Heel Pain Treatments: The Basics, part 3 Arch Support

Did you know that in 1949 Joe DiMaggio missed the first 65 games of the season because of heel pain?  Officially it was called “an inflamed right heel”, but now we know it was plantar fasciitis.  Unfortunately for Joltin’ Joe, there was not a lot known about plantar fasciitis or heel pain.  Arch supports did not exist at that time.

If you suffer from pain in the heel of your foot, you can relate to what “the greatest player in major league baseball” was going through back in 1949.  That searing pain when you stand up after resting, improving as you get going on your feet, only to return later in the day.  Just when you think you’ve beaten the pain, it comes back.

In this series I have already described the treatment of plantar fasciitis as a pyramid with the base supporting all higher levels.  Basic treatment includes ice, stretching, and arch supports.  The ice is used to help alleviate inflammation, because as I always say, you can’t heal until the inflammation is gone.  Gentle stretching helps the over-worked muscles in your foot work more efficiently and stop hurting.  Flexible strength is what stretching achieves.

Arch supports come in numerous forms.  There are those that you see at flea markets or even in the grocery store.  You can stand on a plate in a store and the “magic” computer will tell you the best insole for your foot, as if the computer can tell what the problem you are having with your foot.

The types of arch supports I use at Desert Foot Surgeons come in 2 forms.  I like to relate these two types to eye glasses.  There are reading glasses and there are prescription lenses made for your eyes and only your eyes.  We have the same thing for your feet.  You can get off-the-shelf arch supports or custom made foot orthoses.

Off-the-shelf arch supports:

These shoe inserts are not made to anyone in particular’s foot.  There is modest arch support to fit a wide range of arch heights comfortably and the materials allow some shock absorption so they do not push too firmly into your arch.  These off-the-shelf arch supports are less expensive than custom molded and are often used as an initial step in the treatment of heel pain.


Custom molded foot orthoses:

Custom foot orthoses are made to your feet specifically.  The mold has to be taken with your foot held in a very specific position, known as neutral subtalar joint with the midtarsal joint locked.  This can be done with a digital scanning device or plaster casting, but it cannot be achieved if there is any weight or pressure on your foot.  The prescription has to be written based upon a detailed exam that involves the effect of your hip, knee, and ankle on your foot, how your foot is aligned and moves, and then how your foot hits the ground standing and walking.  The materials used to make a custom orthotic depends upon the shoes you want to wear them in.  This involves a discussion between you and me.  This is the Desert Foot Surgeons difference.  I talk to you, exam you sitting, standing, and walking.  Video gait analysis is done to see what the naked eye cannot in order to get you the best custom foot orthotic possible.

That’s the basic treatment of heel pain.  Most of these you can try before going to see a doctor so that a solid foundation will have been established upon which more advanced treatment can be added.  Your time spent with the podiatrist will be more efficient because basic treatment will have been done and you will get better sooner.  Remember:  ice, stretching, and arch support.  It all starts there!