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If you have pain in the back, inside of your arch, especially when getting out of bed in the morning or getting up from sitting, the structure that is feeling that pain is the plantar fascia.

The plantar fascia is a thick band of connective tissue that attaches from the inside of the heel to the balls of the foot. Plantar fascia’s “job” is to support the arch of your foot, as well as provide stability, power and shock absorption while you walk, run or jump or during any weight bearing activity.

The pain that you are experiencing at the back/inside of the heel is due to an irritation of the plantar fascia at the point where it inserts into the heel. The plantar fascia can become painful for a number of reasons: flat feet, excessively high arches, starting a new weight-bearing activity like running, jumping or prolonged walking. These can all cause undue stress and finally irritation of the plantar fascia. When the plantar fascia becomes irritated, it tends to shorten when you are sitting or lying down.

Tight calf muscles and limited big toe motion can also lead to plantar fascia irritation, since they both create improper walking mechanics leading to undue stress to the plantar fascia.

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The road to getting back on your feet without pain starts with getting a private, free screen from our physical therapists, who will listen to the problems you are having and tell you how we can resolve your heel/arch pain.

Here is a look at the process of helping reduce the pain:

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  • One of the physical therapists will watch you walk and stand with and without shoes to see if you are in the correct shoe (and shoe size) for your foot type.
  • The physical therapists will determine if you have flat feet, high arches or something in-between that is contributing to your heel/arch pain.
  • They will resolve your tissue tightness and irritation to allow for competing healing and return to activity.
  • The physical therapist will instruct you in the proper stretching and strengthening exercises to normalize foot mechanics when walking/weight bearing.
  • If appropriate, the physical therapist will fit you with custom orthotics, which are devices that are inserted into the shoe to support the arch and decrease stress and pressure in the arch and heel.
  • Physical therapists may also videotape your running or walking pattern to help correct faulty walking or running mechanics.

If you have a question you would like me to answer in one of my upcoming columns, please email your question to smiller@cardinmillerpt.com

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Steve Miller is the owner of Cardin and Miller Physical Therapy and can be reached by email at smiller@cardinmillerpt.com. His column will appear bi-monthly in the Thrive section of the Sentinel and on Cumberlink.com.

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