Wednesday, July 3, 2013

Twinkle Toes

Whenever I use that saying, one image comes to mind:

I love The Flintstones

While this is more amusing then anything else I can think of, it's not quite what I meant.

I'm talking about sore feet.  I'm not an expert by any means, (and my information on this post comes from the internet and personal experience, always consult your Dr. for diagnosis and professional assessment)

For as long as I could remember, my feet always hurt.  I remember going on a school trip that involved A LOT of walking and after half way, being in so much pain that I could barely make one more step.

I also remember the family Dr. encouraging my mom to have me pick up things, like a pencil, with my toes to strengthen those muscles.

For the past 8 years, I have been a receptionist at an orthotics clinic.  A good number of our clientele have a diagnosis of plantar fasciitis, also known as heel or bone spur.

Plantar Fasciitis

Plantar Fasciitis is caused by excessive pull of the soft tissue (plantar fascia) on the bottom of your foot.  This unwanted pull leads to inflammation of the plantar fascia and is perceived as sever pain and is amplified with each step.  Often it is worst first thing in the morning (or long periods of rest) and gradually gets better as the day goes on.

Some contribution factors to the development of plantar fasciitis can include:

  • being overweight
  • if you walk, run or stand for long periods of time, especially on hard surfaces.
  • if you have very flat feet or high arches
  • poor supportive footwear (worn out shoes, flip flops, high heel or flats)
  • tight calf muscles 
There are a number of treatment options for plantar fasciitis, a few which can be done at home.

  • Rest - reduce or avoid running, excessive walking and prolonged standing
  • Ice - this can be done with a chilled can of pop or frozen bottle of water and slowly running your foot over it, concentrating on the painful area for 10 minutes, 2 - 4 times a day.  AVOID HEAT
  • Weight Control - maintaining a healthy body weight is helpful throughout treatment
  • Footwear - try to wear supportive shoes that are cushioned, lace up with stiff soles. and have good arch support
  • Custom Foot Orthoses - this is a custom removable footbed to replace the one in your existing shoe, placing your foot in it's proper position.
  • Oral medication or cortisone injections - an anti inflammatory, such as Aleve, can be helpful, a cortisone injection would come from your doctor.
  • Night Splint - a device meant to put your foot in a stretch position that is worn at night in bed (think plastic ski boot) and there are a number of options and styles.
  • Stretching exercises - some simple exercises to stretch the inflamed area that can be done at home.  Doing them twice a day is beneficial.
IMPORTANT: These stretching exercises should not cause pain, but rather a pulling feeling. Try to do each exercise 2 or 3 times during the day; not necessarily all in one sitting.

Heel pain exercises: before getting out of bed

Plantar Fasciitis causes many people to experience intense heel pain in the morning, when taking the first steps after getting out of bed. This pain comes from the tightening of the plantar fascia that occurs during sleep. Stretching or massaging the plantar fascia before standing up will help reduce heel pain.
Plantar Fasciitis Foot Stretch1) Before sitting up, Stretch your foot by flexing it up and down 10 times.
2) While seated, roll a rolling pin or tennis ball with the arch of your foot. If you are able to, progress to doing this exercise while you are standing up.
After these exercises, put on your shoes (with orthotics inside them) or wear supportive sandals. Do not start the day walking barefoot on hard floors or tiles, or your heel pain will return.

Heel pain relief exercises: during the day

Calf Stretchheel pain exercise-calf stretch

Stand facing a wall with your hands on the wall at about eye level. Put the leg you want to stretch about a step behind your other leg.  Keeping your back heel on the floor, bend your front knee until you feel a stretch in the back leg.
Hold the stretch for 15 to 20 seconds. Repeat 4 times.

Achilles Tendon Stretch

heel pain exercise - achilles tendon stretchStand on a step as shown. Slowly let your heels down over the edge of the step as you relax your calf muscles.
Hold the stretch for about 15 to 20 seconds, then tighten your calf muscle a little to bring your heel back up to the level of the step. Repeat 4 times.

Hamstring Stretchheel pain exercise-hamstring stretch

Extend one leg in front of you with the foot flexed. Bend your other knee and lean back slightly. Your pelvis should be tilted forward. Keep your upper body upright as you hold the stretch for 10-20 seconds, then switch sides.
You should feel the stretch up the back of your extended leg (all the way up your calf and thigh).

Marble Lifts

plantar fasciitis exercise-toe marble lifts
Place marbles on the floor next to a cup, as shown. Using your toes, try to lift the marbles up from the floor and deposit them in the cup. Repeat exercise 15 times.

Plantar fasciitis exercise-towel stretch

Towel Stretch

Grab a rolled towel at both ends, holding it under the ball of your foot. Gently pull the towel toward you while keeping your knee straight. Hold this position for 15 to 20 seconds. Repeat 4 times.

Original source for exercises can be found here

At our clinic, we made our custom orthoses on site from start to finish.  We take a plaster cast of your foot, build the orthotics off of that mould.  This allows us to easily make adjustments.

When you get new orthoses, we suggest you break them in slowly, just like you would new shoes.  An hour today, two hours tomorrow, etc.


  1. Okay were you snooping on me yesterday? I was back at the physiotherapist yesterday as my PF has flared up again in my left foot, so has the Sinus Tarsus as well.... sigh my feet are a mess! My problem is VERY tight and muscular calves.... I've got calves a man would be jealous of! Speaking from personal experience... I've done all of the above treatments and I would avoid the cortisone injections if you can. I had a bad case in my right foot years ago and the sports Dr. did several cortisone injections which led to me partially tearing the PF in my right foot! That put me off of any activity for a year! Also a cortisone injection into the heel of the foot is the most painful thing I have ever experienced! And I've got a good tolerance for pain... like screaming into the pillow painful! People should be aware that multiple cortisone injections will cause a break down/weakening/dammage of tendons and ligaments. Something I didn't know back then... I would use that as a last option and I wouldn't do it more than once or twice.

    I recommend a good physiotherapist!

    We did try an experimental treatment in my right food called prolotherapy, it is injection of saline into the dammaged ligaments. This kick starts a healing cycle and the ligaments start to produce new collagen. Since I had prolotherapy and lost weight I've never had trouble with my right foot again. I'm seeing my Sports Dr again on Sat and I'm going to ask him about Prolotherapy for my left foot for both conditions, I'm also willing to try a Cortisone injection in the Sinus Tarsus a second time but no more than that (and no where near painful like the PF).

    Gosh I feel like I"m an expert on foot problems!

  2. Amy- I am passing along this blog entry to my mother-in-law, who jokes with me about finding a store somewhere that will sell me new knees and her new feet! I know what my problems are, but she seems to just have bad feet. I hope she gets some good insight from this and maybe asks her doctor about seeing a specialist for some further info!!

    Thanks girly!!