Choose Your Own Heel Pain

Do you remember Choose Your Own Adventure books? The ones that would tell a story, then ask you to continue it with a choice like:

  • If you want to chase the assassins, turn to page 42.
  • If you would rather have ice cream, turn to page 80.

Often, your adventure would take some pretty big turns depending on the path you chose. Other times, however, the differences would not be as dramatic (and, like any kid, you would learn this by cheating and switching between all the choices).

In real life, the choices you make can have big consequences; but they can also end up not feeling so different on certain levels. We sometimes see this with heel pain.

For example, we may have two patients. One is an avid runner, always in motion. The other is a factory worker who spends most of their day standing at a station. If both come in for heel pain, the diagnosis may be the same: plantar fasciitis.

Now, this isn’t because plantar fasciitis is the only cause of heel pain out there. It’s one of the most common, sure, but Achilles tendinitis, bursitis, stress fractures and more afflictions are all possibilities.

So what choices led to similar fates for these two patients, and does this mean their courses of treatment would be similar as well? Let’s dive into that.

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Two Sides of the Same Page

When it comes to plantar fasciitis and other causes of heel pain, there is more than one way to bring about misery.

First, let’s take a look at plantar fasciitis itself. This common form of heel pain centers on the plantar fascia, which runs along the underside of the foot. It’s built to be durable and flexible, but too much stress placed upon this thick band of tissue can cause microtears and inflammation. That’s what can cause that terrible pain in the mornings and after long periods of inactivity.

So in each of our patients’ cases, what are the likely culprits for this damage?

In the case of the avid runner, a good place to look would be in running habits. The plantar fascia is built to take a beating. However, like the rest of our body, it needs enough rest after that beating in order to restore itself and even grow stronger. This might sound like a brutal way to go about it, but that’s literally what working out and training are all about.


Without proper recovery time, though, the light damage sustained by the plantar fascia stays and builds up, leading to eventual inflammation. This stress can build up over time, or it can come largely in a short period if you are pushing yourself faster and harder than you are currently conditioned to go.

So what about the factory worker, then. They’re not running laps around the shop floor all day, after all. What gives?

The forces that can cause heel pain are not just generated by movement. They can also result from simple physics and gravity.

Our bodies are not built to stay in one place all day. When we do, the plantar fascia is remaining largely in one position, bearing the weight of our bodies the whole time. The more we weigh, of course, the more our feet must bear.

The risks of inflammation and pain rise depending on the structure of our feet. With a normal structure, our feet may be bearing weight for a long period of time, but at the very least it’s being properly distributed. If there is an abnormality such as high or low arches, however, it can throw off the way weight is distributed and cause excess pressure in certain areas. This can hurt the plantar fascia, as well as other soft tissues.

Although these two lifestyles are different, they have led to a similar diagnosis. But what does that mean?

Not All Treatments are the Same

One thing to keep in mind when practicing medicine is that a diagnosis is never a full answer in itself. Just because you know what is ailing a patient does not automatically mean you know all the factors that are responsible for that problem.

Treating plantar fasciitis in our runner and our factory worker may take different approaches. That’s why it’s important to know your history, levels of activity and other factors when we examine your heel pain.

For our runner, we would definitely take a look at their exercise habits. Do they need to start taking more time off from running to allow for recovery? Are they focusing way too much on working the legs and feet and could spend other days cross-training? Is their footwear appropriate and supportive enough for their needs?

For our factory worker, can we make changes to where they stand? Can we add a mat to reduce stress on the feet? How about more accommodating footwear here, as well? Can there be more movement and breaks to improve matters further?

In terms of direct treatments, custom orthotics might benefit both cases if abnormal foot structure is a factor. Rest, icing, and strengthening exercises may be helpful as well, and we also offer advanced treatments such as MLS laser therapy for cases it may be effective.

The Choice for Heel Pain is Clear

Whatever path you’ve taken in life, heel pain should never be a normal part of it! Our experts at Associates in Podiatry have the knowledge and tools to get to the source of the problem and provide the relief you need.

Choose to take the first step! Give us a call at (609) 924-8333 for our Princeton office or (908) 687-5757 for our Roselle Park office. We will also be happy to answer questions and take appointment requests via our online contact form.

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