If your heel is hurting, here’s a bit of good news: In most cases, taking the right steps at home to calm swelling and reduce the burden on your feet can relieve your pain, says AdventHealth podiatrist Gerald Bornstein, DPM.
When that pain is in the sole of your foot, a condition called “plantar fasciitis” is usually to blame, Dr. Bornstein says. This is caused by injury and swelling to the plantar fascia, a thick band of collagen tissue that runs from the bottom of your heel to the base of your toes.
The plantar fascia is made up of thousands of individual collagen fibers. Much like the thin but numerous bristles of a broom. They’re not strong individually, but when thousands are bundled together they support the arches of your feet.
When these bristle-like fibers tear or degenerate, the plantar fascia will become painful and oftentimes start to swell as part of the healing process.
There are two main ways to relieve your foot and heel pain, Dr. Bornstein says. First, reduce the inflammation, then allow them to heal by taking some of the load off, perhaps with supportive shoes.
“But there’s no need to throw away your high heels or other stylish shoes,” he says. “Wearing them during special occasions is fine as long as you wear more supportive shoes on days you spend on your feet.”
Plantar fasciitis is not the only cause of foot pain — Achilles tendinitis is also common — but most of these painful conditions have a similar cause: overuse. Preventing foot and heel pain is often about taking it slow.
Too Far, Too Fast
Often, Dr. Bornstein says, the stories patients tell him start a similar way. Someone gets a Fitbit or similar step-counting gadget as a gift. Or maybe they’ve committed to a running plan.
Both goals are praiseworthy. Setting targets and tracking progress can motivate people to begin and continue exercise routines, as AdventHealth cardiologist Rodrigo do Lago, MD, explains in a recent blog post.
Moreover, far from wearing out our knees, ankles and other joints, running can actually protect them. Weight-bearing exercise like running builds bones and keeps joints lubricated, protecting them from arthritis and other damage.
But it’s important to start at a pace you’re comfortable with and build slowly. For someone who doesn’t walk much to begin with, starting an exercise plan by walking several thousand steps a day is a recipe for pain, Dr. Bornstein says.
“People may get excited and go too far, too quickly,” he says. Instead, the load on plantar fascia, those bundles of thin fibers in the foot, should be slowly increased, giving them time to toughen up.
Dr. Bornstein says there are plenty of apps, either free or inexpensive, that guide walkers and runners through the step-by-step process of gradually getting more active. For those starting from scratch, “Couch to 5K” is a popular option.
But what if you’re in pain now? The first step is to treat your swelling.
Getting the Swelling Down
There are plenty of ways to treat inflammation, including:
- A cold pack or ice
- Anti-inflammatory ointments and creams applied to the foot
- Over-the-counter medication like Naproxen and Ibuprofen
- Steroid pills or injections
One way to combine two of these methods is to freeze water in a bottle and roll it up and down the arches of your feet, Dr. Bornstein says. It’s important when massaging or stretching to avoid being too vigorous — if your feet are hurting from overuse, pulling too hard on the plantar fascia can increase your pain.
Dr. Bornstein says injections oftentimes aren’t needed because inflammation can be successfully managed with other methods.
But relieving inflammation only works if you’re also cutting out the overuse that caused swelling in the first place.
‘Unloading:’ A How-To
When pressure is applied to your foot as you walk, a doctor may refer to it as carrying a “load” — the rest of your body, in other words. Unloading means relieving some of that burden.
To see how it works, consider how your foot flattens as you walk on a hard surface. As this happens, the plantar fascia is being placed under tension. This is normal but when you overdo it injury occurs. The fascia is not designed to stretch.
Unfortunately, many of our habits at home put the plantar fascia at risk.
“In Florida, an issue is that people come home and take their shoes and socks off, typically walking on tile or laminate floor,” Dr. Bornstein says.
Ideally, people would wear supportive shoes — that prevent the foot from flattening as they walk, keeping the plantar fascia from being pulled — at home. But that’s not realistic, so he suggests wearing something light, even a sandal with arch support, so when you stand your arches don’t flatten out as much.
A similar principle applies to fashionable footwear like high heels.
“You can wear high heels that may not offer support on a special occasion for a few hours, but you don’t want to wear them when you’ll be walking around a theme park,” Dr. Bornstein says.
An Aching Heel
What if your pain is coming from the back of your heel instead of the soles of your feet? Achilles tendinitis, swelling in the tissue connecting your calf muscle with your heel bone, is also usually caused by overuse, Dr. Bornstein says.
“Many of the treatments that apply to plantar fasciitis also apply to Achilles tendinitis,” he says. One difference is that stretching can be more effective for Achilles tendinitis relief.
This is because the Achilles tendon is attached to two calf muscles. Lengthening them through stretching puts less tension on the Achilles tendon.
As with all muscles, stretching can be difficult at first but easier with practice.
AdventHealth’s foot and ankle care experts believe in the body- and mind-building benefits of staying active. If foot or ankle pain is slowing you down, we’ll get to the root of the problem and help you take these challenges in stride.