HELP FOR ACHING SOLES

  According to the American podiatric Medical Podiatric Medical Association, 40 percent of Americans suffer from heel pain.  Feet withstand the equivalent of 120 tons of pressure for every mile walked.  Plantar fasciitis is the most common cause of such pain, but a lesser-known and more easily treatable condition called heel pad atrophy might also take some blame.  Plantar fasciitis is caused by inflammation of the fascia, the tough tissue that wraps around your heel, extends forward to the base of the toes, and cushions every step.  The inflammation occurs when there is excessive stretching at the point where the fascia attaches to the heel bone.  A thick web of fat in the heel works like a shock absorber and extends forward to the base of the toes but can wear down over time, called heel pad atrophy.  “Both conditions make you feel like you’re walking on rocks and are not hard to diagnosis,” says Judy Baumhauer, M.D., M.P.H, president of the American Orthopaedic Foot and Ankle Society.

   The pain is most severe when you take a step after being off your feet, such as when you get out of bed or stand up after prolonged sitting.  The fascia stretches and the pain usually subsides.  Heel pad atrophy becomes more painful the more you place weight on your heel and it is better when the heel is cushioned.  Plantar fasciitis hurts more towards the inside of your foot, around the heel, while pad atrophy is very focused in the center of the heel, Baumhauer says.  People with atrophy often feel intense pain if they push on the foot’s center.  In addition to the fat pad under your heel, there is another beneath the ball of your feet.  It can also wear down and cause pain, but that mostly occurs in women who regularly wear high heels.  The heel fat pad simply wears down in time.  If you’ve had a cortisone shot or sustained trauma (such as a heel fracture), it can lead to bleeding into the structure, which can cause atrophy and make it lose resiliency. 

   Plantar fasciitis is more complex.  It can be caused by weight gain, worn out shoes, and barefoot walking.  Severe heel pain after vigorous athletics could indicate a rupture of the plantar fascia.  Baumhauer says it will usually go away in less than a year by avoiding the activities that irritate the area.  The tissue can stretch out and become supple over time and advises people to be cautious about surgery since it might cause more significant problems.    Cushioned arch supports can speed up healing and help avoid a recurrence of the condition.  Stretching exercises are important and we will give details about them in tomorrows Blog.