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Heel pain can be treated (11-19-99)

A pain in the foot, especially in the heel, can cause tremendous discomfort. The condition known as plantar fasciitis makes the simplest movement painful.

"The plantar fascia is the support beam of the foot; itís similar to a ligament but its purpose is to connect the bone and tissue. When something damages it, tiny microscopic tears can result, causing any weight on the heel to be uncomfortable," says orthopaedic surgeon Robert Schenck, M.D., associate professor of orthopaedics at The University of Texas Health Science Center at San Antonio. "The microscopic tears are usually the result of wearing ill-fitting shoes, standing for an extended period on hard floors and weight gain."

Most people probably wouldnít think much of gaining 10 or 20 pounds, but thatís a lot of extra weight feet have to bear. "Your foot takes a lot of pounding every day and those tiny tears are telling you something is wrong," says Dr. Schenck.

The treatment for plantar fasciitis is relatively simple. Dr. Schenck recommends buying shoes with good support and using heel cups. Another option is taking over-the-counter anti-inflammatory medicines or other newer prescription medicines.

"Whenever you have a tear, it heals with the chord shortening," he says. "Stretching helps lengthen the chord." Stretching is especially vital for exercise buffs.

A good stretching exercise consists of standing on the ball of the foot on the edge of a step, holding onto the railing and slowly dropping the heel down until one feels a stretch in the back of the calf. Holding this for 30 seconds and repeating the exercise four times a day is recommended.

If the pain persists and the medications and stretching donít result in improvement, steroid injections are the next step of treatment. The final alternative is surgery, but it is the very last resort, Dr. Schenck says. "For the most part, plantar fasciitis can be treated effectively and easily," he says. "Thatís the good news, but it takes diligence on the patientís part."

Contact: Myong Covert