Articles on heel

The Hidden Costs of High Heels

Dr. Nidhi Kumar, Physiotherapist
In the world of style, stilettos form a quintessential section of the footwear closet. From a special occasion wear, high heels are snuggly finding their ways into daily life as office wears or shopping companions. High heel trends are ensuring their wear by millions of women without knowing their long term effects. These are-1. Foot painShoes with a heel of two inches or higher, slides the foot forward in the shoe, forcing the toes into the unnatural shape of the shoe & redistributing the weight incorrectly, by resting the whole body weight on the balls of your feet.2. Low-back acheThe increased weight on the toes causes the body to tilt forward, and to compensate this, one tends lean backwards, leading to exaggerated low back arch. This change in position of spine puts pressure on nerves in the back & may cause sciatica (a condition where the nerves get compressed, triggers pain & numbness in the leg).3. Ankle sprainThere are potholes, cobblestone roads, air vents, drainage gates, and so many other things that are just waiting to latch onto the pointy tip of pair of high heel shoes .4. Foot deformityBeginning as a bunion (bony swelling at base joint of big toe), leading to deformity as big toe angles inwards towards other toes. Hammer toe may also occur.5. Early arthritis of kneeIncreased pressure on inside of the knee leads to early degenerative changes.6. Shortened calf muscle7. NeuromaMorton’s neuroma or nerve thickening on the underside of the foot due to high heels with narrow toes, leading to toe pain & numbness.DO YOU HAVE TO GIVE UP YOUR HEELS?NO, but to avoid the problems that develop over time, you can take the following precautions:Choose sensible heels; select shoes with low heels, an inch and half or less-a wide heel base, a slightly thicker heel will spread the load more evenly. Narrow stiletto type heels provide little support. Three inches and higher heels may shorten the Achilles tendon.Wear soft insoles to reduce the impact of heels.Make sure that your shoes are the right size, so the foot doesn’t slide forward, putting even more pressure on the toes. Pick a shoe with wide enough toe box that allows toes to spread well.Wear heels on days that require limited walking or standing.Alternate your shoe choice throughout the day or from one day to the next.Don’t wear high heels all the day. Wear comfortable shoes such as walking or athletic shoes while commuting to & fro from the work. Wearing shoes that allow body to move naturally during walking will allow feet, legs, hips & back to stretch.Stretch; take time every day to stretch the calf muscle & feet. Standing on the edge of the step with shoes off. You can also put a pencil on the floor & try to pick it up with your toes.FINAL WORD ON FOOT HEALTHDon’t let the sense of style cripple your ability to stand or step pain-free. Feet are base of support, if they are not happy, nothing above them will be. Take a closer look at your shoe selection & take small steps now to prevent big foot problems later.

Pain in the Heel?

Dr. Anshu S.R Sachdev, Orthopedist
Plantar Fascitis & Heel PainOh, My Aching Heel!!The combination of foot and ankle consists of 26 bones, 33 joints and an excess of 100 ligaments & tendons. The longest bone present in the foot is the heel. Over usage or injury to the heel would lead you to experience pain in the heels. The severity of the heel pain can range from mild to excruciating.The cause of heel pain is typically associated with excess usage of the heel bone. Straining of your heel occurs if you excessively pound your feet on surfaces that are hard, or you are overweight or even if you wear shoes that do not fit your feet properly. These strains cause irritation in the muscles, bones or tendons that are present in the heels. Some of the other common causes include:1. Heel Spurs:  Development of heel spurs occurs due to the continuous stretching of the lining, which covers the heel. Upon continuous stretching, pieces of the lining tend to break off. Development of heel spurs is common in athletes who frequently jog or run. People who are obese also tend to experience pain due to heel spurs.2. Plantar Fasciitis:  Development of Plantar Fasciitis occurs due to the inflammation of the tendinous tissue that connects the heel to the ball of the foot. Development of Plantar Fasciitis is common in athletes who frequently jog or run as well as people who wear shoes that don’t fit the feet properly. It may occasionally be associated with Vitamin B12 deficiency and raised uric acid in blood3. Achilles Tendinitis: This is the inflammation of the Achilles tendon. Achilles Tendinitis occurs commonly in people who have active lifestyles, such as people who are joggers, runners or even dancers.Treatment: Physical therapy, medication or alternative treatments can be used to treat this form of pain. Medications for heel pain can only be in the form of anti-inflammatory drugs. Although these oral medications cannot significantly relieve heel pain, some injections containing substances such as corticosteroids, as well as Arthrocentesis (removal of fluid present in joints using hollow needles) might be able to provide relief. Recently PRP (Platelet Rich Plasma) injection have been found very useful in treating recalcitrant Plantar fasciitis and heel pains.Common practices that can be used to relieve discomfort include:Application of ice to the heel for a duration of 15 minutes dailyUtilize over-the-counter pain medicationsHave adequate amounts of restWear shoes that fit properlyWalking on tip toes to stretch the plantar fascia helps to relieve heel pain

Don't Ignore That Heel Pain!

Dr. Sarika Jambhulkar, Physiotherapist
If you are waking up with acute pain at your heel, then mostly you are suffering from plantar fascitis. This is one of the most common foot problems. Many times pain is very severe & disabling.What is plantar fasciitis?Plantar fasciitis (plantar fasciosis) is inflammation of the plantar fascia. The plantar fascia is a strongbowstring-like ligament that runs from the calcaneum (heel bone) to the tip of the foot. When the plantar fasciia is stretched it results micro tear of soft tissue fibers, usually where it attaches to the heel bone.Sometimes the problem may occur in the middle of the foot. The patient experiences pain under the foot, especially after long periods of rest. If inflammation persists for longer duration it can lead to calcaneal spur.Causes:Plantar fascitis is not usually caused by a single injury, such as a twist or fall, but rather the result of repetitive stress and pounding of the heel. Still following factors play important role in increasing severity of plantar fascitis.Arch type: Flat feet, High arch or in betweenFootwear:Wearing too flat or too high heel footwearLifestyle: continuous standing, walking or runningBody weight:  Overweight results in more stress on plantar fasciaOsteoporosis: Weak bones will aggravate pain moreDiagnosis:Podiatrist/Foot doctor is the right person to diagnose & treat the heel pain. Assessment should include detailed history, lifestyle evaluation, detail assessment of foot arches & gait. Real skill is to identify the toot cause & treat it.Treatment:Rest: Temporary rest is important to allow plantar fascia to healCold pack: Helps to reduce inflammation. Right orthotics: To support your plantar fascia & correct your faulty alignment.Supportive shoes: Orthotics with proper supportive shoe gives long term reliefWhat to avoid:Bare feet walking on hard surfacesWearing too flat or too high heeled footwearHeel Cushions: Silicone or foam heel cushions commonly available from pharmacies do nothing to actually cure this condition and at best provide temporary comfort.

10 Easy Tips for Heel Pain

Dr. Yogesh Kumar, Ayurveda
Women have been wearing high heel sandals to look good but this fashion fad could give rise to Back and Heel problems.Heel and back problems can occur in men also .This problem in medical terms called "The Painful Heel Syndrome".Women with Progressive age, Arthritis, Overweight women are more prone to this problem.The heel pain could be different according to the age groups.Young men tend to have Bursitis while older men have Plantar Fasciitis. Due to increased overload on Foot , Stress fracture, and Osteoporosis, heel pain can occur. Besides that,Foot Pain could be due to Nerve damaging Diseases like Diabetes and Peripheral Neuritis.Below the heel bone, there is a bedding of fat, there lies  some fat in between nervous fibers.In progressing age,the fat layer of the nerves reduces and the nerve fibers deteriorate and because of that the whole weight of the body falls on the heel and heel pain occurs.The Mainstay of the Heel Pain is Physiotherapy.It uses Hot and Cold Fomentation,Short Wave Diathermy,Strengthening and Mobilizing exercises.The Patient should follow the dietary advice ,Eat fat-free diet,Should not consume fried and spicy food and Excess Sugar-containing food. If still, the problem persists,medical help should be taken.Some Useful Tips for Heel PainHot Fomentation For 10 minutes Daily.Use Pain Reveling Gel,Spray or Cream.Use Ice Fomentation For 10 minutes after injury.Exercise for Joint and Heel.Soak the feet in  warm salt water daily three to four times.Oil Massage of the feet daily.Use special footwear with extra padding on a heel. Pull the fingers of the feet first inwards than outwards.For feet, exercise uses the tennis ball.Place the tennis ball under the feet and roll.It increases the blood flow in the feet.Take Sessions of Acupressure from the expert,it reduces the pain by increasing the blood flow.

Homeopathy Treatment for Heel Pain (Plantar Fascitis)

Dr. Rangadhar Satapathy, Homeopath
Plantar Fascitis (heel pain) is now a common problem among people. In gender ratio, it occurrs in women than men. This occurs when the plantar fascia gets inflamed due to over stress. The pain is usually more on first putting the step after along resting position, early morning when waking from bed, stretching the feet upwards. In some cases the pain is so severe can’t able to put the heel on floor when rising from a sitting position.The  triggers factors that causes plantar fasciitis are long standing posture on a hard surface, obesity, excessive pressure on foot etc.The plantar fascia is a thick flat band of tissue (ligament) that originate from the heel bone to the base of toes. It supports the arch of your foot. Actually the plantar fasciitis as it is named not an inflammatory condition of plantar fascia. It is a non inflammatory micro tear of the fascia result from over stress on its surface.  There is also calcification of fibrous tissues of plantar fascia. Management with Homeopathy treatment:Try to avoid prolong standing posture on any hard surface. In case of women, they usually do cooking and other house hold work standing for a long periodds. In this case it is advisable not to stand for a long period and give break for few minutes. Otherwise they can use silicon pads inside the shoes. Though in our tradition the shoes not allowed inside the kitchen, but a silicon pad packed shoe can be kept only for using inside kitchen.To relieve pain you can apply both ice and warm application alternately. Keep two tub, in one tub fill with cold water and in other one warm water. Dip your foot first in warm water tub for 1 to 2 minutes then remove out and put in cold water tub for 1-2 minutes. Do it 5 to 6 times daily before going to bedHomeopathic medicines- Common homeopathic medicines that help in plantar fascitis are Rhus tox, Ruta,  calc flour, arnica, calcarea carb, silicea, calcarea phos etc. Some exercises to relieve pain:Toe exercise- Sit in a chair, and extend your affected leg so that your heel is on the floor. With your hand pull your big toe up and back. Pull toward your ankle and away from the floor. Hold the position for at least 15 to 30 seconds. Repeat 2 to 4 times a session, several times a day.Calf exercise- Stand facing a wall with your hands on the wall at about eye level.Put the leg you want to stretch about a step behind your other leg. Keeping your back heel on the floor, bend your front knee until you feel a stretch in the back leg. Hold the stretch for 15 to 30 seconds.Repeat 2 to 4 times.Towel stretch- Place a rolled towel under the ball of your foot, holding the towel at both ends. Gently pull the towel toward you while keeping your knee straight. Hold this position for 15 to 30 seconds.

Causes and Symptoms of Heel Pain and 5 Tips That Help!

Rhea Lakhiani
The heel bone, referred to as the ‘calcaneus’ is the largest bone in the foot and serves as an attachment point to several muscles and tendons that help in walking, running and jumping.Heel pain can be very disabling as most people suffering from it, complain of discomfort on weight bearing, which causes them to limit basic activities like standing and walking.Heel pain can be categorized as pain under the heel or behind the heel. It can arise from a number of structures, but biomechanical faults or improper mechanics that load some areas in the foot more than others, tends to be a major contributor to heel pain.In this article, we will explore the spectrum of causes that can be responsible for heel pain:-PlantarfascitisThis is one of the most common causes of heel pain. The plantar fascia is a dense, fibrous connective tissue structure extending from the medial tuberosity of the calcaneus through the medial longitudinal arch inserting into the base of each of the toes. It is an important static support for the longitudinal arch of the foot.Over pronation or flat foot, strains the longitudinal arch which causes the plantarfascia to stretch excessively. This exerts a pull on the plantar fascia, especially at its origin on the medial process of the calcaneal tuberosity, thereby putting strain on its attachment at the heel.Patients typically complain of pain that is worse in the mornings especially when they take the first few steps after long periods of rest or inactivity.Fat pad syndrome/ Fat pad degeneration There is a cushion of fat which is made up of elastic fibrous tissue that acts as a shock absorber and protects the heel. Fat pad syndrome may develop either suddenly after a fall onto the heels or gradually due to thinning out from excessive loading and poor cushioning. Patients often complain of heel pain that is particularly felt during weight- bearing, mainly in the outer portion of the heel.Calcaneal (Heel) spurCalcium deposits may accumulate and build up on the under surface of the heel. This happens over time and is often caused by strains of muscles and ligaments of the foot or excessive stretching of the plantar fascia. Running or jogging on hard surfaces, excess body weight or improper footwear can cause repeated tearing of the membrane that covers the heel bone. This places excessive stress on the heel. Heel spur with no other associated abnormality may not be symptomatic. However, excessive repeated wear and tear can result in inflammation which may then lead to pain.Calcaneal Stress fractureAlthough a rare occurrence, it can be seen in athletes or people with overuse history and repetitive high impact activity, like runners, dancers or jumpers. There is diffuse pain over the entire heel, which tends to aggravate with loading activities. An X-ray or MRI is needed to confirm diagnosis.Achilles tendonitis, Haglund’s deformity and Retro calcaneal bursitis Haglund’s deformity also known as ‘pump bump’ is characterised by a prominence or tenderness over the back of the heel, and often causes it to rub against the tendon.This may predispose the bursa or tendon to mechanical irritation. Constant irritation causes inflammation of the fluid-like sac situated behind the heel between the tendon and heel bone. Inflammation of this bursa is called Retro calcaneal bursitis.The tendon connecting the calf muscles to the calcaneus also known as the Achilles tendon attaches to the back of the heel bone. Achilles tendonitis is commonly associated with repetitive impact loading due to running and jumping. Achilles dysfunction can also be related to postural problems (e.g.high arches, fallen arches), poor footwear, or tight calf muscles. These postural and biomechanical faults may alter the alignment of the tendon and cause rotation of the heel. This rotation of heel (inward or outward) may cause grinding or friction of the calcaneus against the tendon. Eventually, due to this constant irritation, a bony protrusion may develop and the bursa may become inflamed.Since the Achilles tendon insertion, the retro calcaneal bursa and the calcaneus are so intimately related, dysfunction in one area, commonly affects the other.Symptoms include pain, swelling, a noticeable bump and redness at the back of the heel which intensifies on walking, as the bony enlargement rubs against the heel counter of the shoe.As discussed, heel pain is common and could be due to various reasons. But like every problem has a solution, this one is no exception and most individuals respond well to treatment. There are a few practice suggestions that have proven to be beneficial for those suffering from heel pain. Regardless of what is causing you the heel pain, the following recommended tips are likely to help:-Relative rest: A fairly logical pointer! Avoid activities that cause pain or aggravate it.Cryotherapy: Icing the affected painful area helps decrease pain and control inflammation if any.Stretching: Plantar fascia and calf muscle stretching helps address the tight structures that may be one of the causes of pain. This helps in pain- relief and prevents recurrence.                                                           Calf stretchStretching of the plantarfascia4. Shoe modifications: Foot wear that has good support for the arches or has adequate heel cushioning can act like a buffer and reduces stress on the heel and other pressure areas along the foot. Eg: silicone gel heel pad, heel cups.                                                                                                                                                                                        Heel pads/ cups5. Bodyweight: If you are overweight there is more stress on the heels when you walk or run. Shedding off those few extra kilos won’t hurt!

Everything You Need to Know About Heel Pain (Plantar Fasciitis)

Dr. Sunil Kumar Tank (PT), Physiotherapist
Plantar fasciitis is a reason of pain under the heel. It normally goes in time. An inflammation and pain of your plantar fascia is known as plantar fasciitis. A strong, thick band tissue or ligament which stretches from your calcaneum (heel) to your middle foot bones is your plantar fascia which also supports your foot arch. It also acts like a shock-absorber in your foot. These pain in plantar fascia is mostly common in runners.Plantar fasciitis is included as one of the very common reasons of heel pain. It mainly causes stabbing pain which normally occurs in morning with your first step. The pain of plantar fasciitis normally decreases, once your foot limbers up. The chances of return in pain increases after standing for a long time or after standing up from a seated position.If foot pain occurs during nights, there are possibility of different problems like arthritis, or nerve problems such as tarsal tunnel syndrome.Plantar fasciitis is more often at risk for active people between the ages of 40 and 70. Also it is little bit much more experience by women than men.Due to injuries that have happened over time, plantar fasciitis may often occur. One can feel less pain within few weeks, after having a treatment from your physiotherapist. But it may take some months to cure completely.SYMPTOMS OF PLANTAR FASCIITIS-The following are the symptoms of plantar fasciitis observed in patient-When plantar fasciitis occurs, sharp and unilateral pain occurs in your foot.Foot Pain occurs in morning during the first step after getting up from bed.Pain occurs after being seated for long time in place and position.Pain and stiffness occurs in morning increases as the day progresses.Pain occurs when you stand on your toes or climb stairs.Pain occurs after standing for a long time.In the starting of exercise pain decreases or may get completely heal as the exercise goes on, but it may come back after the completion of exercise.The presence of numbness, swelling, radiating pain and a tingling sensation.CAUSES OF PLANTAR FASCIITIS-There are some of the reasons responsible for the plantar fasciitis-Plantar fasciitis may due to standing for a longtime or if one do lots of walking, running, etc.If one have started exercise recently on a hard surface.There are chances of plantar fasciitis if you are overweight or obese, as theses increases pressure on your plantar fascia ligaments.Women during pregnancy experience plantar fasciitis, specially during late pregnancy.Plantar fascia problems are likely happen in long distance runners.People such as factory server, waiters having active job that includes being on feet often are at the risk.People having a very high arches or very flat feet, may often develop plantar fasciitis.Tight achilles tendons may also result in plantar fascis pain.It may occur due to wearing shoes with soft soles and poor arch support.DIAGNOSIS AND TESTS FOR PLANTAR FASCIITIS-The following are the ways to diagnose plantar fasciitis and the following tests are to be taken for the same:-          PHYSICAL DIAGNOSIS:-As the diagnosis are based on the history related to the injury. So your physiotherapist will often take a sight at your walk and will check if you can stand on your tiptoe or not.                            Thompson TestWith the help of calf squeeze test or thompson’s test method your physiotherapist will check your tendon.         IMAGINARY DIAGNOSIS:-MRI Scans:- The magnetic resonance imaging gives the better images of the body’s soft tissues, like muscles, disks, nerves, and the spinal cord. MRI determines the damage to soft tissues.              Ruptured Planter FasciaX-Ray:– An X-ray is a kind of electromagnetic radiation that can penetrate most solid objects to create pictures of an object’s interior. Calcaneous spur is the most common causes of Planter fasciitis ,which are easily shown in X-ray finding                 Calcaneous SpurUltrasound:- An ultrasound can assist in difficult diagnosis. These tests can also assist in determining which treatment will be much beneficial depending on degree of injury.                USG Planter FasciitisHOME TREATMENT FOR PLANTAR FASCIITIS-The following home treatment can be done by patient at home to prevent the plantar fasciitis become worst:-The patient should protect the injury by having rest and should avoid lifting heavy weight.Using ice packs can to reduce pain and swelling can be very effective. The patient should apply it regularly.One should use pillow under your leg while sleeping and sitting. It will provide rest to the calf.The patient can also apply pain relief spray suggested by the physiotherapist.Under the guidance of physiotherapist, if the pain exceeds and becomes unbearable patient can also have anti-inflammatory painkillers such as naproxen, ibuprofen.

Footwear With Heels And Their Biomechanical Impact On Heel Pain

Mr. Vasanth Kumar, Physiotherapist
Women love high heels, but if they continue wearing them all the time chances of significant foot pain and associated problems either can occur directly or exacerbated by wearing heels. (Morin, n.d.).Any time person wears footwear that disturbs or realigns the natural counter of the foot they are bound to cause foot pain, the experts says. While, if you add a bit of inches (high heels) in to this calculation then the pain can soon escalate to damage says, Stuart Mogul expert in podiatry. Due to this, there exists the change in the body segmental alignment. For instance wearing high heels will restrict the natural movement of the foot and in addition to the restriction there is increased loading of weight on that area hence the person is not just crushing the toes, but adding exaggerated body weight on them says the Sports Scientist (Biomechanics) Vasanth Kumar from Chennai who is also a performance coach.Consequences of wearing footwear with heelResearchers have found that people wearing high heels (2 Inches or more) have tighter calves. About 13% short on the calf muscle fibres on an average was found in the calf muscle scans among the people with frequent heel wearers in comparison with the people who avoided wearing heels. A study by Journal of Experimental Biology found that high heels led to stiffer calf (Achilles) tendons.A study by Professor Marco Narici, (Manchester Metropolitan University) that involved 11 volunteers from 80 group of women who wore 5cms (2 Inches) of heel for over a period of two years had issues and struggled while walking on flat foot (Bare Foot). An MRI Scan of these volunteers showed no significant difference in length of the calf muscles in comparison with the group of women who wore flat shoes. While, an Ultra Sound scan showed shorter calf among the women who wore heels. In addition, the women who wore heels were asked to lie on their front on the couch and the researchers noticed the angle of the heel were greater due to the shortened calf. Above all these, the tendons were much thicker and stiffer among the women wearing heels than those who wore flat footwear that causes discomfort while walking on flat feet since the tendon cannot stretch sufficiently.PreventionSammy Margo, chartered physiotherapist from London says not to wear heels or flat shoes all the time but to wear variety of heel heights that can keep the muscle in right length (Anon., 2010). Secondly, the researchers and scientists have found out that performing some regular stretching activities can minimise the issue of calf muscle tightening.Stretching ExercisesStand on tiptoes on a step, and using a handrail for balance to lower their heels as far as they can and hold the position for 10 – 15 seconds.Strengthening the Tibialis anterior (Shin Muscle) muscle can be of a help (Toe Raise) for a count of 8 – 10 Repetitions 2 -3 sets a day says the Sports Scientist.TipsSelect footwear with low heels – an inch and a half or lesser while a wider heel base can be of more help; a slightly thicker heel will spread the load more evenly. Narrow, stiletto-type heels provide little support and three inch or higher heels may shorten (Tighten) the Achilles tendon.Softer insoles can reduce the impact on the knees.Selecting right size footwear is more essential. Wearing shoes that allow your body to move naturally during walking will allow your feet, legs, hips and back to stretch.Stretch your muscles as many times as possible during the day and while during rest.To conclude do not let your sense of style cripple your ability to stand or step pain-free. “Your feet are, quite literally, your base of support. If your feet aren’t happy, nothing above them will be,” says Dr. Nevins. “Take a closer look at your shoe selection and take small steps now to prevent big foot problems later.” (Nevins, 2015). In addition to all these the above exercises as a regular routine will keep the muscles in the right length and can be used as the preventive factor.ReferencesAnon., 2010. BBC News. [Online] Available at: http://www.bbc.com/news/health-10651020[Accessed 23 June 2015].Morin, M., n.d. Director of podiatric medicine, Hackensack University Medical Center: s.n.Nevins, D., 2015. American Osteopathic Association. [Online] Available at:http://www.osteopathic.org/osteopathic-health/about-your-health/health-conditions-library/womens-health/Pages/high-heels.aspx [Accessed 23 June 2015].

Foot & Heel Pain - Plantar Fasciitis

Dr. A Mohan Krishna, Orthopedist
Heel pain is an extremely common complaint, and there are several common causes.Plantar Fasciitis:  It is the most common condition that causes heel pain. Plantar fasciitis is due to irritation and inflammation of the tight tissue that forms the arch of the foot. The most common symptom is pain under the heel after a period of rest, i.e. severe pain and inability to walk in the morning after getting up from sleep. The same might happen after sitting for a long time and then trying to walk. Interestingly the pain gets better after a few steps though it may not go away completely.  Again, the pain may get worse with prolonged walking and standing. X ray may show a bony spur which may develop in long standing cases of heel pain due to plantar fasciitis, but it may not cause the symptoms.Posterior Heel Pain:  Posterior heel pain causes symptoms behind the foot, rather than underneath. Posterior heel pain causes include Achilles tendinitis and retrocalcaneal bursitis. These patients may also develop bony growth behind the heel bone and when they are large may lead to rupture of Achilles tendon. Patients may have difficulty to walk comfortably on the affected side and pain that occurs at night or while resting.Treatment Options:Not all of these treatments are appropriate for every condition, but they may be helpful in your situation.1.Rest - Avoiding the precipitating activity; for example, take a few day off jogging or prolonged standing/walking.  Rest can reduce the severity of pain and will allow the inflammation to begin to cool down.2.Ice Packs - Icing will help to diminish some of the symptoms and control the heel pain. Icing is especially helpful after an acute exacerbation of symptoms.3.Exercises and Stretches - Are designed to relax the tissues that surround the heel bone. Some simple exercises performed in the morning and evening, often help patients feel better quickly.4.Anti-Inflammatory Medications - Help to both control heel pain and decrease inflammation.5.Shoe Inserts - Are often the key to successful treatment of heel pain. The shoe inserts often permit patients to continue their routine activities without heel pain.6.Injection therapy - In some cases, corticosteroid injections are used to help reduce the inflammation and relieve pain.7.Removable walking cast - May be used to keep your foot immobile for a few weeks to allow it to rest and heal and is used only for severe cases.8.Night splint - Wearing a night splint allows you to maintain an extended stretch of the plantar fascia while sleeping. This may help reduce the morning pain experienced by some patients.9.Weight reduction – It helps to reduce stress on foot and heel and thus help to reduce the severity of pain.If, after several months of non-surgical treatment, you continue to have heel pain, surgery will be considered.Not being able to take first step out of bed in the morning can be frightening. More over severe pain from the heel may force you to restrict several day time activities. Except for a handful of cases and some uncommon conditions, most cases improve with treatment and time. Even though the time taken for the recovery may vary from person to person there is a natural tendency for these conditions to get better spontaneously.Stretching exercises:1.PLANTAR FASCIA STRETCH:Sit in a chair and cross one foot over your other knee. Grab the base of your toes and pull them back toward your leg until you feel a comfortable stretch. Hold for 10 seconds and repeat 5 to 10 times.2.ACHILLES STRETCH:Stand on forefoot at the edge of stair, reach the step below with your heel, until you feel the stretch in the arch of the foot. Hold this position for 10 seconds and repeat 5 to 10 times.3.HEEL RAISE:Stand behind the chair or any support and raise your body up onto your toes and hold for 5 seconds. Then slowly lower down yourself. Repeat 5 to 10 times.4.TOWEL PICK:Drop a towel on the ground and pick up the towel with your toes. Release and repeat 5 to 10 times.5.FROZEN CAN ROLL:Take a frozen juice can or tin, roll your feet on the can from front to back. Do it for 3 to 5 minutes.6.TOWEL STRETCH:Loop a towel around your toes and pull the foot towards your body keeping your leg straight. Hold this for 10 seconds and relax. Repeat 5 to 10 times.

10 Ways to Choose The Right Shoes

Dr. Shreedhar Archik, Orthopedist
Vincent is a young medical representative who visits my clinic every month. One day he asked me sheepishly, “Sir, my feet really hurt at the end of the day. How can I choose a right shoe which can help me deal with this pain?"There are lots of people like Vincent who either have to walk a lot or need to stand a lot while working. I observe routinely that my patients hardly pay attention to which kind of footwear they wear. There are patients who really have bad feet. They have deformities and loss of arches and what not. I tell them to go and get customised footwear. They go to the orthotics shop and come back to complain! Doc, the speciality shoe costs more than 5000 rupees! 5000 for a pair of shoe?We typically are not very keen to spend money on our footwear. Many of us buy footwear from the street vendors.If you remember the famous second law of Newton “Action and reaction are equal and opposite,”, then you will realise why the footwear is so important. Every time you strike the floor with your foot the floor will impart an equal force to your foot and thereby to your knee and the hip as well. The better cushioning you have at the sole the better it is.This is what I told Vincent:Shoes are better than chappals as they provide a 360-degree support to your feet.Always buy your shoes in the late afternoon period. Our feet are largest in size by then and what fits you in the late afternoon will fit you well.Always buy from a good store where the staff is knowledgeable.Try and bend the shoe in your hand. It should bend easily at the junction ball of your feet. It is the natural junction and if the shoe is stiff it will cause pain.Then find the “heel counter,” a stiff cup sewn into the back of the shoe to provide heel support. Squeeze this cup into the shoe. It should be very stiff and not collapse inward easily.Allow 1/2 inch (or the width of your index finger) between the end of your longest toe and the end of the shoe. If one foot is larger than the other, buy the larger size.Wear the same weight of socks you intend to use during activity. Socks with high cotton content retain moisture and cause blisters more easily. Look for socks that are made with synthetic fibres such as acrylic, polyester. It will also matter which part of the country you are from!Walk around in the shoes to determine how they feel. Is there enough room at the balls of the feet? Do the heels fit snugly, or do they pinch or slip off? Don't rationalise that the shoes just need to be "broken in." Find shoes that fit from the start.Trust your own comfort level rather than a shoe's size or description. Sizes vary between manufacturers. And no matter how comfortable an advertisement claims those shoes are, you're the real judge.You can also look at your old shoes for clues to the shape of your foot. Bring your old walking shoes with you when you shop for a new pair — most shoe professionals can give you some tips on what to buy based on the wear of your old shoes.