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The answer

It sounds like Robert may be suffering from plantar fasciitis. In this condition, the plantar fascia – the band of tissue that runs under the sole of the foot, connecting the heel bone to the foot bones – degenerates as a result of repetitive microtears, which causes persistent heel pain. This pain is usually most intense when walking after a period of inactivity, although it tends to get better after a few steps. It can then worsen again as the day progresses, or after long periods of standing or walking.

Most people make a complete recovery from plantar fasciitis within a year, but there are a few self care measures that may make a difference to Robert in the meantime:

• Resting the foot and avoiding standing or walking for long periods, where possible

• Not walking barefoot as this increases the impact that goes through the feet, and instead opting for shoes with good arch support and cushioned heels, such as trainers. If Robert requires smarter shoes for work, orthotics can be purchased. These offer a similar level of support and correct abnormal foot posture

• Losing weight, if he is overweight or obese, to ease the load on his feet

• Regular stretching exercises. These can include looping a towel around the foot then pulling it with the knee straight and holding the position for 30 seconds; rolling the arch of the foot in all directions over a tennis ball for a few minutes at a time; standing on the stairs, facing upwards, with heels hanging over the edge, then lowering the heels while keeping the knees locked and holding the position for around 30 seconds. Each exercise should be performed at least twice a day for maximum benefit

• Taking over-the-counter analgesics and applying ice packs to the foot for 15-20 minutes at a time for symptomatic relief.

 

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