Taking care of our bodies should be on the top of all of our lists. One area of the body that is too often neglected is the feet. I used to work for Marriott Corporation and was required to wear suits with pumps every day. Imagine Orlando, Florida in the 98 degree heat traipsing around a resort in high heels. My feet are wide, and they have no business at all being wedged into pointed-toed shoes with high heels. It isn’t natural, and my feet protested. I vowed once I began working for myself that I would never wear uncomfortable shoes again. I have become a self-avowed Birkenstock junkie. This past weekend I attended a conference in Savannah and decided that I would forgo my usual comfortable, good-for-my-feet Birkenstocks for a pair of more stylish white sandals since I probably wouldn’t have to be on my feet as much as I usually am. That was a huge mistake. My feet have not forgiven me for it, and I am suffering a bout of plantar fasciitis as a result. I treat people with plantar fasciitis regularly, and it is no picnic.
Plantar fasciitis is a condition of the feet in which connective tissue on the plantar side, or bottom, of the foot becomes inflamed. The plantar fascia covers the muscles of the foot and acts as a sort of bridge which connects the ball of the foot to the heel while it supports the arch. When you walk, the plantar fascia is put under tension that is about twice your body weight. If your feet and legs are in good health, this normally does not create a problem. If your calf muscles are too tight or are not stretched with regularity, maximum tension is placed on the plantar fascia and it becomes inflamed. There are other causes of plantar fasciitis and they include being overweight, having sudden changes in physical activity, using shoes with no arch support, using shoes with no cushion in them while you walk on hard floors, spending too much time on your feet, and using shoes which are not flexible enough to bend at the ball of the foot.
The first sign of plantar fasciitis for most people is that they have a very difficult time taking the first few steps in the morning. This can also mimic sciatic pain, and it must be differentiated. If sciatica isn’t the offender, treatment for plantar fasciitis often is the route you need. Rest, ice, and stretching are marvelous for the pain. One of the treatments that I recommend for my patients is to take a golf ball and put it in the freezer. Once it is frozen, place it on the floor and roll it around with your foot. It hurts to do but almost always leads to relief. Stretching the calf muscles is essential to getting better. If walking or any impact-related exercise is part of your regimen, don’t even think of doing it without thoroughly stretching your leg muscles and warming them up.
If plantar fasciitis goes untreated, heel spurs often result. The heel spurs are calcium deposits in the tissue that result from extended periods of plantar fasciitis. The body’s response to injury or instability is to deposit extra calcium in an effort to stabilize the area. Many people have surgery to remove these spurs, but find that the treatment is worse than the condition itself all too often. Every surgery brings with it scar tissue which can complicate matters in an already tight space. Recovery, while it is stated to be shorter, often stretches to 6-12 months. A new and promising technique for treating heel spurs is extracorporeal shock wave therapy. One of my patients is undergoing this treatment, and I will update you on her progress. The treatment is less invasive than surgery and poses fewer risks. The downside, of course, is the expense of the treatment and the effort it takes to convince your insurance company that it is a good idea. In Canada there are podiatric clinics which cater to Americans who want to escape the high cost and offer the treatment for about one fifth the cost in domestic clinics. But they are in Canada. Maybe when the treatment is offered by more podiatrists and more competition is presented, the cost will come down. It is not a good idea to have surgery unless you can confirm with people who have had the same procedure the success rate and safety of it.
I do not like for my feet to be angry with me, and right now they are. Looking cute for a few hours on Friday definitely was not worth the aggravation of my right heel’s reminders. I am about to thumb through the Birkenstock catalog and do some serious shopping. Treat your body well.