Healing the heels
By: Altaf Patel
While buying the next pair of shoes, you must carry a pair of your own socks, ribbed for comfort.
Several years ago I suffered from an ailment called plantar fascitis. It is basically inflammation of the deep fascia of the sole causing pain on the inner heel particularly after waking up. This was the direct result of tread milling which initiates or aggravates the condition.
The inflammation of the plantar fasciais often associated with a spur formation on the heel bone. Inessence the spur is the body’s response to protect the heel and is in no way the cause of pain –in fact it results from the fascial inflammation. I once had a lengthy conversation with an orthopedic surgeon who explained that long before inserts were developed, the gentry had the inner portion of the heel of the shoes elevated by 3/8 inches or so especially if there was an inequality of lower limb length (also called medial float) to give comfort and maintain equality. He insists that the origin of the term well heeled starts here.
There is no real effective therapy for plantar fascitis. Drugs and diathermy are marginally helpful. Lithotripsy has been tried with variable results. Injection of platelet-rich plasma or making cuts in the fascia to release tension and improve circulation has also been tried with some success. But since it is a condition that you are unlikely to die of, most physicians reassure you of the benignity of the condition and no great research in the development of medication is made.
One of the important causes of this condition is ill-fitting shoes. Running shoes have more cushioning on the fore foot with no lateral stability, while walking shoes have stiff rubber to support the heels. If you do want to use the same pair as an all purpose pair, then they should have a firm heel, be light-weight and you should not be able to bend the shoe easily. This is only recommended for casual exercise. You need to change your shoes every 400 miles if you are a runner and if you are a casual exerciser then once every six months. It is also imperative that you choose your shoes in the evening when the foot is at its largest size. You need to measure length, width and arch length. Most stores now have the standard Brannock device or the metal plate measuring length of your feet. It is also important to know if you have a flat or high arched foot. Sophisticated biomechanical pads give you an exact print out of your foot to help.
A commonly useful test is the wet test that looks at the imprint of the wet foot on a surface. Normal feet have a normal sized arch and will have a forefoot connected to the heel by a broad band. The flat foot leaves an imprint of the full sole of the foot.
Ahigh-arched foot leaves a wet imprint of the fore foot with a narrow band or none connecting it to the heel and unlike the flat foot it doesn’t roll inwards (pronate) enough. In that case, you would require cushioned shoes and should avoid shoes that reduce foot mobility. If you have flat foot, you would require high stability shoes with firm soles to reduce the degree of pronation.
When you buy shoes, you must carry a pair of your own socks, ribbed for comfort especially if your feet pains. There should be one finger space between the tip of the great toe and the end of the shoe and you should be able to wriggle your toes comfortably. If you find a hard spot, try another pair. Remember you should feel extremely comfortable when you put them on. Do not buy them with the idea that they will break in with time. That is not going to happen.
On the other hand, there are diametrically opposite view points. Some believe that walking barefoot helps the pad of fat on the heel to increase and provide natural cushioning. Barefoot running has been known throughout human history. Olympic runners such as Zole Budd, Abebe Bikila and Bruce Tulloh all ran barefoot. However, there is no real scientific consensus about this.
Let me put in a word against high heels. They affect the balance of the body putting strain on various ligaments of the foot. In addition, repeated use may cause calluses and corns and shortening of the tendon behind the ankles – the achilles tendon of the heel. Curling inside of the great toe may cause a hammer toe. Since the weight of the body is balanced on a heel, the back tends to come out to maintain balance causing back problems as well. Worse still are stilettos. Needless to say, a lot of heel and ankle pain is the result of high heels and they are to be discouraged. Flip flops are not to be encouraged either, they offer no arch support or heel cushioning and the foot makes a constant effort to hold the flip flop to the sole as you raise your foot, causing unnecessary foot strain. If you must wear something like this then wear something with a strap behind the heel which is a wee bit better.
Arch supports though recommended and other similar devices are out of scope of this article and one should consult a qualified podiatrist regarding this. Now the next time you need to buy footwear - in particular forsports , you are well informed how to go about it.
While buying the next pair of shoes, you must carry a pair of your own socks, ribbed for comfort.
Several years ago I suffered from an ailment called plantar fascitis. It is basically inflammation of the deep fascia of the sole causing pain on the inner heel particularly after waking up. This was the direct result of tread milling which initiates or aggravates the condition.
Various opinions and several orthotic inserts later when I was still suffering, my colleagues injected my sole with steroids to relieve me of the excruciating pain. Foolishly, I was again back on the treadmill only to relapse. With three steroid shots I was only marginally better and in desperation called up my student, a consultant rheumatologist in the United Kingdom. His well meaning advice resulted in my flying there to consult a podiatrist. This speciality is still in its infancy in India. He provided me with a tailor-made insert lifting the inner side of my heel.
The inflammation of the plantar fasciais often associated with a spur formation on the heel bone. In
There is no real effective therapy for plantar fascitis. Drugs and diathermy are marginally helpful. Lithotripsy has been tried with variable results. Injection of platelet-rich plasma or making cuts in the fascia to release tension and improve circulation has also been tried with some success. But since it is a condition that you are unlikely to die of, most physicians reassure you of the benignity of the condition and no great research in the development of medication is made.
One of the important causes of this condition is ill-fitting shoes. Running shoes have more cushioning on the fore foot with no lateral stability, while walking shoes have stiff rubber to support the heels. If you do want to use the same pair as an all purpose pair, then they should have a firm heel, be light-weight and you should not be able to bend the shoe easily. This is only recommended for casual exercise. You need to change your shoes every 400 miles if you are a runner and if you are a casual exerciser then once every six months. It is also imperative that you choose your shoes in the evening when the foot is at its largest size. You need to measure length, width and arch length. Most stores now have the standard Brannock device or the metal plate measuring length of your feet. It is also important to know if you have a flat or high arched foot. Sophisticated biomechanical pads give you an exact print out of your foot to help.
A commonly useful test is the wet test that looks at the imprint of the wet foot on a surface. Normal feet have a normal sized arch and will have a forefoot connected to the heel by a broad band. The flat foot leaves an imprint of the full sole of the foot.
Ahigh-arched foot leaves a wet imprint of the fore foot with a narrow band or none connecting it to the heel and unlike the flat foot it doesn’t roll inwards (pronate) enough. In that case, you would require cushioned shoes and should avoid shoes that reduce foot mobility. If you have flat foot, you would require high stability shoes with firm soles to reduce the degree of pronation.
When you buy shoes, you must carry a pair of your own socks, ribbed for comfort especially if your feet pains. There should be one finger space between the tip of the great toe and the end of the shoe and you should be able to wriggle your toes comfortably. If you find a hard spot, try another pair. Remember you should feel extremely comfortable when you put them on. Do not buy them with the idea that they will break in with time. That is not going to happen.
On the other hand, there are diametrically opposite view points. Some believe that walking barefoot helps the pad of fat on the heel to increase and provide natural cushioning. Barefoot running has been known throughout human history. Olympic runners such as Zole Budd, Abebe Bikila and Bruce Tulloh all ran barefoot. However, there is no real scientific consensus about this.
Let me put in a word against high heels. They affect the balance of the body putting strain on various ligaments of the foot. In addition, repeated use may cause calluses and corns and shortening of the tendon behind the ankles – the achilles tendon of the heel. Curling inside of the great toe may cause a hammer toe. Since the weight of the body is balanced on a heel, the back tends to come out to maintain balance causing back problems as well. Worse still are stilettos. Needless to say, a lot of heel and ankle pain is the result of high heels and they are to be discouraged. Flip flops are not to be encouraged either, they offer no arch support or heel cushioning and the foot makes a constant effort to hold the flip flop to the sole as you raise your foot, causing unnecessary foot strain. If you must wear something like this then wear something with a strap behind the heel which is a wee bit better.
Arch supports though recommended and other similar devices are out of scope of this article and one should consult a qualified podiatrist regarding this. Now the next time you need to buy footwear - in particular for
Disclaimer: The views expressed here are the author's own. The opinions and facts expressed here do not reflect the views of Mirror and Mirror does not assume any responsibility or liability for the same.
