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Oh, my aching heel

By TOM VALEO
Published May 30, 2006

Your feet contain 26 bones, 33 joints and more than 100 tendons. As you age, your bones tend to thin, your joints to stiffen, and your tendons to lose some of their elasticity.

It means that, sooner or later, your feet are likely to give you trouble.

For many people, "sooner" means plantar fasciitis, an ailment that can hobble the heartiest walker.

Although it is more common among older people, plantar fasciitis pronounced fash-ee-EYE-tus also plagues long-distance runners of any age. As they pound their heels on the pavement, they accumulate microscopic tears in the tendons of their feet. The resulting inflammation causes the tendons to become stiff and inflamed during sleeping hours, so the first few steps these runners take after getting out of bed often produce a sharp pain in the heel.

Runners can stop running and rest their feet, which almost always cures the problem (at least temporarily).

Older people, however, who have a thinner pad of flesh under their heels, and whose tendons are becoming less elastic because of age, may have to take more drastic action to prevent and cure plantar fasciitis.

The first step should be to buy shoes with plenty of cushioning and support.

"Sneakers tend to give the best support in the heel and the arch," said Dr. Cary Zinkin, a podiatrist in Deerfield Beach and a marathon runner. (He's also a spokesman for the American Podiatric Medical Association.)

"They provide good shock absorption, and they keep the heel in the proper position. A good running shoe will cost around $75 to $100."

Some people may need an orthotic insert for their shoes to provide even more arch support and heel cushioning, the doctor said.

Zinkin wears running shoes at home and at work, as well as when he runs. He also stretches his feet, to keep the tendons flexible and supple. Nonrunners, especially as they get older, would benefit from the practice, he said.

To stretch the tendons that attach to the heel, face a wall and stand with one foot about 3 feet in front of the other. Bend the knee of the forward leg, supporting yourself by placing your hands against the wall.

"You should feel the stretch in your midcalf," said Zinkin. "Stretch gently for 10 to 15 seconds - don't bounce - and repeat six to eight times with each leg."

Walking barefoot on a hard surface, especially if you've recently gained weight, invites plantar fasciitis, Zinkin said.

That's how he developed his own case.

"In the past year I gained some weight and found myself standing barefoot on the tile floor in the kitchen cooking a lot," he said. "My heels started to hurt, and I knew exactly why."

Now he wears an old pair of running shoes around the house, and the pain has disappeared.

If heel pain develops, an anti-inflammatory such as ibuprofen, aspirin or acetaminophen will usually help, he added. If that doesn't do the job, an injection or two of a steroid should reduce the inflammation and the pain.

Plantar fasciitis goes away on its own in about 80 percent of cases, but treatment can speed healing, especially if started immediately.

So if your heels start to hurt when you get up in the morning, see a doctor.

And if you have plantar fasciitis, remember that you have plenty of company, says the doctor:

"About 2-million cases a year are treated in this country."

Tom Valeo is a freelancer specializing in health issues. Write to him c/o Seniority, the St. Petersburg Times, P.O. Box 1121, St. Petersburg, FL 33731 or e-mail features@sptimes.com.

[Last modified May 30, 2006, 07:28:39]