Debilitating pain in both heels.

June 3, 2008 6:00 AM

Unusual, debilitating pain in both heels. Ouch. Advice?

Woke up Monday morning with pain in both heels but was able to function OK. By the end of the workday I was limited to about 50 percent mobility, and walking was not particularly unpleasant. It's now a couple of hours before dawn on Tuesday and I was awakened because the pain has turned debilitating, even the pressure of a single sheet hurts. I'm pretty much unable to walk, got down the hall slowly on the balls of my feet and supporting myself on the wall.

My best guess is that I injured it Sunday afternoon when I climbed up a sort of metal grate. On the way down I hopped the last couple of feet, landing more solidly on my left foot, which is the more painful of the two. I performed this act of gymnastics while wearing shoes that, admittedly, are very very worn down in the heels and probably don't have good support. I'm thinking I have a bad sprain most likely. But are there any other things that could cause these symptoms? Something more serious that I should be concerned about?

Note that I did not experience any pain at the time of the incident. The onset was about 12 hours later when I woke up.

A couple of things:
* No visible bruising. Don't particularly notice any swelling, although it's possible since I don't examine this part of my body closely or with enough interest to really remember what's it's supposed to look like.
* There's also pain/soreness in the joint of the knee of the left leg, the one that took the harder hit on Sunday.
* I will go to the doctor if necessary. I will go to the doctor if necessary. I will go to the doctor if necessary. But insurance and phobias and other issues make it something I'd prefer to avoid if possible. Just like many others who'd post an anonymous health AskMe, of course.

posted by anonymous to health & fitness (11 comments total)

Sounds like plantar fasciitis. It's excruciating pain, but can be easy to fix. The local running shop sold me some Powerstep arch supports; the pain was gone in hours.
posted by Wet Spot at 6:20 AM on June 3, 2008 [1 favorite]

Possible that you could have injured your Achilles' tendons. My wife hurt both of hers running several years ago, pain symptoms sound somewhat similar. Get thee to a specialist. It may not be what you want to hear, but you don't want to risk messing with this if it means potentially hurting your mobility and a longer recovery.

At the very least see if you can find a sports injury clinic. Sometimes you can get some good advice from people who do physical therapy or rehab work, occasionally you can find them outside of doctor's offices.
posted by caution live frogs at 6:33 AM on June 3, 2008

Had a similar episode of this myself--sudden extreme pain in one of my feet, so much that I couldn't touch it, that got better throughout the day. Remembering that my physical therapist had told me on a few occasions "You think this hurts? You should see me working on people with plantar fasciitis," I was a bit afraid of going to my MD and winding up in PT again. Fortunately, the alternative care route helped; a chiropractor did a number of cold laser treatments, and it loosened back up. And seconding the recommendation of arch supports; I've been more careful with my shoes since then, which has helped.
posted by bloggerwench at 6:35 AM on June 3, 2008

Morning pain in the heels sounds like plantar fasciitis. This is an overuse problem, associated with bad foot biomechanics, tight calf muscles and achilles tendons, and unsupportive shoes.

But PF doesn't come on suddenly from a single incident, and the pain is worst in the morning, or after you've been sitting down for a long time. It sounds as if your pain came on in the morning, but is getting worse throughout the day, so your case may not be PF, or it may be PF plus some foot bruising (which would not necessarily be visible on the outside of your foot), muscle tightness and knee strain, or it may be an achilles tendon problem.

As long as the pain does not get worse, give yourself a couple of days to see if you can improve things. But if the pain does get worse, go to the doctor immediately. As you can see from my list above, it could be any number of things, and a good doctor will get you on the way to recovery more quickly.

For now:

MORNING
1. When you wake up, stretch your calves very gently while you're still lying in bed. Raise each leg in the air and point your toes back towards you gently, just until you feel a little stretch. When you get out of bed, do a runner's stretch on each leg, again, only until you get a gentle stretch. Your muscles are cold now, and trying major stretching will make things worse.
2. Gently massage your heels and the sole of your foot up to the ball of your foot with your hands. Use your thumbs to push at the tightest, knottiest areas. If you can massage your tight calves as well, or get someone else to do it for you, that would help.
3. Light stretching again. You may find that you can stretch a little more without feeling sore, but don't force yourself to stretch further than before.
4. Take some Advil and use cold packs on your soles and on your bad knee for 20 minutes.

THROUGHOUT THE DAY
1. Take Advil as often as the bottle label allows, and use this time to sit down while icing your sore areas again.
2. If you have been sitting for any time, and find that you are tight and sore, keep stretching gently every time you get up.
3. Wear your best supportive shoes until this gets better. You may end up needing shoe inserts or custom orthotics, but let a doctor recommend those.
posted by maudlin at 6:40 AM on June 3, 2008 [1 favorite]

maudlin's advice is pretty sound. i agree that PF is sucky and horrible and hateful, but it doesn't come on all of a sudden like your pain seems to have.

i'm betting that you strained/bruised your heel/achillies tendon from the landing after your jump. i've done this.

it it's not feeling better, or at least starting to get better, i'd suggest going to a podiatrist and telling that person what you told us.
posted by misanthropicsarah at 6:47 AM on June 3, 2008

Yes go see a podiatrist.
posted by Penelope at 7:48 AM on June 3, 2008

Maudlin gives great advice. If it is PF, a cheap ($20 or so) potential cure is the Spenco full-length orthotic insoles. Make sure you get the ones with the stiff plastic in the heel and arch area.
posted by Kibbutz at 8:45 AM on June 3, 2008

I was diagnosed with plantar fasciitis, and I can definitely pinpoint the day I first noticed it. One day I didn't have pain, the next I did. I had definitely been abusing my feet -- I had been on vacation for two weeks, doing a lot of walking in not-very-supportive shoes -- and my feet decided to just blow up on morning. For the next 2 years I hobbled around until I finally went to a doctor.

I agree with maudlin's advice, I would only add that you might want to try to wear shoes most of the time, even when you are at home. I had been doing my stretches, wearing good shoes when outside, etc, but was going barefoot at home. My physical therapist told me I should wear shoes indoors. I bought a pair of Crocs (God help me, they are hideous, but they are for indoor use only!) and the very first day I spent wearing them indoors the difference was remarkable. I used to have constant pain when barefoot, now I can go barefoot for a while with no pain at all.
posted by DrGirlfriend at 9:40 AM on June 3, 2008

From what you say they could be bruised. I had an extremely sore left heel for a long time before I figured out that it was because I was playing a lot of honkey tonk piano and stomping my left foot on a hard floor to the rhythm.
posted by weapons-grade pandemonium at 10:54 AM on June 3, 2008

Nthing plantar ... Also, make sure of the following:

1) That your shoes are properly fitted. I always would measure my right foot - size 13 - and get a pair of shoes that were that size. Unfortunately my left foot was 13.5 inches. Down the road I had tremendous pain. I also wear shoes that support my very very flat arches.

2) Rotate your shoes. Don't wear the same pair day after day.

3) Discard them when the soles are broken down or the shoe no longer properly supports your foot.

I follow this, and I got rid of my expensive orthotics four years ago after some nasty PF.
posted by EastCoastBias at 11:38 AM on June 3, 2008

From what you say they could be bruised.

I've also experienced a bruised heel. Something more serious like PF would be nagging you for awhile. If it's just bruised, it should be gone within a couple of days.
posted by P.o.B. at 9:41 PM on June 3, 2008