Athletic Training

Remedies for chronic plantar fasciaitis

04/12/1999 02:42PM

Question:

My wife has chronic heel pain. It has been diagnosed as plantar fasciaitis. She is a health educator an teaches aerobics. In the last two-three months she quit teaching her aerobics classes and has only swam or rode a stationary bike for excercise. She limits her walking, uses ice packs and various salves on her foot and has otherwise restricted any weight-bearing activities. Yet, her heel pain remains. She has kept a diary to try and identify why some days the pain is greater then others, but, as yet, her diary, and consultation with a podiatrist and physician have not produced any lasting sucrease from the pain. She has also tried some accupressure and acupuncture, with no significant or lasting benefits. Any suggstions?

Answer:

Plantar fascitis can be a real "Pain in the Heel". Plantar means bottom of the foot. The fascia is a strong band of fiber that supports the base of the foot. Fascitis means inflammation of the fascia and symptoms include pain, swelling, and warmth in the area. I suggest that you seek a medical team of clinicians that can evaluate the condition, your wife`s biomechanics, her shoes, and her stretcing routines. The problem could just be plantar fascitis, but should be checked for other possible painful mechanisms. It is important to stretch the plantar surface of the foot and the lower leg. Plantar fascitis often gives patients pain especially in the morning. Stretching while still in bed may help relieve this early pain. Take a towel, wrap it under the foot and gently stretch the foot up toward the shin. Stretching should never be hurtful, so stretch till you feel a gentle stretch. Also it is important to stretch the lower leg. Stretch the calf with the knee bent and with the knee straight. Stretching should be held 10-15 seconds and repeat each stretch 3-5 times to begin your routine. You can also stretch the plantar surface by facing close to a wall, place your toes on the wall and your heel on the floor. Gently press down till you feel a gentle stretch. The stretching can not be too agressive because it will make the area more tender. When you finish your stretching it is important to ice the area. I suggest doing an ice massage. This involves taking a small paper cup, filling 3/4 with water, freeze, then when needed take the cup and peel some of the paper away from the cup. Gently rub the top of the cup to smooth the ice. Then take the cup and gently massage the ice over the tender area. This is not a comfortable treatment but it can be helpful. I suggest starting the ice massage for 3-4 minutes and try to work your time to 8-10 minutes. This will help relieve the discomfort and hopefully keep it from accummulating. Also have your wife try to wear shoes that are comfortable and supportive. I still feel you need to seed a medical team that can look at your wife`s heel, biomechanics, shoes, and stretching routine. There are new treatments out there that physicians and clinicians can use to assist you with this problem.

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Response by:

Linda Weber Daniel, MS, ATC, PT
Athletic Trainer
Athletic Department
The Buckeyes Online
The Ohio State University