DEAR DR. DONOHUE: My left heel is killing me. It started about two weeks ago. I had to stop jogging and playing volleyball. When I step on my foot after a night’s sleep, the pain is unbelievable. Would it help if I took something like Advil? How about soaking my foot in warm water? – L.M.

ANSWER: You make a good case for plantar fasciitis, one of the biggest causes of heel pain. The plantar fascia is a wide band of tough tissue that attaches to the heel and fans out on the bottom of the foot to the spot where the toes join the foot. It provides support for the foot bones and the foot’s arch. Inflammation of the fascia – fasciitis – makes the bottom front part of the heel hurt. The pain is worst on taking the first step in the morning. It’s also bad after a person sits for a long time and then gets up and takes a step.

Overuse is the usual cause of this inflammation. Rest is important. Advil or another anti-inflammatory medicine helps, as do warm soaks. A heel cushion will take some of the stress off the heel bone. Weight loss, if it applies, is very important. If the pain doesn’t let up in another week, your doctor can inject the area with cortisone. That almost always quiets the inflammation.

To prevent a recurrence, stretch the fascia when you’re pain-free. While seated, cross one leg over the other so the crossing leg’s foot rests on the knee of the leg whose foot is still on the ground. Wrap your fingers around the toes of the foot that rests on the knee and pull the front of that foot toward the ankle. Hold the pull for 10 seconds. Do 10 consecutive pulls and repeat the exercise at least three times a day. Stretching the fascia makes it less susceptible to inflammation.

The book on aerobic exercise is a good introduction to physical fitness. Readers can order a copy by writing: Dr. Donohue – No. 1301, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I work out at home on an exercise bike and a treadmill. On days my knees are bothering me, I don’t do either. One doctor suggests that I cease the exercise bike but use the treadmill. The other says just the opposite. They both can’t be right. Who is? – R.G.

ANSWER: You can answer this one for yourself. Which hurts your knees? I find that bike pedaling is harder on my knees. Others find running a bigger source of pain.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com

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