Column: The bottom of my heel hurts, what now?

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Commentary by Dr. Joseph Hui

I recently had some folks ask what can be done about their chronic foot pain. The pain is typically described as sharp at the base of the heel on the bottom of the foot. It’s typically the worst when getting out of bed in the morning and causes the first step you take to be very painful. Sometimes, it even feels like there is a pebble on the bottom of the heel. There is usually no injury and no pain while off of the foot.

This problem is typically known as plantar fasciitis and must not be confused with heel pain in the back of the foot. Plantar fasciitis is one of the most common foot ailments in the United States and is responsible for about 1 million visits to the doctor each. The peak incidence occurs between ages 40 and 60 in the general population, with a younger peak in runners. It may affect both feet in up to one-third of cases.

This foot issue has a good prognosis, and even if ignored will usually go away on its own within one year. However, most folks want to resolve it sooner, so the following is a step-by-step description of how to help this go away.

In full disclosure, I have no financial interest in the products I mention. 

Step 1: Soften the lower leg muscles by rolling your calf muscles and the bottom of your arch for 10 minutes. A tennis ball or racquet ball can help with the arch. A good foam roller to use is Rolflex, which can be found on Amazon for about $70.

Step 2: Soft tissue scraping. Using a smooth, blunt, ergonomic object, scrape the length of the arch, moving from the toes to the heel with emphasis near the heel where it hurts the most. Scrape toward your heart for 10 to 15 minutes. These tools can also be found on Amazon by searching “Graston tool.” You have to scrape with some effort for it to be effective, so it may feel uncomfortable.

Step 3: Make sure to buy shoes with arch support. For those shoes you love that do not have good arch support, buy some good orthotics, such as Superfeet that can be found at Dick’s Sporting Goods.

After six to eight weeks, if the regimen fails, consider injections into the area for additional relief. There are a variety of things that can be injected, not just steroids. There are some minimally invasive procedures that can help with this as well.

For any sports medicine questions you’d like to see covered in the next article, be sure to email AskHui@riverview.org.

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