heel pain

Plantar Faciitis is not a soft tissue tear, it's an inflammation in the foot. Generally pain is felt in the arch but also in the heel sometimes. See a specialist to make sure you don't have a spur. Swimmers put a lot of strain on their feet pushing off walls and dorsiflexing (toe pointing). See a sports medicine specialist who is experienced with gymnasts/soccer players/ballet dancers. Ideally you'd want to speak with an orthopaedic surgeon for the best information. A removable cast will work wonders if you follow the treatment plan. It will require you to sleep in a brace for at least 6 weeks. You can also choose to swim in a small brace if you desire.

Since I think I know better than some of what was said I feel obligated to put some things right. I am not a doctor, nor have I taken any classes on this subject, but, plantar fasciitis is the result of "micro tears" in the plantar fascia. Typical of injuries, and also of normal wear and tear, inflammation plays a key role. Inflammation is supposed to do the healing but all too often inflammation gets out of control and becomes the "injury". In this respect, I am unsure of the exact role of inflammation in plantar fasciitis but it is definitely associated with the problem. If this problem were only inflammation, then I think it would be called arthritis. Anyway, the plantar fascia is the stretchable connective tissue between your heel (the "calcaneus" bone in your hindfoot) and your metatarsal region (the bones in your forefoot close to the ball). The plantar fascia is VERY narrow (the big problem) where it connects to the heel and wide where it connects to the forefoot. I believe the large majority of heel spurs (calcium buildups) ARE related to plantar fasciitis which often happens when the plantar fascia is torn at its narrow point, where it attaches to the heel. I believe, far and away, most plantar fasciitis results in heel pain. Note that the existing heel spurs are normally NOT the source of the heel pain, the plantar fascia is. Note also that there may be, or may not be, an area of tenderness to be found by poking the bottom of your feet with you fingers. Arch pain is a far less common occurrence than heel pain in plantar fasciitis and many times the heel pain can be partially relieved by applying pressure to the arch. Plantar fasciitis has many causes and overuse is a big one. Just being on your feet a lot is frequently all it takes, possibly because you are stressing your sole with insufficient recovery time. However, very many normally sedentary people, in addition to overweight people, are vulnerable and get it quite easily. Wearing improper shoes is another popular way to help bring it on. Obviously, you need to back off the stressful activities if you get plantar fasciitis. You also need to wear footwear ALL THE TIME, even on carpet - and even RIGHT UP TO THE DAMN POOL. You need to wear shoes that are comfortable and the more support the better. "Super Feet" (a popular brand of fairly rigid arch/heel supports) can be particularly useful for those people, unlike me, who have one and sometimes both feet that happen to curve the same way the Super Feet do. Devices like the Strassburg Sock can be worn at night to hold the foot in a level position (not plantar flexed as we usually sleep) so that the plantar fascia does not heal in its "shortened" state. For as much trouble as these devices may be, they are highly recommended. I must correct the use of dorsiflexed (and plantar flexed). Dorsa or dorsum (like on a fish) means "back." Plantar means bottom or sole (but not the fish). When your foot is plantar flexed (bent down - "toe pointing" was used), the plantar fascia is in it shortened state. When the foot is dorsiflexed (turned up towards your head), the plantar fascia is in its elongated or stretched state. Many people with plantar fasciitis feel extra pain in the morning when they first stand because their feet had been plantar flexed all night. I "stretched" the truth in my first post because I was trying to be brief (seriously) when I said the breaststroke kick involved stretching and snapping. The foot "snapping" (somewhat of an exaggeration too) of the kick is in going from a dorsiflexed position (the long or stretched) to the plantar flexed position (shortened plantar fascia). Nevertheless, the plantar fascia gets a good jar, many times. I am better than 90% sure that the breaststroke kick played the most significant role in my self-diagnosed plantar fasciitis and I am 99% sure that the breaststroke kick is the NUMBER ONE aggravator of my now sore plantar fascia. Fortunately, for my swimming turns, I always push softly off the walls. When I am getting ready for masters racing, I will learn to turn. In the meantime, I am doing what is most appropriate for the pools I swim in, and for my health and vision; and quintessentially, I get far more stroke counts in than all you fudgers. Who is the one getting cheated! (Also, the only previous foot problem I've ever had (and long had) was a badly hurting "instep" (top forefoot) so pushing off hard feels risky. This year I figured out the amazingly simple and effective cure to this problem: skip the middle shoelace eyelet on all my running shoes.) Anyway, I'm sure glad I haven't used fins either; I'll bet they can play nasty on a vulnerable fascia. Tim says that swimming, especially the breaststroke, helps his heel spurs on both feet. Maybe it's the spark in hormones you're getting from swimming Tim (which would have to be just as valuable as the weather)! Also, I've scraped the side of the pool a few times and lost a little calcium. Ok, enough being a smart aleck, there may be truth to it. Most things can be good to a point. Walking is good for your feet, maybe even walking a whole lot. Cycling is good for your knees, maybe even cycling a whole lot. Breaststroke can be good for your knees, and your feet, maybe even breaststroking a lot. Some of us are more vulnerable (and less able to recover) in some areas than others and other people. However different we are, we all toy with our limits (and typically they don't improve with age). Anyway Tim, I'll bet your heel spurs are not related to plantar fasciitis, despite that heels spurs usually are.

PeirsolFan: For one posting bad information, you sure are touchy. The statement "plantar fasciitis [] is indeed caused by small tears in the plantar fascia" is correct so you were wrong. Your use of dorsiflex was wrong. Running shoes are indeed frequently recommended for regular use by people with foot problems. Good fitting sturdy running shoes provide a very good platform for the feet and make good walking shoes. What does "mesh" have to do with it? Good running shoes are typically no more or less flexible than most other shoes so I don't know what you are talking about. You want your shoes to flex in the right place and little flex can be bad. No barefooting! Absolutely correct. Bad foot things about swimming for everybody: barefooting, and barefooting on concrete. Some potentially bad foot things about swimming for some people: breaststroke kick, use of fins, pushing extra hard off walls.

Originally posted by sftom Hi Tim: I believe that Piersolfan is mistaken. My podiatrist told me when he diagnosed my plantar fasciitis that it is indeed caused by small tears in the plantar fascia, which is a tendon-like tissue supporting the arch of the foot. My doctor prescribed over-the-counter analgesics to reduce inflammation, that I eliminate unnecessary walking for the time being, that I wear running shoes at all times, that I ice the bottom of my foot for 10 minutes... http://tinypic.com/dmtr9l.jpg My information came not from a podiatrist, but from a top surgeon who treats the feet and ankles of the famous prima ballerina above. Nothing is more brutal on feet than dancing en pointe. The surgeon also used to dance and after following all of her advice I am still pushing off walls and pain free. Running shoes are for running. They flex and bend to allow your foot freedom of motion. Sturdy shoes with non-mesh support and not so flexable soles are best when not running. Also, walking around barefoot is a bad idea. I think when people ask for advice you should provide what you know and not attack the information provided by others. Let people pick and choose. Not all things work for all people. I understand that some doctors use night-braces which keep your foot and tendons stretched out (at a 90 deg. angle) while you sleep. A colleague of mine had one of those, and it damaged the nerves in his foot, so that his pain is now worse than before. It simply keeps your foot in the exact same position as if you were standing and walking. The cast I mentioned, is different than a splint not only in cost but in effectiveness.

"PeirsolFan: For one posting bad information, you sure are touchy" Actually, no. I don't level attacks. It's sad that in your struggle to be "right" you felt the need for that. There's a lot of information on the internet and a good portion is faulty. If there were significant tears in tissue then an MRI would be ordered and immobilization would be necessary. I don't consider my information bad when my PF was so bad at one point they gave me crutches, and now I'm barefoot and pain free. (famous last words.) The sports medicine specialist didn't know anything about shoes. I quit physical therapy after 2 months because the person was actually making the pain worse (she was a tri-athlete). Her advice was flexible bendy shoes. Sounds right, but it didn't help. When the surgeon gave the exact opposite advice (shoes that don't flex easily where the ball of your feet are, and a cast) I went with that. It doesn't make sense when you think about it. (shrug) One last thing. Splint estimates given to me were around $300. The removeable night cast? $50.

Thanks for the immature response. I still maintain that Plantar Fasciitis is an inflammation of the foot. Please cite your sources - actual surgeons and physicians and the AMA or NEJM count. Internet sites don't. Post your heart out in response. Regretfully, I wont have the time to follow-up, but I'm sure others will be interested.

" I wont have the time to follow-up" Follow-up or make more embarrassing posts? Either way, it's a good thing. No one said, implied, or hinted that plantar fasciitis was not inflammation. Proof enough. For all except for you. It would take a chisel.

PeirsolFan: "It's sad that in your struggle to be "right" you felt the need for that. There's a lot of information on the internet and a good portion is faulty." You must mean yours! It's good to see you have a sense of humor and that you can brush off mistakes well! People were rather polite to you after your first inaccurate post. Then you decided to pick on (rather attack) someone for absolutely no reason. I hadn't wanted to pick on you but obviously you need a good spanking. Yes, the "itis" suffix indicates inflammation. I grant you your doctor might have told you your problem was inflammation but after that you got flat out careless. PF is micro-tears resulting in inflammation. I'll bet you can't see most tears on an MRI, only inflammation. This does not mean there are no (micro) tears, it probably means the contrary. Generally, "the" pain is NOT in the arch but I suppose you took that on good faith from your doctor. But then again, this is the internet. Running shoes or similar is definitely one of the better choices for PF. Why don't we admit that we have, or should have, a need to get things right. In this thread, I haven't had one bit of struggle even in cleaning up your mess. If you can actually point out where I might be wrong, I will take it like a man, which I am. Either way, no harm, no foul. Anyway, and sincerely, it is good to hear all about your success over PF and I hope you (and me too) can keep it from happening again.