Finally heel pain explained!

[Offthegrid]

I'm afraid this post is really long, but I want to give you advice that's gotten me to the point where today I can run 3.1 miles without any heel pain before, during or after exercise -- or even in the mornings. I struggled with heel pain for a long time and had given up walking completely because I thought there was no hope.

Somewhere in 2005, I started getting bad heel pain. I had started walking for exercise, and saw a podiatrist who said there was nothing I could do but to stay off of it while it healed. Said the only alternative was surgery, which might not work anyway. He taped it and sent me on my way. (I'm quite overweight, BTW. My weight was about what it is now because I gained weight after that and into 2006.)

In August 2006, I started a beginner walking/running program. I got top of the line shoes from a running store -- the Brooks Ariel -- that is designed for heavy people who overpronate. I was only walking in this program. I had heel pain no matter how much stretching I tried, and I got shin splints so bad that I was walking somewhere around 2.0 mph. I bought $30 PowerSteps insoles. Did nothing to relieve the pain.

I asked the program director for the recommendation of another podiatrist, and saw him. He took a quick peek at my X-ray, and said that I have a mechanical problem that is causing my heel spurs (I have one at the back at the achilles AND one on the bottom of my heel).

He also said I don't overpronate much and was wearing too much shoe. He gave me over the counter $20 orthotics. I also started physical therapy because my calves are tight. (Couch potatoes measure at 10, and I measured at a -1.)

I went back to the running store, demanded to have the owner fit me and got completely different shoes.

Within minutes of wearing the $20 orthotics, I felt the pain greatly reduced and within a week my shin splints and heel pain were COMPLETELY GONE.

The physical therapy was tough. Ideally, you need to stretch 3-4 times a day. I use this handy device. I *really* *really* *really* like it because it gets me a deeper stretch without the pain of pulling on my foot with a strap or towel. I was in physical therapy, twice a week, for a month. The physical therapist also had me ice the plantar fasciia after each session, and I did this at home, too.

I have a foot rest at my desk at work, and I can use that to stretch also.

I was also given an anti-inflammatory, but I wasn't good about regularly taking it.

I tried using the night sock, but could never get through the night with it on. In my opinion, this did little to help me heal.

I now have custom orthotics, which were covered by my insurance, but the other ones would have worked fine, too. I will warn you, though. It took me a good 2 months of daily wear to get to the point where I like the orthotics. Now I don't even notice them but can tell right away if I try to go without.

I also have custom orthotics that fit in my cycling shoes, but I did have to pay the full cost of those because they were not covered by my insurance. PowerSteps makes insoles designed for cycling shoes. And if you're using a clipless pedal like SpeedPlays, that may not be a wide enough platform to keep your foot stable. A co-worker tore her plantar fasciia, and she said having a bike fitting by a physical therapist (run through a medical center here) really helped her after she was out of the cast.

I am completely pain free, but if I neglect my stretching I do feel it, so once you feel better, you will need to continue stretch regularly.

So, to sum up a reeeeeaaaaaaalllllyyy long post:

1. Get a second opinion before having surgery.

2. Get custom orthotics! This has helped me more than I ever thought possible, even though I didn't like going from the $20 pair to the custom pair at first.

3. Have the owner or manager of a running store look at you and fit you with shoes. If you can at work, wear comfortable shoes. I wear Merrels with my orthotics, and then have dressier shoes if I have to go to a meeting.

4. Stretch, stretch, stretch. Every time you go to the bathroom, stretch. Stretch before getting up after you sit for a while. Stretch the calves ALWAYS after you warmup and ALWAYS when you're cooling down. Don't skip stretching even though it's boring.

5. Ice.

6. Try taping.

7. Don't push it. Rest and then take things gradually.

[Jenn]

I cannot thank all enough for the GREAT advice!! I'm glad I'm not the only person in with this....Gosh, it hurts sooo bad at times and then not so bad. I work at home, chasing a 1 year old all day so stretching isn't a problem I just have to remember to do it. I did my spinning this morning and tried to pay more attention to how I'm moving my foot, don't know if that makes much of a difference.
Thank you for giving me some hope!!
It was just a horrible thing, after being a nurse and seeing the xray and knowing what my normal heel is suppose to look like, then seeing this HUGE spike looking hook calcification coming under the bottom....... no wonder it hurts so much.
Thank you all again!!
Jenn

[KnottedYet]

We used to do iontophoresis with acetic acid to heel spurs to help soften them up and resorb them. Depending on the size and thickness of your spur, it may or may not be worth a try.

[mimitabby]

Knot, what is that?
My son Tom has a heel spur from an old injury (either Karate or climbing)
so i don't think it's postural but it sure could be..

It has been suggested to him that he have surgery but he keeps putting it off.

[KnottedYet]

soak an iontophoresis pad (like a big gooey bandaid) with acetic acid (the stuff in vinegar) slap if on the heel, and run an electric current thru the pad and then out a grounding pad with no acetic acid.

The current drives the acetic acid thru the skin and into the area around the heel spur, where the acidity helps to disolve the spur.

It doesn't get rid of the spur, and it doesn't stop whatever structural or functional issues are causing the spur, but I've seen it decrease the severity of spurs enough that with PT and shoe adjustments the patients could avoid surgery.

It doesn't work for everyone, but it does work for some.

[Offthegrid]

I had something done with ultrasound in physical therapy. Waved a wand over my foot. It felt really good, but that could have just been the massage.

[Wahine]

+1 what OTG and Knot said.

You really don't want to have surgery if at all possible and conservative management can often resolve the pain if not the spur.

One thing to remember is that your body put that spur there for a reason. There is too much tension on the plantar fascia and it's pulling on the bone. The bone responds by laying down more bone to try to heal it, much like it would in the case of a fracture. You need to resolve the stress on the fascia to solve the problem. That's where PT, orthotics and stretching come in. If you go in and take out the spur without solving the biomechanical issues, you can continue to have problems, not to mention the risk of surgery.

[Mr. Bloom]

The physical therapy was tough. Ideally, you need to stretch 3-4 times a day. I use this handy device. I *really* *really* *really* like it because it gets me a deeper stretch without the pain of pulling on my foot with a strap or towel.

I found that I got the same effect that this device provides by standing on the edge of a step on my toes and stretching my heels downward toward the next lowest step. I haven't had a problem in years since I've been doing this...

But now I feel deprived: I'm a gadget junkie and I've been using a gadgetless solution not knowing that there was a gadget solution out there

[Jenn]

Unfortunately, I have an unusually high arch, which he said is really adding to my problem. He did NOT like my biking shoes I just bought, he did NOT like my running shoes, Oh me, am I doomed to wear the dreaded Birkenstocks? (sp)
I have been doing ALOT of stretching and icing it everynight. I stretch it like I believe Mr Silver said by putting the ball of my foot on the end of my treadmill and pushing down, I can really feel that. I'm taking iburofin and I a can of frozen O.J. at night rolling it back and forth is helping.
Thank you all for the anti surgery advice, I left his office in tears. I saw a procedure done for a spur when I was 20 something, and that was the first time I ever fainted as a nurse, course the patient was awake.
Anywho, thanks again for the great posts. I'm suppose to go back and see him after our trip to Mexico, wish I could take my bike!!

Jenn

[Wahine]

Unfortunately, I have an unusually high arch, which he said is really adding to my problem. He did NOT like my biking shoes I just bought, he did NOT like my running shoes, Oh me, am I doomed to wear the dreaded Birkenstocks? (sp)

Jenn

Jenn - an unusually high arch also typically means a relatively stiff arch. This allows for less shock absorption. This in turn can lead to the spur. Your focus should be on stretching (I know you already said you're doing this but I felt I needed to say it again because it's *that* improtant) and getting shoes with very good cushioning. This is especially true of walking and running shoes. Cycling shoes aren't designed to reduce shock. You may want to try to put a gel insert in them and try to increase your cadence. Faster cadence = decreased force per pedal stroke.

[Jenn]

You know, he put a small pad under my arch and taped my foot that day and it felt soooo good. I wore a bag on my foot in the shower for 2 days just to keep it on Does anyone know if wrapping it with an ace bandage or soemthing like that would help? I also NEVER walk around barefoot anymore, which kills me but oh well...

[KnottedYet]

You know, he put a small pad under my arch and taped my foot that day and it felt soooo good. I wore a bag on my foot in the shower for 2 days just to keep it on Does anyone know if wrapping it with an ace bandage or soemthing like that would help? I also NEVER walk around barefoot anymore, which kills me but oh well...

Sounds like orthotics with a good arch support (which the pad and "low dye" tape pattern mimic) might be a large part of your answer!

No, an ace bandage won't do it. Ask him to show you the tape pattern, tell him how much you loved it, look into custom orthotics. (plain ol' off the shelf insoles like Superfeet might not be the answer in this case)