There is very few times when a foot doctor will recommend high heels. And most Podiatrists will be very anti-heels. But I've found myself recommending certain heel heights for a specific foot problem. Heel pain comes in a variety of forms. The most common presentation of heel pain is sharp and burning on the bottom of the heel with the first steps in the morning or after prolonged rest. This may be indicative of plantar fasciitis, an inflammation of the ligament attached to the heel bone. Another common problem is pain in the back of the heel, caused by either an enlarged bone or an inflamed Achilles Tendon as it attaches to the heel.
The heel bone is the monkey in the middle when it comes to the pulling forces that occur while standing, walking, running, etc. These forces come from the Plantar Fascia, pulling along the bottom of the heel which counters the force of the Achilles Tendon pulling away and up toward the calf. There are many other muscles and ligaments attached to the heel bone, but the Plantar Fascia and the Achilles Tendon are the main players.
Most heel pain is caused by an imbalance of these pulling forces. The Achilles Tendon comes from the large muscle in the back of the calf and is a much stronger pulling force as compared to the Plantar Fascia. The Plantar Fascia is a ligament, not very elastic. The Achilles Tendon is more elastic, and the calf muscles are very elastic.
It is this elasticity of the Calf muscles and Achilles Tendon that is the main focus of why I prescribe rigorous stretching as the ultimate treatment for heel pain. Stretching is an art and needs to be perfected with diligent practice and proper technique. I have written about stretching and will continue to write on the subject.
But there are instances when stretching alone or in combination with other treatments is not enough and even fails to alleviate the symptoms even a little bit. These instances are usually a result of chronic, prolonged tightness of the Achilles Tendon and Calf muscles. Such tightness can be a result of genetic predisposition to a tight heel cord, improper fetal positioning within the womb, and prolong use of high heeled shoes.
High heels have gotten the brunt of the negative feelings and have been blamed for a multitude of foot ailments. One ailment that prolonged high-heel use does indeed cause is a shortened Achilles Tendon. The tendon adapts to the consistent position of the foot and the shortened distance from the calf to the heel. The patient who has worn heels for most of their adult lives feel most comfortable in them because of this adaptation.
I do prescribe stretching and other modalities to attempt to relax and lengthen the heel, but during these early stages of treatment, I do prescribe the use of a heel or wedge to relieve the stress on the heel. If the pain goes away while wearing heels then wear them. When the shoe gear changes from heels to flats to flip flops back to heels, the pain will start. It is a great burden on the chronically tight heel cord, Achilles Tendon, and calf muscles to switch heel heights so frequently.
Slow and steady wins the heel pain race. Injections may be warranted to treat the acute flare-ups, surgery may be necessary to lengthen the Achilles Tendon for the more recalcitrant cases, but rushing treatment will only lead to failure. Patience is more than a virtue. It is necessary when attacking this chronic problem. Stretch. Relieve the pain with anti-inflammatories, icing, soaks, raw cabbage application. And wear the high heels if that is what it takes to get through the day!
Have you ever felt a sharp pain at the tip of your great toe, noticed it was a bit swollen, red, and angry looking? And then you'd chalk it up to tigh...