Heel Pain Treatment Sioux City IA
Heel pain is commonly caused by plantar fasciitis, heel spurs, stress fractures, tendinitis, tendinopathy, arthritis, nerve entrapment, cyst, or fat pad syndrome. Your heel or calcaneus bone is a very strong and dense bone in the foot that supports your body weight. Every step you take places stress upon the bones, tendons, ligaments, and fascia in the foot and ankle. Chronic stress and strain to the foot and ankle produce several soft tissue injuries and joint conditions.
What is the Most Common Cause of Heel Pain
Plantar fasciitis is the most common cause of heel and foot pain on the bottom of the foot. The plantar fascia runs on the bottom of the foot from the calcaneus bone towards the toes. It help support the arch of the foot during foot strike while walking, or whenever the foot impacts the ground.
The fascia runs from the heel toward the toes, and the tissue has a tendency to heal poorly. Chronic irritation and damage leads to continuous remodeling and repair. Eventually scar tissue or fascial adhesions develop that produce a “temporary” patch and lead to a chronic source of foot pain with physical activity. This is the most commonly talked about condition on the news and in running articles when referring to pain on the bottom of the foot.
Common Causes of Heel Pain
The most common cause of heel pain or plantar fasciitis is excessive stress and strain with activity. This injury can occur with acute trauma, such as landing hard while jumping or stepping on a pointed rock while hiking. The sudden and sharp force causes micro tearing on the plantar fascia. Sudden physical or mechanical stretching of the fascia causes tissue tearing, especially where the fascia inserts on the calcaneus. The most common site of plantar fasciitis is at the insertion on to the calcaneus.
Usually plantar fasciitis pain develops with chronic standing or walking, especially in old or worn out shoes. Old shoes have broken down the natural support in shoes. The remaining soft rubber is no longer absorbing the pounding forces and protecting the foot while walking and standing. The plantar fascia ends up absorbing excessive force while standing, walking, running, skiing, or jumping, leading to micro tearing, inflammation, and scar tissue accumulation in the plantar fascia.
Plantar fasciitis is common in individuals who change their work routines and begin standing or walking more than in previous occupations. It is also common when people increase their body weight, which produces more force with every step. People who increase their exercise activities, especially running or hiking, are prone to developing plantar fasciitis. Runners tend to develop pain on the bottom of the foot after increasing their mileage or training for the next big event like half marathons and marathons. New runners commonly develop this injury as they are inefficient runners and tend to pound the pavement.
Symptoms of Heel Pain
Plantar fasciitis is characterized by dull and sharp pain on the bottom of the heel and foot, and can extend into the arch and toward the toes. It is usually the most intense and sharpest first thing in the morning or after prolonged sitting. In most cases, the pain slowly develops over weeks and months. Many people notice stiffness, tightness, and soreness in their calf and ankles with increased activity; they expect muscle fatigue with their exercise habits, which is why they prolong seeking treatment. They tend to ignore the increasing dull pain in the bottom of their foot thinking it will go away. Months later they realize the dull pain has progressed to sharp, stabbing pain that lasts longer in the morning and is much worse after long days of standing or walking.
Diagnosis and Examination of the Foot
Your healthcare provider or physician will examine your foot and ankle. The location of pain along the bottom of the foot and calcaneus helps distinguish plantar fasciitis from fat pad syndrome. The location of the damaged fascia is very different from the pain in the back of the leg and heel associated with Achilles tendonitis, posterior tibialis strains, foot tendinopathy, calcaneal joint conditions, degenerative joint disease, stress fractures, or tarsal tunnel syndrome. Foot pain in the arch muscles, ball of the foot, metatarsalgia, and foot joint arthritis are also distinctly different, even though those conditions produce similar pain symptoms.
An X-ray, MRI, or CT may be utilized to further evaluate the foot and ankle. Heel spurs are commonly associated with plantar fasciitis, as chronic stress and strain aggravate the plantar fascia and help produce heel spurs. Plantar fascia ruptures or fractures to heel spurs are not common. Patients with plantar heel spurs commonly blame their foot pain on the spur and do not seek appropriate plantar fascia-specific treatment, thus prolonging their chronic plantar fasciitis.
Your doctor may refer you to a podiatrist or foot and ankle surgeon. However most cases of plantar fasciitis and heel pain do not need surgery, nerve ablation, steroid injections, oral steroids, pain drugs, or orthopaedic devices. It can be treated at home and with conservative treatments with great success.
A foot and ankle specialist can provide custom orthotics, boots, heel straps, cortisone injections, or shockwave therapy in severe cases. Pain medication, over-the-counter anti-inflammatory medication, NSAIDs, ibuprofen, and analgesics are commonly recommended by your primary care or healthcare provider. Specific procedures are provided based on severity of the condition, history, home goals, athletic goals, professional occupation, and the functional impact on your quality of life.
Physical therapists or sports medicine therapies are complemented with weight loss and treatments that reduce pounding during running or walking. Often physical therapists or running coaches who specialize in running gait analysis can help increase foot strike and running gait efficiency with sport-specific exercises. Specialty running stores can recommend more appropriate footwear to reduce foot pounding and improve foot arch mechanics. Running stores often have information for running athletes to improve performance and pain while maintaining their training schedule. Specialty running stores often have recommendations to local doctors who specialize in treating foot pain and athletes.
Home Therapies and Treatments for the Heel
Icing is one of the best home treatments available for chronic plantar fasciitis and heel pain. Applying ice to the bottom of the foot and back of the heel for 15 minutes helps decrease pain and inflammation. Repeating ice therapy several times a day decreases the overall pain and inflammation. Recommendations are given to reduce stress and strain from daily activities, work, recreational, running, jumping, plyometrics, explosive activities, soccer, basketball, and CrossFit. Limiting these activities reduces overall stress and strain along the heel to rest and recover.
At home changes in shoes can make a tremendous difference. Most people tend to overwear work and everyday shoes, and continuing to wear worn out shoes contributes to the soft tissue damage. Some people are very good at replacing their exercise shoes but forget about their work shoes. Men may be the worst offenders at not replacing old dress shoes, while women tend to wear high heels or too narrow of shoes, which changes their walk and places excessive strain on the arch and plantar fascia.
There are several different types of braces, boots, night splints, heel lifts, and arch supports available to help reduce the trauma, stress, and strain to the foot and ankle. The Strassburg sock is an excellent treatment for helping to stretch the plantar fascia out at night and reduce the scar tissue accumulation and pain first thing in the morning. The sock can be uncomfortable to wear and disrupts your sleep, however it is a very valuable treatment in the early phases of care. The sock causes dorsiflexion of the foot, or lifts the big toe and foot up. This position stretches the plantar fascia, calf, and Achilles tendon and reduces scar tissue formation.
Conservative Treatments for Reducing Heal Pain and Scar Tissue
Specific exercises and stretches are given to strengthen the foot, ankle, and lower leg. These exercises build up the arch muscles, which helps protect the arch and reduce strain on the plantar fascia. Many people with plantar fasciitis have a tendency to over pronate their foot standing and walking, which increases the strain of the fascia on the calcaneus insertion. Proper footwear, arch supports, and foot strengthening exercises help relieve foot pain and reduce improper foot mechanics.
Stretching exercises are given to increase flexibility in the plantar aspect of the foot, calf, hamstring, and lower leg muscles. Tight and spasmed muscles in the lower leg alter your walk, which increases the pounding forces absorbed by the bottom of the foot. Increasing flexibility of these muscles helps the muscles absorb forces while walking, running, hiking, and sports, which improves overall outcomes of therapy.
Massage therapy, manual therapy, Graston Technique, and Active Release Technique (A.R.T.) are often applied to the same muscles to reduce fascial adhesions and scar tissue that have accumulated with repetitive microtrauma. Scar tissue is exceptionally common on the bottom of the foot, plantar fascia, calf, and across the heel. The specific techniques and treatments reduce scar tissue adhesions and allow the foot to function normally during walking and running. Improving muscles’ ability to absorb force also allows the plantar fascia to heal.
Graston Technique Treatments for Heel Pain
Graston Technique is especially effective for patients who have been suffering from heel pain for months or years. Scar tissue has developed into a source of chronic irritation in the plantar fascia that has undergone several cycles of inflammation and partial healing. Because the ligaments and fascia have not completely healed, the next time the tissues are overwhelmed the same scar tissue flares up and the pain returns. Patients experience heel pain relief with just a few Graston treatments. Active Release Technique often compliments Graston Technique on the arch muscles, tibialis anterior, fibularis longus, fibularis brevis, posterior tibialis, gastrocnemius, soleus muscles, and achilles tendon.
Plantar fasciitis and heel pain can be quickly improved with the right treatments. Combining conservative treatments with the proper home care icing, exercises, stretches, and shoe modifications makes a tremendous difference. Patients respond to chronic foot pain treatments better and faster when Graston Technique, massage therapy, and Active Release Technique are combined in the treatment therapy. Overall, patients can expect several weeks to a couple months of treatment in moderate cases of plantar fasciitis. Severe cases may take longer, especially if the patient continues to run and jump during treatment. Multiple factors contribute to developing heel pain, and each of these factors needs to be addressed for resolving chronic foot pain.