Heel Pain: Plantar Fasciitis 

Heel pain is a common problem in adults and, occasionally, children. The pain can be difficult to relieve because we walk on our heels all the time.

In adults, the insertion of the tendon on the bottom of the foot (plantar fascia) into the heel becomes inflamed. If the problem persists for long periods, a spur can form. An examination by a physician usually finds point tenderness on the bottom of the heel. The patient usually has normal function of the foot and ankle and very little swelling is noted. Sometimes there is a limp with walking. If X-rays are done, they often (not always) show a heel spur.

In children, heel pain is usually caused by irritation of the growth plate by the Achilles tendon. The pain is worse with activity and is relieved by rest. Examination often reveals pain at the base of the heel. X-rays in a child may show an irritation of the growth plate on the back of the heel.

Less than 1% of adult patients come to need surgical release of the plantar fascia. Children sometimes need casting to allow the growth plate irritation to calm down.

The one thing that seems to relieve heel pain is a shoe lift. A quarter to half inch rubberized heel cup usually does the trick. This combined with anti-inflammatory medication, stretching exercises, and modification of activities often relieves symptoms.

Here are some easy stretching exercises you can do:

 
Stand on your toes on the edge of a step. Slowly shift your weight on to the heel while keeping the knee straight. You will feel a stretch in your calf and your foot.  Slowly rise up and, on the next stretch, bend your knee as you slowly lower your heel.  Do not bounce when you are stretching!  Work up to three sets of 15 repetitions.

From the position above, slowly lean forward while keeping the heel of your rear foot on the ground. Keep your knee straight and your toes facing forward. Then gently bend your rear knee while keeping your heel from rising off the floor. Do not bounce as you stretch. Hold each stretch for 15 -30 seconds. Work up to 10 -15 repetitions.