When experiencing mild or severe pain at the heel area, rest is the most important thing. A patient should avoid standing for a prolonged period or walking long distances. One should also avoid any task demanding for the heel such as jogging, running or other sports activity. This will certainly decrease the amount of inflammation and the pain.
Heel pain exercises
Regular exercise for calf muscles and plantar fascia is necessary to alleviate the pain and improve the flexibility of the affected muscle. However, these exercises are advised for both the legs even if the pain is in one heel only. Some of the highly beneficial exercises are given below:
Towel stretches: This exercise should be done every morning before you leave your bed. Take a towel and make a loop of it and pull your toes towards the body with it with the knees straight. Perform it three times on each foot everyday.
Stair stretches: Stand on your staircase with the heels off the edge of the step. Hold the banister for support and lower your heels gradually till you feel your calves tightening up. Maintain the lowest position for about 30-40 seconds and then take a normal standing. Repeat this workout six times twice every day.
Chair stretches: Sit on a chair with your knees slightly pushed off the sides pointing your feet in the opposite directions. Now slowly lift the toe of the affected leg without taking the heel off the ground. When you feel a tightening in your Achilles tendon and calf muscle, maintain the position for some 20 seconds and then relax your toe. About 10 reps a day are good.
To reduce the tension in plantar fascia, athletic tape is applied on the sole. This tape, when applied properly, stops the plantar fascia from stretching thus giving this tissue the necessary rest for healing. However, the tape should be removed in the evening to help the skin breathe.
Ice and heat
Though applying ice to the sore area of the heel will mitigate pain almost instantaneously, application of ice packs and heat packs in alternating fashion will greatly accelerate the process of healing, which is a long term effect. Doctors advise applying ice and heat in the morning and evening respectively. This works best because of its direct effect on tissue, tendons and muscles.
When we sleep at night, the plantar fascia is in a shortened and relaxed position. The first few steps in the morning are very painful because this tissue suddenly needs stretching. However, if we use night splints, it maintains the tension in the plantar fascia thereby reducing the stress on the tissue when we are walking or running
This is the most effective way to treat heel pains with long-term result. When you use Orthotic insoles, you are directly treating the cause of the symptoms and not just alleviating the pain or reducing the inflammation. It corrects the body biomechanics and body postures by supporting the metatarsal arches and controlling over-pronation. These insoles developed by podiatrists are designed to restore body balance and prevent the plantar fascia from experiencing strain on walking. Beside support, the wearer also gets a cushioning for walking comfort.
If all the non-invasive treatments mentioned above don’t work, then surgery is probably the next best option. However, surgical treatments are given mostly to sportspersons and athletes for whom heel pain can be detrimental to career.
Plantar release surgery: In this commonest form of surgery, the Plantar Fascia is released by cutting it in at the heel bone. It completely eliminates the cause of inflammation. Both open and endoscopic (minimal incision) surgeries are available for releasing the tissue. However, the recovery time is significantly lesser for endoscopic surgery and the operation requires a specialized surgical team and equipments.
But plantar release surgery can be a risky form of heel pain treatment as it can potentially trigger severe side effects like nerve damage, loss of some foot movements, aggravation of heel pain, infection and numbness.
Extracorporeal shockwave therapy (EST): EST is a relatively new treatment and yet to be used in massive scale. In this therapy, therapeutic high-energy sound shock waves are given to your heel to promote healing.