|Anatomical diagrams illustrating the components of the plantar fascia. (Photo credit: Wikipedia)|
Listed below are some common misconceptions and treatments frequently used for heel pain.
You have a heel spur: In most cases the heel spur is irrelevant. Many people who have huge heel spurs have never experienced pain.
Heel spurs are caused by plantar fasciitis: There is no definite cause, however it may be a result of chronic long-term inflammation in the area.
The heel spur is the body trying to elongate the heel bone so the fascia is not pulled so much. This was proven wrong many years ago; however, you can still read it on the internet. The fascia actually goes around the spur and attaches toward the bottom back of the heel, not at the spur.
I was given an injection and the doctor told me it would dissolve the heel spur. Although you may not experience any more pain, it is a result of reduced inflammation; the heel spur is still there.
A heel pad will help. This may or may not help. Often, in many of the cases I’ve seen, the fasciitis is the result of imbalances in the front of the feet in which a heel pad will not help. Also, what type of pad do you get? There are many types of heel pads. Different imbalances require different treatment pads, etc.
You need to stretch the plantar fascia, it contracts at night: If overstretchingtension of the fascia is the problem, additional stretching won’t relieve the pain. This fibrous band actually does not stretch; at least I am not aware of any proof of such. Surgically, when you feel it, it is like a thick leather belt. However sometimes it may feel better to do so because when you stretch, you may actually be compressing the inflammatory fluid away from the area, which reduces pain. You may also be stretching the Achilles tendon, which can be a factor in causing the fasciitis. Pain in the morning is not from a sudden stretch on a contracted fascia, it is sudden compression on an inflamed area.
Wear a night splint: If you can tolerate sleeping in it, it may help IF your Achilles tendon is tight. Again, it doesn’t stretch the fascia; it stretches the Achilles tendon AND compresses the fascia against the heel bone so not as much inflammatory fluid builds up and thus less pain (mytheory). I believe stretching in the morning helps stretch the Achilles tendon and reduces and moves the inflammatory fluid buildup away from the sore fascia.
Get a good shoe or insert: What type? There are many different types for many different reasons and types of feet. What may have been “Good” for one person may not be for another.
I tried orthotics, they didn’t help. Orthotics are not alike. Even when made with the same materials, two different people who cast or fabricate them use different techniques and positions.
It will take forever to heal, but it will go away. Although there are some cases that just don’t seem to heal, it is rare for any type of surgical procedure or shock wave therapy to be needed. Usually, if it is not healing, the imbalances in the lower extremity where not adequately addressed. You should not have to suffer for 5, 2, or even 1 year as I hear frequently on first visits. Many cases can be resolved sometimes immediately with controlled taping followed by physical therapy and functional custom molded RX orthotics and the ideal shoe to match.
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