Feet First

Tuesday, July 29, 2003
By Balancetv.ca

What's the deal with heels? Are you walking tall or are your feet feeling flat? Podiatrist Dr. Sheldon Nadal talked about chronic heel pain with Balance Television host Dr. Marla Shapiro.

"It starts with first few steps in the morning, you're miserable as soon as you get out of bed, it can hurt all day and it can make life very unpleasant," Nadal said.

So why does some heel pain tend to be most acute first thing in the morning? According to Nadal, it's believed that the planta fascia -- the thick band of tissue that runs from the heel to the toes -- tightens up while you sleep. When you stand up and stretch it in the morning, the pain begins again before loosening up through use during the day. The condition is commonly known as plantar fasciitis.

"It can be due to improper balance, maybe you don't have enough support, maybe the shoes aren't right... it can be overuse," Nadal said of the possibles reasons for the pain.

Plantar fasciitis is a very common problem and it can be chronic, Nadal said. But most people can get rid of plantar fasciitis with anti-inflammatory medicine. "You should see your podiatrist if your heel is bothering you," he said. Sometimes a person may require an orthodic, which helps to support the foot and improve balance.

"A heel insert may help some people with mild problems and it's less expensive because it's off the shelf," Nadal said, "but an orthodic is made to measure and we make them using a plastic mold of the foot while holding the foot in the proper position."

Most orthodics last about two to three years but they should be checked annually to be certain they're in good shape and doing the job.

In the past, plantar fasciitis that didn't improve through conservative treatment your only alternative was surgery. But the newest treatment is non-surgical and you can walk immediately following the procedure. The treatment is called shockwave therapy and uses high-intensity soundwaves.

Dr. Nadal offers the following tips for preventing plantar fasciitis:

• make sure your shoes are in good shape
• if you're working out regularly be sure to change your shoes every six to nine months, don't let them get worn down
• stay in shape
• stretch before and after you work out
• take anti-inflammatory medicine -- such as aspirin -- at the first sign of inflammation