My name's Emma Supple.
I'm a podiatrist and podiatric surgeon here at Supplefeet in Enfield.
Heel pain is anything that affects the heel,
so it can be as simple as a blister,
it can be more complicated, like a verruca that's hurting you
or obviously a splinter or anything like that.
Heel pain classically is where the plantar fascia,
which is a deep tendon that attaches to the heel bone,
starts to get inflamed and sore.
The terms are fairly interchangeable between heel pain and plantar fasciitis.
Heel pain is a very classic problem
that occurs in about 25 per cent of my caseload.
It's a very painful condition.
Heel pain starts because our foot has to interact with the ground,
and grounds are hard and flat most of the time,
so this plantar fascia tendon moves down and rotates down
every time we take a step.
If there's a problem with the way our foot is functioning,
if we have a tendency towards a flatter foot,
if our foot tilts and rotates as we're taking a step,
then it starts to irritate this tendon at its insertion.
So it's something that happens to us later on in life,
oftentimes middle-aged, so 40 onwards,
often if you're a bit excessive in your weight.
Any extra weight you're carrying will have an effect on your feet.
And it comes about if you have a slightly flatter foot.
Sometimes, and not as commonly, you can have it from an injury.
So if you've actually got a pressure,
you've stumbled and you've torn the plantar fascia tendon,
then that will cause the inflammation around the tendon as well.
But more commonly this is a chronic injury, not acute,
and it comes about slowly and literally creeps up on you slowly.
When you first come to a clinic, all podiatrists will look at your foot,
ascertain the foot type, see if there's an underlying foot fault
that's contributing to this pain. We'll check out your calf muscles.
Calf muscles are a very important part of heel pain.
If there's any tightness,
we'll immediately put you on a calf-muscle-stretching programme.
We'll have a look at how much tenderness there is in the tendon,
and if it needs some help, we'll strap it,
give you an insole that will always help to protect it,
have a look at your shoes and give you advice on your shoes.
If it's really sore and really making you hobble, which oftentimes it can do,
then a steroid injection into that sore spot
can really help to clear up the inflammation.
We will also recommend you use some anti-inflammatories
for about three weeks just to clear up the inflammation.
So it's stretches, strapping, insoles and sometimes an injection,
and always looking at your shoes.
If you have a tendency to wear a very flat, unsupportive shoe,
and the classic example is going on a summer holiday
and wearing your flip-flops, a flat shoe,
and your foot's just not used to it, and that will stretch out
the plantar facia tendon, the calf muscles and the Achilles tendon
to the point where they're not used to being stretched
which sets off the inflammation that causes the heel pain.
So a very flat shoe is not what you want to be wearing.
You want a shoe with some support.
To instantly make your foot feel better,
if you've got plantar fasciitis, put a high-heel shoe on.
That shortens the tendon, takes the pressure off the heel bone
and you'll feel comfortable.
When I was working in America, I could get men to wear high heels.
I could put them in cowboy boots.
You can get men in a moderate heel. It's important.
There's a big fashion now for very flat shoes, for men.
Encourage them into a shoe, a brogue, with a small heel.
It will always be better than very, very flat.
Using some ice to the area can help enormously,
that very sharp point.
Just simply using a tennis ball to roll under the arch of your foot
or, if it's very tender, getting a bottle of water, freezing it,
and rolling the arch of your foot under there
can again help to bring a great deal of comfort.
Plantar fasciitis does resolve naturally
but it can take quite a bit of time.
So the evidence does suggest that the pain does go away,
but it takes a long time. It's better to get it actively treated.
Foot pain is not normal, so always look into foot pain.
Ask your doctor, go and see a podiatrist, get some advice.
The most important thing you can do is wash your feet daily.
I put a lot of stress on this.
Wash your feet. It makes a huge difference.
So you're not carrying any nasty ingrained dirt into the following day
and that's causing hard skin formation.
Second thing is to moisture the skin on your feet. It makes a big difference.
Thirdly, be careful with the shoes you're wearing.
Don't wear too high a heel for too long and too far.
Make sure the shoe is appropriate for what you're doing.
If you're playing tennis, wear tennis shoes.
For mountaineering, you have a mountaineering boot.
Just be shoe savvy, a very good idea for your feet.