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Foot problem hard to bear
Plantar fasciitis causes enormous heel pain

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Date published: 6/3/2007

The first step each morning is excruciating.

The sufferer keeps his heel up as he hobbles to the bathroom, and often can't put weight on the bottom of the foot until well after his shower is over.

"It's agony," said Dr. Ilene Terrell, a podiatrist.

Odds are, a friend might tell the sufferer that he has a heel spur.

And that may be true.

But a heel spur doesn't cause pain.

The pain comes from the plantar fascia, which connects the ball and heel of the foot.

"Plantar fasciitis is the number one thing I treat in adults," said Terrell, who owns Foot Doctor of the Rapphannock in Fredericksburg.

Pain is the first symptom.

Sufferers feel pain--typically at the front and bottom of the heel--that is worse when getting up after a night's sleep, at the end of the day, after driving or sitting for an extended period of time. But the pain can extend the entire length of the foot. It may come and go. It can range from uncomfortable to downright debilitating.

pain lasts months, years

For Marian McCabe, 62, of Fredericksburg, it came on the first time more than a decade ago, after a long, rapid walk along the streets of Dublin, Ireland, in a pair of sandals.

"Several days later, I felt like I had a pebble in my shoe," McCabe said. "I kept shaking out the shoe, but there was nothing there. And it just got worse and worse."

A doctor recommended a cortisone shot, but McCabe declined. Six months of physical therapy and orthotic inserts in her shoes cured that first bout. But it struck her other foot about two years ago, again after a long walk in non-supportive sandals.

"You'd think I'd have learned," she said.

Physical therapy, ice and stretching helped resolve the most recent case--along with a night splint, which keeps the plantar fascia stretched while a person sleeps. But this time, it took about 18 months for her to heal.

Stafford's Julie Paris, 35, wasn't so lucky. She's been dealing with plantar fasciitis in her right foot for about seven years. She thinks she originally injured the plantar fascia when she was in sixth grade and a dancer.

She's done cortisone shots, physical therapy, and a newer treatment called Extracorporeal Shock Wave Therapy that uses sound waves to stimulate healing.

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Plantar fasciitis is a painful inflammation of the plantar fascia, the band of tissue that connects the heel bone to the base of the toes. As a person's foot hits the ground, the plantar fascia goes from most relaxed and shortest to most stretched-out. Excessive wear can trigger the condition and cause a related problem, heel spurs.

People at risk for it include:

runners, walkers and those starting new exercise programs

people with flat feet or high- arched feet

those who stand for long periods of time.