Pain in bottom of heel while walking

You wake up ready to start your week. You hop out of bed to begin your morning routine and bam – an excruciating pain radiates from the bottom of your foot and heel and you can hardly put weight on it. You walk it out for a few minutes and then all feels fine.

This is often how plantar fasciitis strikes - after a long period of rest, such as sleeping or after a long car ride. It also may show up suddenly after exercising or doing another activity. If you’ve ever experienced pain in the bottom of your heel, you may have plantar fasciitis.

According to the American Academy of Orthopaedic Surgeons, approximately 2 million people are treated for plantar fasciitis each year. It happens when the plantar fascia – the long, thin band of tissue that supports the arch of your foot – becomes inflamed or irritated. It’s the most common cause of heel pain.

The plantar fascia’s function is to absorb the strain and stress we put on our feet as we go about our daily lives. Over time, or when too much pressure is put on the feet, the tissues can become damaged or even tear. This injury causes inflammation, resulting in stiffening of the plantar fascia. Heel pain is the primary symptom.

Risk Factors

Although most cases of plantar fasciitis have no specific cause, there are factors that may make you more likely to develop it.

• Tight calf muscles making it hard to flex your foot up
• High arches
• Obesity
• Participating in sports that involve repetitive impact, such as running
• Doing a new or increased activity

If you experience pain in your heel, an orthopaedic surgeon can help determine the cause of the pain. Your orthopaedist will examine your foot and discuss your symptoms and concerns with you. X-rays and other imaging tests are usually ordered to help diagnose plantar fasciitis or determine if the heel pain is caused by a different problem. In some individuals, arthritis or a fracture may be the cause of heel pain. Once a diagnosis is confirmed, your orthopaedist will recommend a treatment plan. Most people with plantar fasciitis see improvement within months of beginning non-surgical treatment methods.

• Rest
• Ice
• Medications
• Exercise and stretches
• Cortisone injections
• Supportive shoes and/or orthotics
• Night splints
• Physical therapy

If the non-surgical treatments do not provide you with effective relief after a year or so, surgery may be considered.

Surgical options for plantar fasciitis include:

• Plantar fascia release: In this procedure, tension is relieved in the tissue by making a partial cut in the plantar fascia ligament. This surgery is appropriate for those who have a normal range of motion in the ankle but continued heel pain.
• Gastrocnemius recession: This procedure consists of lengthening one of the two calf (gastrocnemius) muscles and is recommended for individuals who may still have difficulty flexing their feet after completing a non-surgical regimen of stretches.

Either procedure can be done using a traditional, open incision or a smaller incision and an endoscope. You and your surgeon would decide which method is appropriate for you.

Don’t let plantar fasciitis keep you down. Relief is possible. See your health care provider and get the relief you need to put the spring back in your step.

Dr. Patrick Barousse is a surgeon with North Oaks Orthopaedic Specialty Center who specializes in diseases and injuries of the foot and ankle. Click here to learn more about foot and ankle care.

You're headed out on your morning walk or jog when—ouch—the area beneath or behind your heel starts to throb. Join the club: Roughly 40% of Americans complain of the issue each year, according to a survey from the American Podiatric Medical Association. "The wrong shoes, repetitive strain, and natural aging processes can all contribute to heel pain," says Christina Long, DO, a podiatrist at Wake Forest Baptist Medical Center in Winston-Salem, NC.

(The Walk Your Way to Better Health plan combines the power of interval walking with simple walking techniques and strength moves that work your upper and lower body, leaving you slimmer and stronger!)

What can you do to ease the discomfort? First, learn the reason behind it—and then follow these expert guidelines to sidestep the pain. (Here are 9 highly effective solutions for heel pain.)

1. Plantar Fasciitis

There's a reason it's bad in the morning, explains Megan Leahy, DPM, a podiatrist at the Illinois Bone and Joint Institute in Chicago. "As you're sleeping, your arch goes back up to its natural position along with your plantar fascia, but when you take a step first thing, it stretches out again and causes micro tears that create a lot of pain," Leahy says. There's a long list of issues that may set the stage for plantar fasciitis, including a tight calf muscle or Achilles tendon, wearing shoes that don't offer enough arch support (bye-bye, ballet flats!), having flat feet, increasing your physical activity too quickly instead of gradually building up, and good old-fashioned wear and tear, says Leahy. (Here's 5 possible reasons your feet hurt.) 

How to treat it: To ease the pain, you can take an over-the-counter anti-inflammatory, such as ibuprofen, and ice the area. "Freeze a bottle or cup full of water, and roll it on the bottom of your foot," suggests Long. To prevent more irritation, rest your foot as much as possible and wear supportive shoes. "You need to replace your shoes at least every 6 months, or 4 months if you run or walk every day," says Long.

MORE: 10 Exercises That Burn More Calories Than Running

Stretching your calves and feet loosens the muscles, which can ease the pressure on the plantar fascia. Incorporate these two stretches into your daily routine:

• Towel stretch: Sit with your legs straight in front of you. Place a rolled towel around the ball of one foot, holding the two ends with each hand. Gently pull the foot toward you, holding for 15 to 30 seconds. Switch sides.

• Heel raise on the stair: Stand on a bottom stair. Move your feet back so that your heels fall off of the edge. Holding the wall or rail for support, shift your weight to one foot and lower that heel toward the floor. Hold for 15 to 30 seconds. Switch sides.

Ache bothering you for more than a few weeks? See a doctor, who can rule out underlying issues, such as a heel spur, a bony formation on the bottom of your heel that can worsen inflammation. He or she may also suggest that you wear a splint while you sleep to stretch out the calf and support your foot. (Here are some more heel stretches to help ease your pain.)

2. Fat Pad Atrophy 
Over the course of a lifetime, our feet step more than 100,000 miles. So it's no wonder that the natural cushioning eventually wears down, like the tread on the bottom of your sneakers. Thinner fat pads increase the pressure on your heel—a reason why it's the second most common cause of heel pain, according to a study published in the Annals of Rehabilitation Medicine.

How to treat it: Rest, ice, and anti-inflammatory medicine can temporarily quell the throbbing, but providing the right support can prevent it altogether. Skip the high heels or flats, and opt for a pair of supportive shoes. You may want to a wear a heel lift, suggests Long. These inserts transfer some of your weight to the front of your foot, relieving pressure on your heel. Treading carefully can also help. Try walking or running on a soft surface, such as grass or a track instead of pavement, and avoid high-impact activities, like jumping.

MORE: Your 10 Biggest Walking Pains, Solved

3. Achilles Tendinitis

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