Heel Pain Treatments: The Basics part 1, Ice

“A journey of a thousand miles begins with a single step.”  Lao-tzu from “The Way of Lao-tzu”

Pain in the heel of your foot can be frustrating.  As long as you keep moving the pain stays away, but when you stop for  while and try to get up again it feels like something just stuck you in the foot.  I can assure you that you are not alone.  This is the most common complaint I see at Desert Foot Surgeons.  The official diagnosis is called plantar fasciitis.  What this means is that the muscles in your foot become inflamed where they attach to your heel bone.  Why these muscles become inflamed involves tightness in your Achilles tendon, how your foot reacts when it hits the ground, a change in shoes, activities, or an injury.  Some people can have a heel spur, but the problem is still plantar fasciitis.

The treatment of plantar fasciitis is like building a pyramid.  You must first form a solid foundation at the base and then progress upward.  It’s the base of treatment I want to tell you about today.  The basic treatment of all plantar fasciitis includes three steps:  ice, stretching, and arch support.

Ice:

Remember what I always say to my patients at Desert Foot Surgeons, “You can’t heal until the inflammation is gone.”  I’ve discussed ice in many other posts on this site.  The general rule is apply the ice for 20 minutes and leave the ice off for 40 minutes.  As long as you stay with this basic rule you may repeat as many times as you want.  Some people need to have a sock on their foot in order to tolerate the ice, others do not.  That’s an individual decision and I would say that if in doubt wear a sock.  Ice can be applied in three forms:  the store bought gel pack, ice massage using a small paper cup filled with water and frozen, or a frozen water bottle.  In the case of heel pain the ice bag is placed on the ground and you put your heel on the bag for 20 minutes.  The ice massage gets the cold deeper.  You peel the top edge off the paper cup, turn the exposed ice toward your foot and use the paper cup in your hand to push the ice along the arch and heel of your foot for 20 minutes.  The frozen water bottle is best done before bed.  The bottle is placed on the floor, your put your foot on the bottle and roll through your arch for 20 minutes.