If you experience a sharp pain in your heel at the first step in the morning, chances are you have plantar fasciitis (plan * tar fash* ee * I * tis). "Plantar" means the bottom of the foot. The "fascia" is a long ligament type structure. "Itis" means inflammation. Plantar fasciitis is a tearing of the ligament on the bottom of the foot. The tearing causes inflammation and the inflammation causes pain. Plantar fasciitis is the most common cause of heel pain. Many individuals with plantar fasciitis find that they hobble to the bathroom every morning because of the pain. They must grab onto the dresser or the wall to balance themselves. After fifteen minutes or so, the pain works itself out, only to come back with a vengeance at the end of the day. Not all individuals with plantar fasciitis experience pain in the morning. Many find that they only experience heel pain at the end of the day or during certain types of activity.

Five steps you can take to help decrease your heel pain:

1. Decrease your activity level: The more you are on your feet, the more tearing that occurs in the fascia. Tearing in the fascia leads to inflammation and more pain. Stop running or walking and try biking or swimming. Avoid the treadmill and the stairmaster at the gym. Limit the number times you go up and down the stairs at work or home. Avoid hills if possible. Do not lift or carry heavy items including your kids. Use a stroller or have your spouse/significant other carry them. Decrease your activity level for at least two weeks. If you have improved after two weeks, do not jump right back into your old routine. A gradual return to your routine is essential.

2. Try an ice massage: Freeze a sports water bottle and place it on the floor. Roll your arch over the water bottle for 20 minutes twice a day.

3. Stretch your calf: Place a towel or a belt on your dresser. In the morning, before you get out of bed, wrap the towel around the ball of your foot. Pull the foot towards you, keeping your leg straight. You should feel a stretch in your calf. Stretch for 30 - 60 seconds. This will help to decrease your pain once you step down. Spend about 5 minutes each evening stretching the calf as described above or with the runners stretch. To really help keep the calf and the bottom of the foot stretched out, try and stretch for 30 seconds 10 times a day.

4. Take anti-inflammatory medications: Anti-inflammatory medications, like naproxen or ibuprofen, will help decrease the inflammation that occurs in the fascia as a result of the tearing. The anti-inflammatory medications will also help decrease the pain. Be careful, you don't want to mask the pain. If the medications decrease your pain enough to allow you to run, jog or walk more, you may be doing more harm than good. Rest, ice and stretch while you are taking the medications. If after two weeks you have improved, slowly start your exercise or work routine again.

5. Wear supportive shoes: This step may seem logical, but most individuals don't realize how poor their shoes are. A supportive shoe will bend only where the foot bends, at the toes. To test this, take your shoe and flip it over. Grab the toe area and the heel and try to fold the shoe. If the shoe bends in half, then the shoe is not supportive. You should wear supportive shoes at all times. Don't go barefoot. Get up in the morning, do your stretch and then slip your feet in a supportive slipper or clog. Having a running or walking shoe does not guarantee a good shoe. Many of these shoes have lightweight designs and tend to breakdown in the middle of the shoe after two or three months. Test all of your shoes.

If your symptoms do not resolve, see a podiatrist.