTTOM LINE: Got heel pain? Try these simple modifications and see your doctor SOONER rather than LATER!

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