Archives for November 2012

November 20, 2012 By heelhealth

Listening to your Body

Each of us is going to have a different experience with plantar fasciitis in terms of what is happening on a daily basis. Plantar fasciitis is quite a democratic disease — striking a huge range of people.

Some of us are runners. Some like to hike and walk. Others are more stay-at-home types. We have all different kinds of body types and weights and tolerance of pain. And we have vastly different daily routines. Some have to work standing up all day. Others sit at computers most of the day and then go for a run.

In my experience, no matter who you are and what you do, your body will tell you fairly precisely how you are doing in your recovery.

Every day is different, and every day I have to trust my body to tell me what is going on. Usually, these days, I don’t have to ice my foot, but sometimes, for no apparent reason, my heel is quite sore, and out of the blue I need to ice again.

If I forget that standing around, like at a party, is one of the worse things on my feet, my foot will let me know right away, as I’m standing there. These days, I pay attention, and even if it makes me feel like an old lady, I find a chair and sit down.

Sometimes, I want to take a longer walk, so I walk, even knowing that my foot may be sore, and I ice it when I get home. If it’s quite bad, I take some ibuprofen, though I pretty much hate doing that.

Some things I do no matter how my foot is feeling, like stretching my calves and Achilles tendons multiple times a day, and before I get out of bed in the morning, and wearing good shoes, but for everything else I pay attention to what my body is telling me on a daily basis.

Action Item

Listen to your body, and respond!

November 20, 2012 By heelhealth

How Long for Plantar Fasciitis to Heal?

I have read that it will take at least as long to heal from plantar fasciitis as the amount of time you have had it before starting treatment. Clearly, this is in no way a scientifically viable theory, but it is a useful way to begin to think about the problem.

Basically, the earlier you begin treatments the shorter your recovery time is likely to be. This really can’t help most of us with painful heels, who are little too far down this road already, but it can help us to spread the word among our friends and family about awareness of the symptoms of plantar fasciitis.

For the majority of us, recovery is going to be a long term process. No one with a badly sore heel wants to hear this but it is clear that it usually takes months or years to heal from plantar fasciitis.

I don’t know why this is and will explore it more in future posts — maybe because we have to use our feet so that it is hard to truly rest them, maybe because we tend to push too hard as soon as we feel a bit better, or maybe because there is a conflict of interest between wanting to be generally healthy physically and needing to rest your foot.

It is common for the pain to lessen in a few weeks, with treatment, but in my experience, it was only the acute pain that toned down after those first weeks of complete rest, multiple daily icing and stretching, ibuprofen, arch supports, etc. I have been treating my plantar fasciitis, earnestly, since June 2012, for about five months now, and things are much better than they were. I can hike a couple of hours now, and I am back to walking 30 minutes or so from work each day on hard city streets (with great shoes), but I am not “healed.” I can feel it improving very slowly, but I have the feeling this will take a year or more to really resolve, which is quite common. Unfortunately, some people keep the problem chronically, for years on end. I hope to avoid that, and to help you avoid that!

Action Item

Start treatments as soon as you can.
Be as patient as you possibly can. For the great majority of us, this is going to take a while.

November 19, 2012 By heelhealth

Icing Plantar Fasciitis

Icing plantar fasciitis is a cheap and easy treatment for the inflammation in your plantar fascia ligament. My podiatrist recommended this and I don’t think I’ve ever read a plantar fasciitis treatment plan that did not include it. I found that it helped a lot at the beginning, when my pain and swelling were more constant and acute. But I’m also using it as a sort of maintenance tool, as my foot begins to feel better and I use it more. So on days I walk the 40 minutes home from work, I ice it when I get home, and when I hiked a few miles recently, I iced it right away when I got home.

Icing Methods

When using any of the methods below, you want to avoid the risk of frostbite. So don’t let the ice come in direct contact with your skin with the methods used below, and don’t apply the ice for longer than 15 or 20 minutes at a time. Basically, ice as soon as possible after exercise or standing for longer periods, or anything that is hard on your feet.

Ice pack

Personally, I prefer using an ice pack for icing. As soon as my heel pain got really bad and I realized I had plantar fasciitis, I started icing my foot at least a couple of times a day. I’m not a fan of being cold, but this helped so much with the pain and swelling that it actually felt good to do it. I freeze one of those reusable ice packs — mine is called Tech Pack, but you could use any ice pack. The Tech Pack has a thin paper cover, but to avoid over-cooling, I still cover it in a thin hand towel, or wear a sock, and rest my feet on it for 20 minutes. (In the photo we didn’t cover it, to show the ice pack better.) You can ice while you’re doing something else so it doesn’t feel burdensome. I usually ice my feet while on the computer. By the way, I ice both feet even though I seem to have the problem in my left foot, as a preventative measure.

Bag of frozen peas

Some people like to use a bag of frozen peas as an ice pack, and I tried this, but preferred my ice pack in the end, only because the ice pack has developed a general shape that sort of fits my foot at this point. Do what you like!

Frozen water bottle

One popular method is to roll your foot on a plastic water bottle full of frozen water, which gives you a double treatment of massage and icing. This sounds like such a great idea, but honestly this never worked for me. First of all, the bottle wouldn’t stay round when I froze water inside it, so it didn’t really “roll.” Also, I didn’t like any of the massage methods besides using my hand on my feet at the beginning, when they really hurt. It just hurt too much to roll anything on it. Now, when it doesn’t hurt much or at all on most days, I still don’t like the feeling of rolling a tennis ball or frozen bottle along my foot. But you should give this a try if you are inclined as a lot of people really like it and find it useful.

Action Items

When your plantar fascia is inflamed and painful, apply ice to the bottom of your feet for 15-20 minute periods, with an ice pack, bag of frozen peas or frozen water bottle. (Don’t put the ice directly on your skin.)
Continue to ice your foot until your plantar fasciitis resolves, anytime that you might overuse your plantar fascia ligament, when exercising or standing for longer periods.

November 16, 2012 By heelhealth

Heel Pain Remedies

Some people may wish to use herbal or natural treatments instead of or in addition to the standard medical treatments. I have used only one of these types of heel pain remedies — an arnica montana cream — but have listed a few of the better-known herbal treatments as well.

For External Use

Arnica Montana

Arnica Montana is a flowering plant extract used in herbal medicine, both as a little pill you take internally and as a topical cream or ointment. Both forms are used for bruising and inflammation. I started using the topical form – an Arnica Montana cream called Penetrex – on the strong recommendation of a friend who used to have plantar fasciitis. (Don’t you love hearing that people “used to” have plantar fasciitis? 🙂

Penetrex for plantar fasciitis — Penetrex cream with Arnica Montana. Click image to read reviews on Amazon.

Although the results of scientific studies on the efficacy of Arnica are mixed*, I have to say I was impressed with the results. Using the Penetrex cream as directed, my foot started feeling significantly better in a few days. I guess I will never know if my foot had healed a lot just at the point I started applying the cream 2-3 times a day, or if the Arnica itself was really effective, but my foot did feel better. I’m still using it now, on a daily basis, and there are days when my feet don’t feel great, so I think it is clear that by itself the cream cannot “cure” your plantar fasciitis. However, my personal opinion is that it is a useful tool in plantar fasciitis “recovery toolkit.” I think the action of massaging the cream into the bottom of my foot is in itself useful.

One note. I used to use an Arnica Montana gel called Arniflora, for repetitive stress problems with my arms, and I like it, but I personally prefer the Penetrex as it seems to me to be more effective. Also, I prefer the way the Penetrix feels to put on – it’s a white cream – compared to Arniflora’s clear thin gel that. But that’s just me.

For Internal Use

I have not tried any of the herbal remedies that one takes internally. We will explore these further, but for now, here are the names of four that some people use for pain relief:

Ginger
Turmeric
Bromelain (pineapple extract)
Willow

Also, I can’t really vouch for the websites below until further investigation, but they have a bit more information on herbal pain remedies:

As Heel Health learns more, we will explore other options. Also, please let us know your experience with any herbal treatments.

Action Items

Consider adding Arnica Montana cream to your recovery regimen. With the one I use, Penetrex, I massage it into all the painful areas at the bottom of my foot once a day (after the first week, when the frequency was 2-3 times a day.)
If you are interested, check out some other herbal remedies, like willow, bromelain, ginger and turmeric. As always, please use all medicines, traditional or alternative, responsibly. Research what you plan to take, and speak to your doctor first.

Footnotes

* See the Memorial Sloan Kettering Cancer Center page on Arnica >>