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CindySays: Pain in the heel needs time to heal

By Cindy Boggs
CHARLESTON, W.Va. -- Dear Cindy,Being a longtime walker, I attempted to kick my fitness up a notch by jogging. I did it gradually adding some short periods of running so basically it was a walk/run workout. Things seemed to be going well until I noticed a pain in my right heel. It has gotten worse and forced me to go back to walking again, and still it has not gone away. I am 42 and never had a problem with my foot before this, so is jogging out of the question for me? -- SondraDear Sondra,More than likely you are describing a fairly common overuse syndrome known as plantar fasciitis -- inflammation of the thick band of tissue that runs through the bottom of your foot and connects your heel bone to your toes. Everyone who has ever experienced that stabbing pain can relate to your question. Revving up your exercise regimen -- jogging instead of walking -- is certainly not out of the question; however, to make this problem go away, it's important to understand what made it show up in the first place.Risk factors for developing plantar fasciitis:
  • Our risk increases as we age, especially between ages 40 to 60.
  • Women are more prone to this condition than men.
  • Failing to warm up thoroughly before a run.
  • Activities that place stress on the heel and attached tissue -- running, aerobic dance, ballet.
  • Degenerative issues -- weak gastrocnemius (calf) and soleus (between the calf and Achilles' tendon), heel fat pad atrophy and/or the degeneration of the collagen fibers of the heel bone.
  • Structural issues -- flat feet, high arches or an abnormal walking pattern.
  • Spending lots of hours standing or walking on hard surfaces.
  • Obesity -- extra weight equals extra stress on your plantar fascia.
  • Wearing stiff, over-supportive shoes.
  • Wearing high-heel shoes regularly.
  • Tight gastrocnemius and/or soleus muscles.
  • Is it me?Contacting the ground with the foot misaligned can cause plantar fasciitis, which, left untreated, may progress into knee, hip or back issues. If poor mechanics is identified as the cause, seek the advice of a professional, a podiatrist or foot specialist, or this will be a chronic problem each time you resume the activity.Are you a pronator?More than likely, you are one of the above. You'll hear the terms "pronation" (inward roll of the foot) and "supination" (outward roll of the foot) when discussing proper body mechanics. Pronation is often blamed for creating plantar fasciitis though this is not the case. In fact, these terms refer to the natural rolling movement of your foot while walking or running. You would find it difficult if not impossible to walk or run without pronation and supination.However, when there is excessive pronation, it can have negative effects on the health of your feet. This is why it's important to get advice from a foot specialist and then choose shoes that can reduce excessive rolling of the feet.Are your muscles tight?While the way your foot strikes the ground during a walk or a run is definitely a factor, too often muscle imbalances are overlooked as the underlying cause. Stretching your plantar fascia gently, as well as your calf muscles and Achilles' tendon, will go a long way toward healing and preventing this painful condition.What to doFirst and foremost, because this is considered an overuse injury, you need to curb your activity and possibly stop activity to give the small tears in your fascia time to heal. This includes walking because that repetitive stress will keep it irritated and inflamed. Other recommendations include:
  • Seek advice to rule out stress fracture or pinched nerve and to check for muscle imbalances.
  • Apply ice 15 to 20 minutes three to four times a day or massage with ice by freezing a water-filled paper cup, then rolling it back and forth on the bottom of your foot for 5 to 10 minutes. Combining ice with gentle pressure will help reduce pain and inflammation.
  • Work to increase flexibility in the gastrocnemius, soleus and Achilles' tendon.
  • Avoid long periods of standing, especially on hard surfaces.
  • Don't walk barefoot on hard surfaces.
  • Eliminate any activity that includes plyometric movement, speed work or hills.
  • Toss old running shoes and buy footwear with adequate arch support and cushioned heels.
  • When you begin exercising, limit your walk/run in terms of time and intensity.
  • Build in extra recovery (nonactivity days) and gradually add activity if pain does not reoccur.
  • Cindy Boggs, fitness presenter, author and Activate America director, has been an ACE-certified instructor/trainer since 1989. Send your questions about fitness, training or health to her at YMCA of Kanawha Valley, 100 YMCA Drive, Charleston, WV 25311, or email Look for Cindy's award-winning fitness advice book, "CindySays ... You Can Find Health in Your Hectic World," at, or contact the YMCA at 304-340-3527.
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