Plantar Fasciitis: Ouch! Pain at it's Worst First Thing in the Morning. - Member Case Study

author : AMSSM
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Question from NYtrigal

 

I have bone spurs in my left heel. It's painful first thing in the morning. Sometimes my heel will bother me running, or on the bike. My podiatrist made me new orthotics for my bike shoes, and added some cushioning to my running orthotics. I feel as if the heel is holding me back. My running times have slowed down since the problem first cropped up last summer.

Do I risk further damage by continuing to train on it? I ice it sometimes. I occasionally use advil, but try to stay away from drugs. I do use a glucosime/chondroiten/msn combination for my knees. I'm not sure that really does much for bone spurs.

Answer:

 

The heel spur may or may not be contributing to your symptoms. Usually, only very large heel spurs cause problems. There are plenty of folks out there who have heel spurs seen on an x-ray that have no symptoms related to their heels whatsoever. It sounds as though you have a very common condition known as plantar fasciitis. This is irritation and inflammation of the thick, fibrous tissue of your arch as it inserts onto your heel bone. When you sleep at night, your toes curl up and your arch relaxes, and the inflammed area on your heel starts to heal. 6 hours later when you wake up and step out of bed, your arch stretches out as you plant on the floor and you tear all of the healed tissue. Ouch! Pain at it's worst first thing in the morning.

There are an number of treatments which may be effective for you. Ice is a great treatment when you have pain after running, but I would recommend ice massage. Take a 20 oz plastic bottle and fill it with water. Place it in the freezer and when needed, drop the frozen bottle on the floor and roll it under your heel and arch for massage and cooling. Stretching your achillies tendons (remember, with a straight knee and a bent knee) and plantar fascia are important as well. Some people find night splints for their ankles helpful, especially for the first thing in the morning pain. These can be custom made by your doctor or obtained by prescription. In persistent cases, corticosteroid injections or rarely surgery become necessary.

Orthotics can be helpful, but with a heel spur padding should be an essential component of the insert. Depending on the type of foot you have (flat foot, high-arched foot, over-pronator, etc) specific types of inserts may be helpful for you. It is best to be evaluated by someone with experience evaluating an individual's gait, and in some cases having your foot custom molded in order to make the orthotic for you. Remember, orthotics wear out like your shoes and need to be replaced every year or two (depending on your mileage), but they tend to last much longer than your sneakers.

 

Hope this helps!

Michael A. Yorio, MD

University of Maryland Sports Medicine
 

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date: May 16, 2005

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AMSSM

The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

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avatarAMSSM

The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

FIND A SPORTS MEDICINE DOCTOR

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