Pain In Heels During Night

Hey, this is Sock Doc. And today I’m goingto talk about plantar fasciitis, a common problem that many people have, painin their foot, pain in the heel. Typically, it’s worse as you get upin the morning and step down out of bed. People get a sharp pain in their heel,sometimes more towards the arch of their foot. And actually it tendsto get better as you walk throughout the day, only to wake up the nextday and have the pain result all over again. It keeps people from walking. It keeps peoplefrom running and a lot of

discomfort in the foot. So it’s importantto realize that like with most issues, most ailments, most injuries it’s importantto diagnose why you have something rather than what have. So obviouslyif you have pain on the bottom of your foot, someone might diagnosethat as plantar fasciitis, as heel pain, or as arch pain, but why did youget that? Plantar fasciitis is often from a weaknessin the lower leg muscles as well as foot muscles that are the result of muscleimbalances caused from too much stress in someone’s life. That can befrom too much physical stress.

Either someone who is overtraining, an athletetraining too hard, too often, too high a heart rate, racing too much.Or someone who doesn’t even work out at all, but they’re standing on theirfeet and causing some pain and muscle imbalances because they’re basicallyworking too hard, maybe too many hours in the office, dealing with kidsat home, too many life stresses, or they’re eating improperly, too. So overall excessive stress in someone’s lifewill actually have a reflection on the lower leg muscles, yourcalf muscles, and your foot

muscles, and cause the connective tissueat the bottom of your foot to tighten up and your plantar fascia will startto hurt and pull on where it attaches to your heel. The next thing youknow you’ve got plantar fasciitis. So here’s some things you can do that aremost likely different than what you have been taught to do for plantar fascia.First, we don’t want to stretch the plantar fascia because when youstretch a muscle or stretch an injury you’re stretch connective tissue, youelongate the fibers.

What you want to do is bring those back togetherso they heal quicker. So stretching is going to delay the injury. Whatyou want to do is look for trigger points, especially down the inside of yourtibia bone which is your shin bone. Run your thumb down the inside of thattibia bone and look for tender spots throughout the leg coming all the waydown, especially where it attaches to the arch of your foot. So here, all the way up on the inside of thistibia bone, not back here on your calf. So you’re not coming this way,but you’re coming in like that.

Also, behind the calf in here and in here.Feel any trigger points? Then work them out. Hold them, squeeze them. Youcan move your foot a little bit and basically rub them out. You really shouldn’tbe very sore at all, but the point is that the muscle imbalances arein here. The injury is more in here even though it’s felt here in yourheel. You also want to strengthen your foot, andyou’re going to strengthen your foot by starting to do some exercises suchas a simple towel exercise, crunching up your toes like this, crunchingup a towel really squeezing

Using a Night Splint for Heel Pain

For this patient, she has chronic heel pain,so we’re going to dispense a night splint for her.Interesting things about night splints, is what they’re supposed to dois just put a gentle stretch on the ligament that’s causing the heel pain, the plantarfasciitis. By itself, in studies it works about 65% ofthe time without doing anything else, so it’s a pretty effective treatment forheel pain and we use it quite frequently. This device, how you put this one on is firstof all, we fit the forefoot. We leave the top unstrapped but we make theforefoot kind of snug –

we use the straps to kind of grip the forefoot.Then, we have the patient bring their toes all the way up as far as they can –toes to nose. Then we adjust the posterior strap.The posterior strap is to hold the ankle at 90 degrees,nd right here we have a little scale on this device.This scale, this is an adjustable strap so you can pull it up a little higher,or you can put it down a little lower, all the way to minimum.But we recommend most people start at 90. The reason that we don’t start with it anyhigher is because what happens is

it becomes uncomfortable and they’ll takeit off after a short period of time. What we want them to do is wear it all nightif they can, with a nice easy, gentle stretch. To take it on and off, we don’t readjustthe Velcro, because the Velcro gets loose and doesn’t work anymore. So we just take it off like a cowboy boot.Now, to put it on, it’s the same way. We put it on like a cowboy boot, just slideit on to the foot and pull the ankle straps up and then off to bed.We recommend sometimes that the patient use a pillow between their legsif they sleep on their sides if this bothers

their foot.If you use a pillow it makes it a little more comfortable.That also is a little tip for back pain – if you use a pillow between your knees,a lot of times that will help your back pain. Other things that are interesting about thisdevice is you can walk on it. It’s got some little sticky pads here soyou won’t slip. Or, you can just take it off if you have toget up at night to use the restroom, just take it off. If you come back, and you’retired of it, don’t wear it. That’s okay. Wearing it for 3 or 4 hours is good enough,but 8 is better.

This is a very handy device that we use fora lot of our patients for heel pain, and we recommend it highly here at the Next StepFoot and Ankle . Thanks for watching!.

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