Dr. Sam Christian

Dr. Sam Christian

Poor feet! They take us so many places. Yet, most of the times we just walk all over them. Women at least, may paint their nails. For men on the other hand, feet are the furthest things from their minds – until they really start to hurt that is.

Even then, they often suffer in silence. They accept it as part of the script that their bodies are falling apart, when in fact this is one of the easiest conditions to treat. Anybody can save somebody a whole lot of grief – just by sharing the techniques listed below.

Of all the things that can go wrong with the feet, plantar (meaning sole) fasciitis (fash –ee-eye-tis) is perhaps the most dramatic. The moment the heel touches the floor upon awakening; the pain is just short of excruciating! This is the signature symptom of this condition. The patient limps off to washroom all bent-over like a semi-invalid. By the time they finish doing their business, the stiffness seems to have worked its way out and they are working erect and almost normal again. Although heel pain persists with the impact of each step, the level is tolerable enough to focus on the activities of daily living… That is, until the saga repeats next morning.

Causes of Plantar fasciitis

The arch extends from the ball of the big toe side of the foot, gracefully upward and back down to the heel. Look at it right now. A few people are born with flat feet; or the arches may ‘fall’ during life. This condition tends to limit walking, running and overall athletic ability. In the days when most young men were gung-ho about marching off to war, the military would disqualify on the basis of flat feet.

If the group of arch bones is compared to a bow (as in bow & arrow), the ‘string’ is the plantar fascia. This is a broad band of ligament from the ball of the foot converging on the heel. For a variety of reasons, such as prolonged standing on hard surfaces and change in lifestyle involving walking uphill, the fascia becomes inflamed and swollen. Cashiers for example, are so susceptible that most businesses allow them to sit, or provide cushioned mats to stand on.

Plantar fasciitis may affect one or both feet. It is more common in the middle-aged, but can occur in younger individuals such as athletes and soldiers doing strenuous drills. Repeated strain causes small tears in the ligament resulting in pain. People whose feet roll inward when they walk (excessive pronation) are more vulnerable. Other risk factors include poor fitting shoes, overweight and tight calf muscles. Arthritis and tarsal tunnel syndrome are some of the other foot conditions, which may be confused with plantar fasciitis.

How you can treat plantar fasciitis

  • Give your feet a rest from the strenuous activity. No medicine or treatment can replace that. Get a medical excuse if you have to. 
  • Avoid prolonged standing, walking or running on hard surfaces. 
  • Ice your heel. You can find the point of most pain by pressing on you heel, usually below the ankle on the arch or inner side of the foot. 
  • Place a can on the ground and firmly roll you mid-foot on it, back and forth. This massages and relaxes the plantar fascia. Some prefer to use a tennis ball, if available. 
  • Do toe-curls by placing a towel on the ground. In the sitting or standing position, curl your toes, grasping the cloth and lifting it a bit off the ground. Hold for five seconds, then relax and repeat. Do that at least 10 times morning and evening. 
  • Do towel stretches. Pass a towel around one foot just below your toes. Pull your feet toward the knee for 5 seconds then stretch it out as far as it will go. Keep alternating these back and forth movements to loosen up the muscles of the feet and calf as well. 

If you do toe-curls and towel stretches before getting out of bed – the typical plantar fasciitis morning pain may evaporate like magic!

How your doctor treats plantar fasciitis

If you are still having problems, make an appointment for a careful foot examination. Together with a thorough medical history, it can reveal important clues to your overall health. After ensuring that you are compliant with your exercises, doctor may prescribe anti-inflammatory medication like Ibuprofen or Diclofenac. X-rays are ordered only if necessary. A special kind of taping to support the plantar fascia may be applied, with or without ultrasound treatment. Occasionally there may be need for a steroid injection. The above treatments are usually quite effective. The need for surgery is rare.

Happy feet

You are not falling apart. Whether you have plantar fasciitis or not, it is a good thing from time to time to pamper you feet. Give them a 15-minute soak in warm water. Add perhaps a bit of Epsom salts or sulphur. Scrub well, dry, massage with Vaseline, castor or coconut oil or your favorite fragrant lotion. No greater love is there than giving this treatment to the one you care for. Roll your ankles, wiggle your toes; shake the tension out of your feet. You may even be doing that right now, even as we speak?

A little attention is all it takes. Get a professional foot exam once a year (required for diabetics). Proper nail trimming is essential as we work harder or grow older. Ask your doctor to check for poor circulation, calluses, warts, bunions, hammertoes, ingrown toenails, athlete’s foot and other things that can spoil you day. Stop being embarrassed about you feet. You have places to go. Bring happy feet along with you!

Dr. Sam Christian is surgeon who runs the Urgent Care on 137 Bath Road. It offers general medical care, office surgery, acupuncture and foot care. He is Medical Adviser to the Dominica Cancer Society and author of the faith and fitness nutrition book, ‘Mannafast Miracle.’ Dr. Christian can be reached at 440-9133 or by writing to urgentcare.da@gmail.com.