In our daily work as endocrinologists, we often advise our diabetic patients to “exercise more to help control their blood sugar! . Then there is another question: can the patient exercise?
The topic of this issue, “heel pain,” is one of the culprits that often prevents people, especially diabetics, from exercising, and even affects their daily lives. (Recently, it was publicly reported that the famous host of the TV show “Do Not Disturb” was suffering from heel pain!)
Q: What is heel pain?
The most common cause of heel pain is plantar fasciitis, and if bone spurs are present, it is collectively referred to as bone spur syndrome. Heel pain can also be caused by other etiologies such as pressure fractures, tendonitis, arthritis, nerve irritation, or in rare cases, cysts. Therefore, it is important to diagnose the etiology of heel pain.
Q: What is plantar fasciitis?
Plantar fasciitis is an inflammation of the thick band of tissue that runs across the bottom of the foot and connects the toes to the heel bone. The pain is usually noticeable in the first step of the morning, and will be significantly reduced after activity; if you stand up suddenly after a long period of standing or sitting, the pain will increase again. It is mostly seen in runners, overweight people, or people who wear unsuitable shoes. Symptoms are.
(1)heel pain
(2) Arch pain
(3) Pain increases when the heel is lifted
(4) Pain that can last for several months
Q: What is the cause of plantar fasciitis?
Under normal circumstances, the plantar fascia supports the arch of the foot like a shock-absorbing bowstring. If there is too much pressure on the arch string, there can be small tears in the plantar fascia. Repeated stretches and tears can then cause fascial pain and inflammation in.
(1) The most common cause is a structural defect in the foot, such as high arches or flat feet, or even abnormal walking patterns, which can lead to abnormal weight distribution, allowing increased pressure on the plantar fascia in the standing position, leading to plantar fasciitis
(2) Age: most likely to occur between the ages of 40 and 60
(3) Type of exercise: Exercise increases the pressure on the heel and fascial tissue, such as long-distance running, ballet, and aerobics
(4) Obesity: excess weight makes too much pressure on the plantar fascia
(5) Occupation: Factory workers, teachers, or other jobs that involve walking or standing all the time can damage the plantar fascia
Q: What are the complications of plantar fasciitis?
Neglecting fasciitis may lead to chronic heel pain that hinders normal life. Improving the way you walk can reduce fascial pain and delay secondary problems in the foot, knee, hip and back.
Q: What are some of the things a patient should do to prepare for a visit to the doctor?
(1) Describe your symptoms in detail
(2) Your family medical history
(3) All medications and supplements you are using
(4) Medical questions you want to ask
Q: What are some of the questions that doctors ask patients?
(1) Is there a particular point in time when the pain occurs?
(2) What kind of shoes do you usually wear?
(3) Do you run a lot or do you play similar sports?
(4) Do you have any experience with foot injuries?
(5) Besides your feet, what other places do you have pain?
(6) What can you do to reduce your pain?
Q: What are the tests and diagnoses needed for plantar fasciitis?
The diagnosis of heel pain or plantar fasciitis is often based on a medical history and physical examination only, and no other special tests are needed. Your doctor will examine the pressure points on your feet, as the location of the pain can help determine the cause. Occasionally your doctor will recommend an x-ray or MRI, which is done to make sure your pain is not due to another cause, such as a pressure fracture or nerve compression. Sometimes an x-ray will show a bone spur on the heel bone (in the past, bone spurs often caused heel pain and needed to be surgically removed. However, many people with bone spurs do not have pain in the heel bone)
Q: What are the treatments and medications for plantar fasciitis?
(A) Conservative treatment
1. medications: painkillers such as ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve) can relieve the pain and inflammation associated with plantar fasciitis
2. Stretching and strengthening exercises, or the use of special equipment, including.
(1) Physical therapy, where a physical therapist can guide you through a series of plantar fascia and Achilles tendon stretching exercises, and lower extremity muscle strengthening exercises, which can help stabilize the ankle and heel. Or use exercise tape to support the bottom of the foot
(2) Splints at night. Splints can help stretch your calves and arches while you sleep and help stretch the plantar fascia
(3) orthopedic appliances, your doctor will prescribe you to use off-the-shelf heel cups, insoles, or special custom-made arch support devices, which will eventually make your plantar pressure even
3. Reduce walking
(B) Surgery or other methods
1, hormone injection: can temporarily relieve pain. Multiple injections are not recommended because plantar fasciitis is still aggravated without pain, and when the fat pad on the heel bone contracts, it may even break the fascia
2.Extracorporeal ultrasound therapy: Ultrasound acts directly on the area of heel pain to stimulate healing. It is usually used when other conservative treatments do not work. Side effects include bruising, swelling, pain, numbness or tingling, and the effects do not last
3. Surgery: Rarely will anyone need surgery to separate the plantar fascia from the heel. It should only be considered when the pain is very severe and other methods are not effective. The side effect is that the arch support will be weakened
(C) Lifestyle adjustments
1. Maintain a healthy weight: minimizes the pressure on your plantar fascia
2, choose shoes with support: avoid high heels, buy low to medium heels, good arch support, good shock absorption
3.Do not walk barefoot, especially on hard surfaces
4, can not wear worn out sports shoes shoes: before the shoe can not support your arch, hurry up and change! If you insist on running or walking, please 500 miles (804.65 km, that is, 10,000 steps a day, about 3 and a half months to replace a new pair of sports shoes!)
5, change the type of exercise: try low-impact sports, such as swimming and cycling, rather than walking or jogging
6.Use ice.
(1) after exercise with a cloth wrapped in ice on the pain area, 15-20 minutes each time, 3-4 times a day;
(2) ice massage: fill a paper cup with water and freeze it, then roll and massage in the uncomfortable part for 5-7 minutes, which can reduce pain and inflammation
7, stretch the arch: simple home exercises can stretch the plantar fascia, Achilles tendon (Achilles tendon) and calf muscles
(1) hold each stretch for at least 30 seconds, repeat 1 to 2 times, do not jump, do 1 or 2 times a day. Stand as shown: straighten back and press down on your heels. Move your hips forward until your calves are completely straight. Change legs and repeat
(2) Top right figure tip: While sitting, you can grab your toes and gently stretch until you feel the arch of your foot stretch. Do not do both feet at the same time
(3) Lower right: Place a roll of towels or plastic bottles on the floor, then step on them and pull the towels with your toes and hands to stretch the arch tendons. Do not do both feet at the same time
(iv) Long-term care
No matter what treatment you use, remember that the cause of plantar fasciitis is still there! It needs your continuous attention. Wearing supportive shoes, stretching, and using specially tailored insoles may all be things that need to be done in the long term.