Heel spurs are not what cowboys wear, lets get that straight right at the git-go, shall we? They are nasty little nippers that plague the gentle minds of men and women who, by simply rising from their place of rest and contentment, step into a daily world of pain and useless invective against gravity, or against whatever and whoever they encounter first that day. Essentially, they hurt like the bloody blazes.
There is of course some disagreement whether it is even proper to call them heel spurs, unless an X-ray shows an actual bony spur at the insertion of the plantar fascia on the inferior surface of the calcaneus. This is because the location and the pain are often referred to as plantar fasciitis. Both have strongly associated symptoms and even the (non-surgical) treatments are similar. In plantar fasciitis, the sheath that the fascia runs through, allowing it to slide/glide as it shortens and lengthens becomes inflamed, causing that smooth motion to "bind," thereby causing even more inflammation, and, well, pain. No nice way to say it, is there?
The pain from plantar fasciitis is often focused near the insertion on the calcaneus, though sometimes it can radiate distally to the entire fascia. When the plantar fascia is especially tight, something that can occur for a number of reasons, like for a woman who wears heels all day, then takes them off late at night. Without a sufficient equivalent amount of time spent walking, and thereby stretching the plantar fascia, the fascia remains tightened throughout the night, as the feet are in a position of rest, sometimes amplified by the blankets weighing the feet down sufficiently to reinforce that relaxed position. Upon waking, the feet hit the floor, and suddenly have to stretch the fascia to it's fullest. One of the prominent symptoms of both plantar fasciitis and heel spurs is "first step" pain. And boy, do I mean pain. Nail driven at high velocity into flesh and bone about approximates the sensation, I'd say.
If an X-ray reveals an actual bony spur, surgery might be required, but there may be alternatives. The same with plantar fasciitis. One of the more unfortunate surgical "solutions" is a plantar fasciectomy, that is, removal of the plantar fascia. Get many second opinions before taking that route. Any surgical solution should only follow a complete exhaustion of non-surgical approaches.
Two initial approaches would include stretching, and ice massage. Stretching means both active and passive stretches. Active includes basic Achilles-type stretching, as this by extension causes the plantar fascia to stretch, as well. Seated on the floor, doing stretches with therapy bands is also suggested. Passive stretching means using something that will keep the forefoot dorsiflexed on the rear foot while you sleep. This usually requires a night splint device (there are many brands, some quite affordable,) that keeps the plantar fascia on stretch all night long. Talk to your podiatrist or orthopedist for suggestions on these.
Ice massage is quite simple - put an ice cube into a small plastic bag, slather some foot creme on the plantar foot, and gently rub along the length of the plantar fascia for ten to fifteen minutes two or three times a day. Any source of ice - cubes, packs, etc., will do, but the real trick is repetition, to help bring down the localized inflammation.
A simple palliative solution to get you through all the other therapies with at least minimal pain is a heel donut or U-pad. This is simply a somewhat firm pad with either a hole cut into the center, or cut into a U-shape, then placed inside your shoe or shoes (these things do sometimes occur bi-laterally,_ which will reduce direct pressure on the area around the insertion point. In very extreme cases, an additional pad of the same thickness (1/4") will help by raising the heels enough to prevent the plantar fascia from stretching fully on each step. But remember, these are merely palliative, and should not be used as complete solutions. Again, work with your doctor on such measures.
Just remember, whether heel spur or plantar fasciitis, you need to work to stretch regularly and properly - no "bouncing," - long, slow, and regular is best. Try to use lower-heeled shoes (gals!) and stay away from really hard heels, like leather or wood, which will help reduce heel impact to some degree.
Nobody likes to be all owie-zowie, baby!
There is of course some disagreement whether it is even proper to call them heel spurs, unless an X-ray shows an actual bony spur at the insertion of the plantar fascia on the inferior surface of the calcaneus. This is because the location and the pain are often referred to as plantar fasciitis. Both have strongly associated symptoms and even the (non-surgical) treatments are similar. In plantar fasciitis, the sheath that the fascia runs through, allowing it to slide/glide as it shortens and lengthens becomes inflamed, causing that smooth motion to "bind," thereby causing even more inflammation, and, well, pain. No nice way to say it, is there?
The pain from plantar fasciitis is often focused near the insertion on the calcaneus, though sometimes it can radiate distally to the entire fascia. When the plantar fascia is especially tight, something that can occur for a number of reasons, like for a woman who wears heels all day, then takes them off late at night. Without a sufficient equivalent amount of time spent walking, and thereby stretching the plantar fascia, the fascia remains tightened throughout the night, as the feet are in a position of rest, sometimes amplified by the blankets weighing the feet down sufficiently to reinforce that relaxed position. Upon waking, the feet hit the floor, and suddenly have to stretch the fascia to it's fullest. One of the prominent symptoms of both plantar fasciitis and heel spurs is "first step" pain. And boy, do I mean pain. Nail driven at high velocity into flesh and bone about approximates the sensation, I'd say.
If an X-ray reveals an actual bony spur, surgery might be required, but there may be alternatives. The same with plantar fasciitis. One of the more unfortunate surgical "solutions" is a plantar fasciectomy, that is, removal of the plantar fascia. Get many second opinions before taking that route. Any surgical solution should only follow a complete exhaustion of non-surgical approaches.
Two initial approaches would include stretching, and ice massage. Stretching means both active and passive stretches. Active includes basic Achilles-type stretching, as this by extension causes the plantar fascia to stretch, as well. Seated on the floor, doing stretches with therapy bands is also suggested. Passive stretching means using something that will keep the forefoot dorsiflexed on the rear foot while you sleep. This usually requires a night splint device (there are many brands, some quite affordable,) that keeps the plantar fascia on stretch all night long. Talk to your podiatrist or orthopedist for suggestions on these.
Ice massage is quite simple - put an ice cube into a small plastic bag, slather some foot creme on the plantar foot, and gently rub along the length of the plantar fascia for ten to fifteen minutes two or three times a day. Any source of ice - cubes, packs, etc., will do, but the real trick is repetition, to help bring down the localized inflammation.
A simple palliative solution to get you through all the other therapies with at least minimal pain is a heel donut or U-pad. This is simply a somewhat firm pad with either a hole cut into the center, or cut into a U-shape, then placed inside your shoe or shoes (these things do sometimes occur bi-laterally,_ which will reduce direct pressure on the area around the insertion point. In very extreme cases, an additional pad of the same thickness (1/4") will help by raising the heels enough to prevent the plantar fascia from stretching fully on each step. But remember, these are merely palliative, and should not be used as complete solutions. Again, work with your doctor on such measures.
Just remember, whether heel spur or plantar fasciitis, you need to work to stretch regularly and properly - no "bouncing," - long, slow, and regular is best. Try to use lower-heeled shoes (gals!) and stay away from really hard heels, like leather or wood, which will help reduce heel impact to some degree.
Nobody likes to be all owie-zowie, baby!
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