Oh, My Aching Feet
Plantar fasciitis is a common condition among golfers.
The condition is characterised by sharp pain at the bottom of the heels. The pain feels worse after getting out of bed in the morning or after sitting for long periods of time. The pain decreases as the individual continues to walk and the ligaments “warm up”, only to become painful again after excessive standing or walking.
Plantar fasciitis is caused by inflammation of the plantar fascia – the connective tissue or ligaments -on the heels of the feet. These ligaments can be compared to rubber bands that stretch and contract as we walk. As individuals get older, and potentially spend a lot of time on their feet, the ligaments start to lose elasticity, flexibility, and become stiff. Additional risk factors for developing plantar fasciitis include:
- Walking with feet pronated (where the feet roll inward)
- Being overweight
- Wearing shoes that do not fit well
- Having a tight Achilles tendon and/or calf muscle
Plantar fasciitis can be diagnosed with a physical exam and a thorough history of the symptoms. The physician may order an x-ray of the feet in order to rule out other possible diagnoses that can cause similar symptoms such as stress fractures or a bone cyst.
Sufferers must accept that treating and preventing future episodes of plantar fasciitis takes time and effort. However, if diligent, patients should experience relief in three weeks to a few months. Strategies that are used to treat plantar fasciitis include:
- Resting and wearing supportive shoes at all times. This allows the ligaments the time and support needed for the inflammation to settle down and the small tears to heal.
- Applying ice or cold packs to the heels, which discourages inflammation
- Taking a non-steroidal-anti-inflammatory medication (NSAID) such us ibuprofen or naproxen. In addition to being a pain reliever, NSAIDS decrease inflammation. It’s important to ensure these medications are taken with food as they can irritate the stomach.
- Stretching the area of the heel and calf by taking a long towel and holding one end in each hand. Place the centre of the towel over the ball of the foot. With your knee straight, pull your foot back towards you using the towel and the muscle on the front of your leg. Pull back and hold for 10 seconds. Relax and repeat for five to 10 minutes. Stretch this area many times a day, especially first thing in the morning, to alleviate stiffness and improve flexibility. The aim is to stretch the ligaments, tendons (such as the Achilles), and calf muscles.
- Massage the heels of the feet with tools such as an Eslon pipe, tennis ball, or golf ball
- Weight reduction for those with a body mass index greater than 26
- Most golfers like to select golf shoes with hard soles that provide greater balance and increase the speed of one’s swing. Consideration should be given to placing a gel shoe insert, allowing for greater support while walking on fairways and floors, but without negatively impacting one’s swing.
- Choose shoes with good arch support
Stretching, purchasing appropriate footwear, and maintaining a healthy weight should be adopted regardless of whether or not one is experiencing the symptoms of plantar fasciitis. Taking good care of yourself helps prevent many chronic conditions, not just plantar fasciitis.
Dr Chathchai Pookarnjanamorakot is an orthopaedic surgeon at Samitivej Sukhumvit Hospital.
