“I’ll wear boots instead of high heels” – Heel Pain
Song Lyrics Courtesy of Tom Waits “Pay Me”
By; Dr. Jen Newell.

This morning I woke up with excruciating heel pain and realized how common this is in my practice. I regularly see people complaining of heel pain and wanted to share a few tips about what causes it and how to avoid it.

What causes heel pain?

There are 2 major causes of heel pain – plantar fasciitis and achilles tendonitis. These are pretty easy to differentiate based on the location of the pain. If the pain is under your heel bone on the bottom of your foot, you likely have plantar fasciitis. If the pain if at the back of the heel, you probably have achilles tendonitis.

Plantar Fasciitis

Plantar fasciitis is caused by inflammation of the thick tissue that extends from the heel to the toes. Stresses and strains cause microtears in the fascia, which become larger with continual loading. Walking and standing interfere with the rest needed for healing.

Plantar fasciitis commonly causes sharp pain directly under the heel, which is often worse first thing in the morning and after long periods of sitting. I often see symptoms persisting in patients for months to years if they continue vigorous activity that strains the fascia.

Methods of treating plantar fasciitis:

I encourage patients to ice the bottoms of their feet both before and after activity to help calm the inflammation. A frozen water bottle rolled under the arch of the foot and heel works really well.

In addition to ice, I stress the importance of altering training/exercise methods. Swapping walking, running and plyometrics with swimming or cycling can help reduce the stress put onto the fascia.

Another strategy to support healing (or heeling if you enjoy a good pun!) is to ensure you are stretching your calf muscles daily. Regular massages can help too!

In those with severe or persistent plantar fasciitis, I recommend regular acupuncture and supplementation of nutraceutical anti-inflammatories. These treatments can be individualized based on the needs of each patient and their specific concerns and health history.

Achilles Tendonitis

Achilles tendonitis is an overuse injury affecting the band of tissue that connects your calf muscles to your heel bone. It is most common in runners after they increase the intensity or duration of their runs or in weekend warriors.

Methods of treating achilles tendonitis:

Over the counter analgesics (pain relievers) like Advil or Aleve often help to reduce the pain and inflammation associated with achilles tendonitis; however, I discourage regular or frequent use of these products. There are a number of natural anti-inflammatory supplements available that can help to reduce the pain and effectively address the inflammation. Reducing your activity is key to promoting healing/heeling J.

Eccentric strengthening can be particularly helpful in healing tendonitis and gentle stretching is recommended. I would encourage working up to the eccentric strengthening with gentle stretching activities first.

Another strategy to both treat and prevent achilles tendonitis is to avoid shoes with excessive heel cushioning. Air-filled, extra cushioned heels in running shoes now more resistant to deformation and leaks which is not good for a sore achilles tendon. The reason for this is quite simple; if you are wearing a shoe that is designed to give great heel shock absorption what frequently happens is that after heel contact, the heel continues to sink lower while the shoe is absorbing the shock. This further stretches the achilles tendon, at a time when the leg and body are moving forward over the foot.

Much like with plantar fasciitis, acupuncture and nutraceutical supplementation can be helpful in reducing the pain and supporting healing so chat with your Naturopathic Doctor to find out the best course of action for you.

Take care of your feet! I am off to ice and acupuncture mine to help heal the plantar fasciitis.

Have an awesome day!

Dr. Jen Newell, ND

Dr. Jen Newell is passionate about helping people embrace health, feel amazing and easily incorporate “real” food into their busy lives. Her mission is to make health accessible and achievable, and to inspire patients to live an active, vibrant and healthy life.

Jen has a clinical focus on digestive health, food sensitivities and healthy nutrition; mental health and stress-related illness; women’s health, hormone balance and fertility; optimal aging; and dermatology. She focuses on integrating healthy foods into one’s diet in a medicinal and therapeutic capacity and providing individuals with nutritional support that is easy to incorporate into a busy day. Dr. Newell practices at the Integrative Health Institute in Downtown Toronto.

Resources:

http://www.mayoclinic.org/diseases-conditions/achilles-tendinitis/basics/definition/con-20024518

http://www.mayoclinic.org/diseases-conditions/plantar-fasciitis/basics/definition/con-20025664