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Painful First Steps – What’s the Cause?

From a dead sleep the sound of “Piano Riff’ came from my iPhone at my bedside. I tried to ignore it but the noise just would not stop. I looked at the clock, not even 5 am PST. It was just my luck on a Monday after a long weekend. Reluctantly, I answered the call.

Before I could even get my disgruntled hello out of my mouth, the voice on the other end chimed. It was one of my oldest and dearest friends on the other end. In a panic he said,” I think I blew out my Achilles tendon!!” Then he continued. “I woke up this morning to go to work, took a few painful steps and dropped to my knees. After a few minutes I made my way to the shower and let some hot water over my heel. It started to feel better but I am still in pain.” “What should I do?”

“First of all calm down and before you give yourself some sort of exotic condition, let’s talk. I said ever so calmly.

From this point forward, I am going to address my dear friend as Joe. Yes, that is not his real name (to protect his confidentiality).

I explained to Joe that is going to be hard to give a proper diagnosis over the phone. This is when I went into Podiatrist mode and tried to get more information from Joe.

Q: “Describe the pain to me?”

A: “Sharp and throbbing.”

Q: “Where on your foot does it hurt?

A: “On the bottom near the heel and the arch.”

Then it is most probably not an Achilles Tendon Tear.

Q: ”Have you ever had this before?”

A: ”No, never. This is the first time and it really hurt.”

Q: ”Do you have any idea how you got this injury; did you increase activity? Buy new shoes or what not?”

A: “Nothing I can recall. We have been preparing the house for Thanksgiving guests and we started hanging our Christmas lights over the weekend. “

Q: “But, no trauma?”

A: “No, everything was fine. I went to bed last night, no problems. When I woke this morning I took a step and felt this sharp pain. I took another step and the pain increased and by the third step I was on the floor.”

I then told him that what he is describing sounds a lot like a common condition called Plantar Fasciitis. One of the hallmarks of Plantar Fasciitis is pain after rest. It is quite common that my patients will tell me that they experience this heel pain after a drive in the car, after sitting through a movie and yes first thing in the morning. My patients also often admit to slight relief from the pain after a few steps.

Plantar fasciitis itself is a simple Latin term. Plantar fasciitis breaks down as follows; “Plantar” meaning bottom, “fascia” meaning rope and “itis”, which means inflammation. So, Plantar Fasciitis is literally inflammation of the rope on the bottom of your foot.

Nothing to panic about and this is fairly common. Plantar fasciitis affect approximately 10% of the population and can be treated with numerous conservative measures. I emphasized that diagnosis over the phone is hard and it is vital that he makes an appointment with his Podiatrist as soon as possible, just in case it is something more severe.

Knowing Joe as long I do, I left him with this: Rest, stretch, ice your heel and take some Motrin but get to your doctor.

Salutations were said and we hung up our phones.

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