Persons suffering from plantar fasciitis, sharp pain in the heel that is usually worse on the first step out of bed in the morning, often feel frustrated when symptoms persist for 6 to 12 months or longer. Most doctors advise a conservative approach, however, noting that symptoms eventually get better regardless of treatment.

One study of 237 patients with plantar fasciitis found that 80 percent were satisfied with treatment that involved anti-inflammatory medications, stretching, night splints and custom or prefabricated arch supports. Only 10 percent had surgery.
[SOURCE: Stephen F. Conti and Deepak K. Jain, “Managing Plantar Fasciitis and Other Heel Pain,” The Journal of Musculoskeletal Medicine, October, 2004]

Big Toe Carries Heavy Load
                                                                                                           

The big toe withstands 40 to 60 percent of body weight with each step–about twice the load of the other toes. During vigorous running or jumping, this load can increase to as much as eight times body weight, putting football, soccer and basketball athletes at risk of injuries such as turf toe.

Turf toe involves damage to the capsule in which the toe joint is housed. The risk is highest when athletes compete on hard, artificial surfaces in light, flexible shoes, such as those used for soccer. Turf toe may require several weeks’ rest. According to one study, about half of persons with turf toe injuries were still feeling symptoms five years later.
[SOURCE: Blake Ohlson, “Turf Toe,” emedicine from WebMD CME, last updated March 21, 2005]

Does Heel Pain Get You Down? 
                                                                                               

Do you have a stabbing pain in the heel when you walk across the floor in bare feet? Heel pain is a common problem among recreational athletes, often leading them to abandon their regular routines. Heel pain can develop when a runner or walker tries to do too much too soon, or it can be a result of wearing the wrong shoes. Inadequate support at the arch can cause repeated tearing of tissues in the heel. To provide the stability the foot needs, an athletic shoe should bend at the toes and not in the middle. When you have pain in the heel, or anywhere else in the body, it's crucial to decrease or eliminate your usual activity until the pain subsides. 
[SOURCE: "Heel Pain Epidemic Afflicts Weekend Athletes," Podiatry Management, November-December, 2002]

Don’t Guess Your Shoe Size
                                                                                                

Getting a correct fit is essential when buying shoes, particularly shoes used for execise. The fact that you wore a size 9 when you were age 18 does not mean that’s your size today. Feet change in size, even over a relatively short period. And sizes vary according to manufacture. Try on the shoe and walk or run in it briefly to see how it feels. There should be a thumb’s width between the front of your big toe and the end of the shoe, and the heel should not slip when you walk. You should be able to wriggle all of your toes inside the shoe. Don’t buy shoes made for the opposite sex. There are differences in shape and structure that are reflected in shoes sold for men and women.
[SOURCE: Christina Frank, “10 tips for choosing athletic shoes,” WebMD feature, reviewed by Brunilda Nazario, M.D.]

Don't Suffer Sore Feet
                                                                                                           

Sore feet are no fun...and not normal at any age. On the other hand, the structure of the foot changes with aging and certain age-related diseases such as diabetes and cardiovascular disease can make the foot more susceptible to injury. Chronic foot pain can change a person's gait and lead to knee, hip and lower back pain, making it difficult to exercise and thereby increasing the risk of additional health problems. Whereas hip and knee replacements have become relatively common, foot and ankle problems that limit mobility often lead to nursing home placement. Early treatment is important. 
[SOURCE: Bryan C. Markinson, "Three-Step Approach to In-Office Assessment of the Geriatric Foot," Geriatrics, November, 2001]

Heel Cups Least Effective Treatment
                                                                                   

Heel cups have often been recommended to treat heel pain caused by plantar fasciitis. Theoretically, they ease tension on the inflamed ligament by lifting the heel, and they provide a soft cushion to absorb impact. In a survey of 411 patients with plantar fasciitis, however, heel cups were ranked as the least effective of 12 treatment options. As one doctor put it, heel cups may be more effective for “treating patients with fat pad syndrome and heel bruises than patients with plantar fasciitis.”
[SOURCE: Craig S. Young, M.D., Darin S. Rutherford, M.D., Mark W. Niedfeldt, M.D., “Treatment of Plantar Fasciitis,” American Family Physician, February 1, 2001]

If It Feels Good, Wear It
                                                                                                           

If you’re a runner, walker, dancer or spend a lot of time on your feet, you may benefit from wearing custom or prefabricated orthotics in your shoes either to prevent or treat foot and leg problems. These shoe inserts are designed to support the arch and correct biomechanical imbalances that may be putting undue stress on joints and muscles.

One study conducted for the Canadian military found that when subjects were allowed to choose their inserts on the basis of comfort, they tended to make wise choices. Subjects using any of six prefabricated inserts for four months had 40 percent fewer foot or leg injuries than subjects who did not use inserts. A previous study by the same author concluded that comfort was a reliable reflection of how well the orthotic device was functioning in changing the mechanics of the foot.
[SOURCE: Cary Groner, “Orthosis Symbiosis–Clinicians Are Finding a Middle Ground in the Debate over Custom versus Prefab Foot Orthoses,” Biomechanics, May 1, 2005]

If You Break a Toe...
                                                                                                                       

A broken toe is not necessarily disabling, but if you suffer a painful injury that you think might be a fracture, it’s important to see a doctor right away. In the meantime, apply ice to reduce the swelling, take antiinflammatory pain killers, wear a wide shoe with a stiff sole and try to keep your weight off the affected foot.

About 75 percent of fractures occur in the smaller four toes, and these rarely require a cast. Proper treatment is needed, however, to prevent deformities in the bony structure of the foot and recurring arthritic pain.
[SOURCE: American Academy of Orthopaedic Surgeons, “Toe and Forefoot Structures,” December, 2001]


Midsole: EVA versus Polyurethane
                                                                                   

A prospective buyer should make careful note of the cushioning in the fore- and mid-sole of an athletic shoe. If this cushioning is made of EVA, it will offer lightweight cushioning and flexibility–best for athletes who are after speed and agility but who do not have a foot style requiring motion control. Polyurethane is a denser and more durable material that will hold up better over time and provide more stability for athletes who are heavier or pronate.
[SOURCE: “Tennis Shoe Buyer’s Guide,” dicksportinggoods.com]

Prevent Fractures with Arch Supports                                                                                     


When you land from a jump, a stress greater than five times body weight is placed on the tiny bones and ligaments of your feet. If you're a weekend athlete who jumps frequently, the accumulated stress can eventually result in a stress fracture. A recent study found that basketball players wearing arch supports had significantly reduced stress on the fifth metatarsal, a small bone running along the top outside edge of the foot. Based on these results, the author, orthopedic surgeon Dr. Joseph Guettler of Royal Oak, MI, believes arch supports would help prevent stress fractures in recreational as well as college and professional athletes, particularly those with flat feet or high arches. 
[SOURCE: Ira Dreyfuss, "Study: Arch Support May Ward Off Injury," Associated Press Health, April 4, 2004]

The Right Shoe for the Right Sport

Athletic shoes today are designed for specific sports. Running shoes, for example, provide cushioning and motion control, but they lack the lateral stability that is needed for basketball or tennis. To avoid injury, wear the right shoe for the right sport. [SOURCE: Jim Morelli, “Twist and Shout: How To Minimize Ankle Sprains,” WebMD feature, 2000]

Use the Wet Test when Buying Shoes
                                                                                   

When buying shoes for sports or exercise, you should take into account your foot type–whether you pronate, supinate or have a neutral stride. Athletes who pronate need motion control shoes with denser material on the inside of the shoe to keep the foot from turning inward with each stride. Those who supinate need less support and more flexibility. One way of determining your foot type is through the “wet test.” Get your feet wet and then walk on dry pavement or a piece of brown paper. If you pronate and have relatively flat arches, your wet foot print will be relatively wide. If you supinate, there will be a large gap on the inside from the big toe to the heel.
[SOURCE: Wendy Bumgardner, “Walking Shoe Guide,” About.com, updated July 30, 2007]
 

When Your Feet Swell in the Air
                                                                                               

Even an athlete can experience foot swelling during a long airline flight, and it’s usually nothing to worry about. The swelling can be attributed to lower air pressure in the cabin, dehydration and prolonged sitting in a position that causes blood to pool in the leg veins. If you have hypertension or are taking certain medications, the swelling may be worse.

The best prevention is drinking plenty of non-alcoholic fluids, wearing clothes that fit loosely around the waist, elevating your feet and legs whenever possible, rotating your ankles frequently and getting up and walking at least once an hour.
Excessive swelling, particularly if it occurs in one leg only and is accompanied by pain, could be a sign of deep vein thrombosis or a blood clot in the leg–a condition requiring medical attention.
[SOURCE: “Foot swelling during air travel: a concern?” MayoClinic.com, January 15, 2007]

Why Is Heel Pain Worse in Morning?
                                                                                   

If you feel a sharp stabbing pain every morning when you step out of bed, you probably have plantar fasciitis, inflammation of the ligament that passes along the bottom of your foot. The pain may subside after a few steps but returns later in the day or when you’re feeling tired.

The reason it hurts worse in the morning is that the tissues tighten up during the night and the first step in the morning rapidly stretches the inflamed tissue. The solution is to stretch your foot and ankle and maybe even massage the heel before getting out of bed. And don’t walk in bare feet. Have a pair of supportive slippers or shoes handy and use them immediately.
[SOURCE: “Why Does My Plantar Fasciitis Hurt Most When I Get Out of Bed in the Morning?” Prevention, January, 2004]

Work Out in High Heels? No

Workouts in skimpy outfits and high heeled shoes, featured recently at some health clubs, might feel and look sexy but they are not healthy for knee, ankle and feet joints. A woman wearing narrow high heeled shoes either for work or play is putting herself at risk of bunions, hammer toes and other painful and unsightly foot problems. In addition, a high heeled shoe forces the foot into a position that takes away most of its usefulness in absorbing shock while adding little cushioning of its own. By forcing the calf and thigh muscles to contract, the shoe places extra stress on the knee joint. [SOURCE: Marc Darrow, “The Functioning Knee,” WebMD Medical Reference from The Knee Sourcebook,” 2002.]