If you limp to the bathroom first thing in the morning because of a sharp pain in your heel, the likely reason is plantar fascia damage. Let's explains why it happens, and how to treat it.

The plantar fascia is an elastic band that starts at your heel and goes along the bottom of your foot. If the band is short, you will have high arches, if it is long, you may have flat feet. A pad of fat at the heel covers this elastic band to help absorb the shock when walking. As we age, the plantar fascia gradually loses its elasticity. The fat pad on the heel also becomes thinner and cannot absorb as much shock as before. Stress on the foot may cause the plantar fascia to be injured resulting in tears which may cause pain, bruises or swelling.

• Jogging, dancing or climbing stairs places much stress on the heel bone and the attached tissue.
• Wearing improper shoes may also cause heel pain. Shoes that are stiff, thin-soled, and loose or lack arch support are not able to absorb shock well. Wearing high heels regularly can also strain the tissue around the heel.
• Being flat-footed or having a high arch can affect weight distribution and thus overstress the plantar fascia.
• Other factors include obesity, pregnancy, standing or walking on hard surfaces for long periods of time due to work

Heel pain may also be due to less common factors like nerve damage, rheumatoid arthritis or long term use of corticosteroid injection. Therefore, if self-care measures appear ineffective after two months, or if the pain worsens, or if you have medical conditions such as diabetes, you should see your family doctor or a podiatrist.

Self-care treatments

• Try stretching exercises to stretch the plantar fascia and Achilles tendon or strengthen lower leg muscles to stabilize your ankle and heel.

Roll the foot over a tennis ball.

Pick up marbles with toes.

Stand straight with your hands against a wall. Put the injured leg behind your other leg. Keep your heels flat on the floor before slowly bending both knees. You should feel the stretch in the lower part of your leg. Hold the stretch for 10 to 14 seconds. Repeat the stretch 6-8 times.

Stand on the balls of your feet at the edge of a step and rise as high as possible on your toes. Relax between toe raises and let your heels fall a little lower than the edge of the step.

Use insoles or soft-heeled footwear

Use off-the-shelf or customized arch supports

- Apply ice on the painful area for 1520 minutes 3 to 4 times a day or after activity to reduce inflammation

Prevention

• Avoid high impact activities such as running and switch to non-impact sports like cycling or swimming

• Reduce body weight

Treatment

• Use a splint at night on the calf and foot to hold the plantar fascia and Achilles tendon in a lengthened position overnight for more effective stretching.
• Use medication e.g. anti-inflammatory painkillers.
• Your doctor may recommend other treatment methods such as using extracorporeal shock wave therapy to stimulate healing, or surgery to detach the plantar fascia from the heel bone if the condition is severe.

Heel pain is preventable. Untreated heel pain may result in a long-term condition that could affect your daily activities. It may cause foot, knee, hip or back problems by changing your walking motion and posture. Do not ignore it.