Policeman’s Heel is a painful condition characterised by pain and tenderness on the underside of the heel bone. It can sometimes radiate further into the sole of the foot, towards the toes. Its real name is actually plantar fasciitis (pronounced FASH-EE-EYE-TUS), and it is, by far, the most common cause of heel pain we see in the practice. The plantar fascia (PF) is a flat band of tissue found on the sole of the foot that connects the toes to the heel bone. It is a taught structure which helps maintain the arch of the foot. If the PF gets too tight or too short, it can pull at its attachment to the heel bone which causes localised pain and inflammation.
Under sole of the foot is a natural fat pad which provides a cushion to the bony texture of the heel bone with the ground we walk on. In some types of PF, we see a significant loss in the height of the fat pad. Over time, like an old pillow, the fat pad loses its cushion-like properties due to long term compression. Thus, the heel bone comes in greater contact with the ground on walking, which squashes the PF more so.
There are certain groups of people who are at greater risk of developing this condition. Being overweight; anyone who is on their feet for long periods of time (e.g. waiters); or those who do long-distance running.
There are different ways of managing this condition effectively:
Rest. Rest from the aggravating activity will give the foot time to recover from the injury. Reduce running or walking on hard surfaces temporarily. We would suggest you only restart running once you can walk 10km without pain.
Heel Cushions. To almost re-create the degraded fat pad, you can buy a heel cushion, usually gel-based and place it under your heel, which can sometimes be very helpful. If you choose to do this, as chiropractors, we would suggest you buy one for each foot, irrespective if the pain is on one side or both sides, to avoid causing other misalignments in your spine.
Footwear. Invest in a decent pair of shoes that can help provide enough support to your foot. Look for cushioned soles and good arch support.
Ice. Try icing the sole of the foot to reduce the inflammation. An easy home-made tool is to freeze a bottle of water and use it as a rolling pin on the sole of the foot. Gently massage the tender spots on the heel bone for about 5 minutes twice a day.
Stretches. Stretching the calf muscles and gently massaging the sole of the foot with a golf ball can be helpful.
Lose Weight, if necessary. Losing weight can be useful to reduce the impact on the soles of the foot.
Manual Treatment. Certain soft tissue techniques, manipulation and acupuncture can be very effective for stubborn cases of this condition. Chiropractors in our clinic use these techniques often to treat this.
Gait Analysis and Possible Orthotics. Speak to a biomechanical podiatrist who will perform a detailed gait analysis to assess the movement of your feet and legs. If necessary, they may prescribe tailor made orthotics or shoe inserts to help correct any dysfunctions. Although these tend to be more expensive, the cost of relief is worth every penny for the disability this condition gives.
Shockwave and or Laser Therapy. These have become an increasingly popular way of managing long term plantar fasciitis. If other avenues have failed, it may be worth pursuing a practice that offers these services.
Steroid Injections. For cases where the PF has become deformed or severely damaged over time, steroid injections may be the only option. You should discuss this with your GP if you have tried other avenues of care without much success.
If you would like further advice, our practice offers a free-15-minute chat with one of our chiropractors, who would be happy to advise on your condition. Please contact clinic reception for further details.