The Sports Doctor Heel Pain Might Be Plantar Fasciitis

By MiChael l groSS Md

Many professional athletes have had plantar fasciitis. It is a common injury among athletes, especially those who engage in high-impact activities, such as running, jumping, and walking on hard surfaces. Most recently, we saw Tiger Woods pull out of the final round of the Masters, due to an excruciating episode of plantar fasciitis. Some other well-known athletes, who have had plantar fasciitis include: David Beckham, a retired professional soccer player; the late Kobe Bryant, a retired professional basketball player; Rafael Nadal, a professional tennis player; Ryan Howard, a retired professional baseball player; Steve Nash, a retired professional basketball player; Peyton Manning, a retired professional football player; Alex Rodriguez, a retired professional baseball player; and Serena Williams, a professional tennis player.

It’s worth noting that this list is not exhaustive, and many other professional athletes have likely had plantar fasciitis at some point in their careers. Please also notice that this list runs the gamut of professional sports from golf to football. No sport and no athlete is immune, and athletes at every level of participation can be affected.

Plantar fasciitis is a common condition that causes pain in the bottom of the foot, specifically in the area of the plantar fascia, a band of fascia or connective tissue that runs from the front of the heel bone to the toes. This condition is often caused by overuse or strain on the plantar fascia, which can result from a variety of factors such as increased weight, high arches or flat feet, tight calf muscles and high-impact activities like running. It is also more common in people who are on their feet for long periods of time, such as those who work in retail or healthcare.

The most common symptom of plantar fasciitis is pain in the heel or bottom of the foot that is worse when first getting out of bed in the morning or after sitting for a long period of time. Foot pain the first time your foot hits the floor in the morning is the hallmark of plantar fasciitis. The pain may also be worse after standing or walking for long periods of time, or after participating in high-impact activities.

If you are experiencing pain in the bottom of your foot that you suspect may be plantar fasciitis, it is important to seek the advice of a healthcare professional. A thorough history and physical examination will usually be enough to make the diagnosis. X-rays can confirm the diagnosis by showing a “spur” on the front of the heel bone, or calcaneus. In fact, plantar fasciitis is also referred to as “heel spur syndrome.”

The first stage of treatment for plantar fasciitis often involves a combination of rest, ice, stretching and exercises to strengthen the muscles in the foot and calf. Rolling your foot on a frozen bottle can stretch your foot and ice it at the same time. Treatment may also involve the use of orthotic inserts or special shoes to help alleviate pressure on the plantar fascia. If plantar fasciitis is suspected, do not go barefoot in the house (socks don’t count). I have found that a specific shoe, Dansko Clogs, can be very helpful if worn first thing in the morning. Over-the-counter pain medication and NSAIDs may also be recommended to help reduce pain and inflammation.

In severe cases, more aggressive treatment may be necessary, such as corticosteroid injections or physical therapy. Treatment with high intensity ultrasound has been useful in many cases. In rare cases, surgery may be necessary to release the plantar fascia if other treatment options have not been successful.

Preventing plantar fasciitis involves taking steps to reduce the strain on the plantar fascia, such as wearing properly fitting shoes with good arch support; avoiding high-impact activities if you are prone to the condition; and stretching the calf muscles regularly. It is also important to maintain a healthy weight and to avoid standing or walking for long periods of time, if possible.

With proper treatment and prevention measures, it is often possible to alleviate the pain and discomfort associated with this condition and to prevent it from recurring.

Michael L. Gross, MD is the founder of Active Orthopedic and Sports Medicine in Hackensack. He is the section chief of sports medicine at Hackensack/Meridian University Medical Center and an assistant professor at Hackensack Meridian School of Medicine.