Ask the Expert Archive Week 22
Heel Pain
You wake up in the morning, put your feet on the floor and almost double over in pain. Heel pain first thing in the morning is a common sign of planter faciitis. Podiatrist Glen Copeland explains what it is, and how to treat it.
One of the most common problems that we see in the world of orthopedics today is that of heel pain. Classically it has been called plantar fasciitis, heel spur syndrome, or fat pad impingement if you will, of the heel. This is the planter fascia on the bottom of the foot, as you can see its a rubber band that attaches on to the heel bone, and in the actual mechanism of walking the planter fascia does tear away from the heel bone if its too tight or too rigid. If in fact you lose the elasticity .
The important thing to remember is that when this happens, the band pulling away from the bone, actually tears the lining of the bone away and over a period of time, the lining is filled in with bone so you actually get on an x-ray what appears to be a heel spur. The important thing to know about this however, is that its not the spur that hurts, its the actual lining of the bone that's being pulled away by the planter fascia.
This happens as a result in most cases of the foot flatting out when the foot hits the ground you get a flatting appearance. Overstretching of the planter fascia if you will. The important thing for the patient who suffers from this is to start with a good athletic shoe, to support the arch of the foot, support the plantar fascia. In severe cases where there is a biomechanical abnormality what you want to do is look at using some kind of corrective custom made orthodic, an insert that goes in the shoe to prevent the abnormal pull of the planter fascia. If you would like to send a question to Ask the Expert you can either email us at rx@tvo.org or fill out our form.
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