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One question patients ask me every day relates to their heel hurting when they get out of bed in the morning. Sometimes the pain is so bad, they end up limping.

There are a number of issues that could be contributing to the heel pain when you get out of bed and after getting up from sitting. The most common reason for your heel/arch pain would be plantar fasciitis.

Plantar fasciitis is an irritation of the tissue that connects from your heel to the balls of your feet. Its job is to provide shock absorption and to support the arch of your foot during weight bearing.

When the plantar fascia is overstretched, shortened or has repetitive stress applied to it, it becomes inflamed and causes pain. Flat feet and high arches can both be a contributing cause to plantar fasciitis for different reasons. Tight calf or tight big toe muscles can also be a culprit in causing plantar fasciitis.

The calf, big toe and plantar fascia all work together as a pulley system. If they cannot function as a pulley system, then too much pressure is placed on the plantar fascia and it becomes painful, which causes the patient to limp when walking.

Another cause of heel pain is calcaneal bursitis. In this case, the fluid filled “bursa sac” that cushions the heel bone becomes inflamed. Usually, irritation of the bursa can also be due to tight calf muscles, flat feet or high arches, which all alter the normal function of the foot, causing excess pressure on the calcaneal bursa at the heel bone.

So how do you get rid of the pain?

Heel pain that is present with the first few steps out of bed in the morning, as well as after you get up from sitting, usually responds well to a multi-faceted approach.

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Improving your calf flexibility, strengthening the muscles that support the arch of your feet, as well as wearing the proper shoe for your foot type and using a custom foot orthotic that distributes your weight more efficiently across your foot, are all pieces of the puzzle to get you back to pain-free walking and weight-bearing activities.

You need an expert in the care of the foot and ankle to evaluate you and determine the root cause of your heel pain. Attacking the root cause will eliminate the heel pain versus just taking medication, resting or getting injections.

The physical therapists at Cardin and Miller Physical Therapy are experts in the treatment of the foot and ankle. We determine the cause of your heel pain and develop a custom rehab plan for you based on your medical history and what we find when we check your strength, range of motion, walking pattern, etc.

Call Cardin and Miller Physical Therapy at 717-245-0400, to schedule your free screen with one of our physical therapists so that we can help you resolve your heel pain and get your life back.

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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