Self-Help for Painful Heels

If you have heel pain, your podiatrist or physical therapist can confirm a plantar fasciitis diagnosis. Often the condition eventually goes away on its own, according to physical therapist Jim Johnson, PT, a clinical instructor at Emory University Hospital, but since this can take months, you'll want to know what you can do to alleviate pain and hasten healing. What helps…

• Stretch the plantar fascia. Do this before getting out of bed and twice more during the day, continuing until symptoms are gone. Sit on the edge of your bed or in a chair and rest the ankle of the affected foot on the opposite knee. With either hand, grasp the base of the toes and gently pull the toes back toward the shin until you feel a stretch through the sole. Hold for 10 seconds...rest...repeat 10 times. For detailed instructions and illustrations, see Johnson's book, The 5-Minute Plantar Fasciitis Solution.
  
• Stretch your calves. Increasing calf muscle flexibility helps support the plantar fascia.
  

Four times daily: Stand on the bottom step of a stairway, facing the stairs and holding the railing. Place the ball of each foot on the edge of the step so your heels hang off. Keeping knees straight, slowly lower your heels until you feel a mild stretch in your calves. Hold for 20 seconds...rest...repeat three more times.

• Use shoe inserts that support the arch and cushion the heel. These change the way your feet sit in shoes, reducing stress on the feet as you stand or walk. The inserts sold at drugstores for about $15 to $20 generally work as well as more expensive custom-made inserts, Johnson noted. Put inserts in both shoes even if only one heel hurts and use them daily for eight to 12 weeks.
  
• Wear a night splint. Tissues in the sole tend to constrict and tighten at night, which is why plantar fasciitis patients often experience pain upon arising in the morning. The night splint, which looks like a big plastic boot, prevents constriction by keeping the ankle and foot at a 90° angle overnight, Johnson explained. Unless you have pain in both feet, it's OK to wear just one splint. Use it nightly for 12 weeks. Night splints start at about $40 and are sold at medical-supply stores and online (for instance, check www.footsmart.com/c-night-splints-20.aspx).
  

Johnson advised that surgery on the plantar fascia be considered only as a last resort. And even then, beware—surgery can cause the arch to drop and compromise foot stability and there is no conclusive evidence that it helps. A better medical treatment option to try is extracorporeal shockwave therapy, in which a machine sends ultrasonic waves through the sole, causing micro-injuries that are thought to increase the flow of blood and healing nutrients to the tissues. Fortunately, though, for most patients the aforementioned self-help techniques are enough to make heel pain a thing of the past.