Why Age?

Plantar Fasciitis - The Achilles Heel Of Ageing

May 25, 2009 – 7:41 pm | by admin

For me it was during a session of kickboxing. As I returned a foot to the floor after kicking the bag, I felt the sensation I came to know from my investigations as “stone bruise”. A perfect description for the acute pain that shot from my heel.

Maybe for you it began as you swung your legs out of bed to start the day and you had to hobble to the bathroom because you could not put weight on one heel. I assumed I had bruised my heel from pounding my naked feet on the floor over and over as I practised my kicks.

The trouble was, it didn’t get better despite laying off kicks in the gym. In fact, it got worse. At first the problem was no more than heel pain first thing in the morning that rapidly disappeared as I went about my personal training business. Then it became chronic, and I realised I had to do something about it. I’ve spent several months treating it and I’m happy to announce I have it on the run and want to share my experience with you and perhaps help you too.

Firstly, I did what most of us do in this information age. I googled “heel pain”, somehow knowing plantar fasciitis would pop up because my mother suffered it and I tend to reprise her ailments.

Now, heel pain points to other conditions as well, so ultimately one should seek medical advice but I figured I would tackle this on my own first. Ah, yes - there was plantar fasciitis in all its painful glory - affecting the middle-aged (me, and many of you), those with flat or excessively-arched feet (mine are pancakes), and those who spend a lot of time on their feet on hard surfaces (my feet ache just thinking about how long I spend on them).

The plantar fascia is the strong and tight tendon that runs from the heel to the balls and toes of the feet and supports our foot arches. When it becomes inflamed, due to degeneration of the fat pads of the feet as we age, excess wear and tear, biomechanical faults that lead to abnormal pronantion (rolling out of the foot) or possibly a combination of all three, the result is the same - heel pain.

Treatment? Here is the bit that really interested me, because I needed to get past this pain so I could get back to all the things that make life enjoyable for me. like kickboxing, dancing, and most of all, not hobbling around in pain most of the time.

I did not particularly want to spend lots of money or experience anything particularly invasive, both surgically or pharmaceutically so I ran down the list of treatments and put them in the “No way”, “I’ll try that”, and “Yes - that sounds good” categories:

No Way!

Non-steroidal anti-inflammatory drugs - To me, these treat the symptom and don’t address the problem.

Corticosteroids - As above, especially as the disclaimer accompanying their use was - “Repeated steroid injections may result in rupture of the plantar fasciia.” Clearly not a desirable outcome.

Ultrasound - It is ineffective, apparently.

Prolotherapy - Even though the prestigious Mayo Clinic endorses this treatment, the injection of non-pharmaceutical and inactive material to treat pain and strengthen connective tissue did not appeal.

Extracorporeal shockwave therapy (ESWT) I just skimmed over the description of this one, knowing it was not for me. It inflames the area to increase the healing benefits of increased blood flow.

Local anaesthesia - Repeated injections can lead to (ouch, here it comes) pain, bleeding, neuritis and infection. No thanks.

Most of these treatments are for long term plantar fasciitis that has not responded to other procedures design to heal connective tissue. I have had plenty of injuries and fixed them over time with more homespun remedies like rest, stretching, icing and heat so surely these would help?

I’ll Try That

Ah, yes, good old R.I.C.E (Rest, Ice, Compression, Elevation) popped up.

 Heel inserts. I’d had some custom-made through a chiropractor before - they cost $400 and broke down after several months but I spotted some off-the-shelf ones for a tenth of the price and gave them a go. It seems so many of us experience heel pain that there is a strong need for this product. Mine have arch support and, after several days of wear were quite comfortable.

Ice - My old friend. I always keep ice cubes in the freezer and often find myself dumping two trays of them into a hand towel and wrapping them around sore bits. This time I started a regular evening routine of wrapping the ice-filled towel around my ankle and balancing my heel over the iceberg, rocking and pressing. What relief! It’s usually recomended that you only ice for 15 to 20 minutes but I did it for hours, figuring the thicker skin under the heel could take it.

Heat - I have treated so many injuries with intermittent heat and ice that I used this technique for my sore heel. It’s usually only your dominant foot that develops the complaint. I find heat plasters very effective so took to wrapping one I cut to size under my heel and wore it all day, then reverted to ice at night.

The nice thing about the heat plaster is even if you discontinue it, your shoe insert will have absorbed the heating medium (capsicum oil in my case) and will provide residual comforting heat for days afterwards.

Yes, I’ll try that

One suggestion I found intriguing was to freeze a water bottle or paper cup of water and roll that under the foot and heel, providing icing and massage at the same time. I didn’t get a chance to try that because I spent 10 days in Thailand and took advantage of cheap massage to have foot massage one day, traditional Thai massage the next. The traditional is fantastic, the foot massage a disappointment - just a skin polish really.

When I got back I tried massaging the underside of my foot with my own hands, then remembered the rolling frozen water bottle (or frozen can of orange juice in another suggestion). I cast around for an object I could use to massage my own foot and heel and came up with a decorative glass egg made from ground beach glass that I had bought on a previous trip to - you guessed it - Thailand.

Bingo! By securing it in the folds of a towel and rocking, rolling and pressing my foot on it I gave myself the best foot massage I have ever had. By this stage my heel pain had improved quite a bit but recovery had plateaued. Egg massage gave me almost instant relief. It was painful at first, to find sore areas and press on them but the round shape of the egg allowed lots of possibilities. The broader cross section placed transverse across the heel and arch was ideal for rolling, placing it longitudinally was ideal for rocking, and using the pointier end was ideal for pressing.

It may be a coincidence that my plantar fasciitis was healing as I took the glass egg cure, but I don’t think so. Stone or pebble massage has a long tradition in various cultures. I had visions of Captain Cook having his debilitating sciatica being cured in one long 24-hour session by Tongan women who tapped, pounded and massaged his lower back and buttock area with river stones. He declared himself cured afterwards and never suffered from it again.

I consider myself cured but still wear my shoe inserts, and roll that blessed glass egg under my stockinged or bare foot as required. That’s usually after boxing, dancing or being on my feet for a long time. It’s good to be back on them with minimal discomfort.

Look around your home for a rounded object for self-treatment. It could be a golf ball, stone, or pebble. Put it in the freezer for a while, heat it in a pan of simmering water, or coat it in liniment and go to work. Study the anatomy of the foot and visualise the broad, fleshy insertion of your tendon as it meets the heel.

Don’t neglect the other non-invasive therapies but I really think this one is the breakthrough as it allows you to use the pressure you can tolerate on the areas you know need it most.

Good luck!