The Center for Podiatric Care and Sports Medicine

Plantar Fasciitis: Heel Pain Remains A Menace For Top Athletes

Posted by on Friday, August 23rd, 2013


Los Angeles Angels’ first baseman Albert Pujols, Tampa Bay Rays’ third baseman Evan Longoria, San Diego Chargers tight end Antonio Gates, LA Lakers’ center Pau Gasol, Chicago Bulls’ center Joakim Noah: aside from being pro athletes, what do all these men in common? They are all haunted by the same phantom menace. Debilitating heel pain, known as plantar fasciitis, brought these Herculean men to their knees in pain on many a morning and made the season terribly frustrating as they wondered when and how they would get back to the sports they loved most.

Plantar Fasciitis Pain In The Morning

For MLB player Albert Pujols, mornings were the worst time. He’d lie in bed wondering how he would stand on his feet long enough to make it to the bathroom. “You almost want to pee in your bed rather than go to the bathroom,” he told USA TODAY Sports. “It’s really painful in the morning.”

The American College of Foot and Ankle Surgeons explains why plantar fasciitis pain is often much worse at this time of day. “Walking stretches the fascia” — which has been tightened up due to inactivity all night, they explain. For this reason, many sufferers wear a special boot that stretches the ligament out during the night hours. However, the pain sometimes returns after spending long periods standing or walking — for which there is no easy answer.

Athletes Can Take A Beating, But Admit Heel Pain Is Excruciating

Plantar pain emanates from a thick band of connective tissue that runs from the heel across the arch of the mid-foot. This tissue is designed to absorb the high stress we put on our feet, but sometimes the pressure is too great. The tissue tears and our body responds with as much inflammation as it can muster — hence, the heel pain and stiffness.

NBA star Joakim Noah heroically played through his heel pain during the 2013 playoff season, but he assures us it was no walk in the park. “Plantar fasciitis sucks,” he said. “It feels like you have needles underneath your feet while you’re playing.”

Heel Pain Recovery Time Can Be Agonizingly Long

The most important ingredient to recovery is rest. Unfortunately, for athletes and active Americans, rest is the hardest part of treatment. The 33-year-old Pujols — worth $240 million to his team — has been instructed to sit out the rest of the baseball season to allow his foot a chance to heal. He had been playing as a designated hitter, but was unable to play first base regularly. His statistics this year were down to a career-low at .258, 17 home runs and 64 runs batted in. Right now, the team hopes Pujols will be in tip-top shape for the spring training season, but there is no guarantee. Pujols says he’s  been dealing with plantar fasciitis for nine years — with this year being the worst — but he is hopeful the extended rest will do him some good.

Plantar fasciitis is one of those conditions that lurks beneath the surface and often rears its ugly head just when you think it’s been vanquished once and for all. The chronic nature of the condition is due largely to the fact that the heel does not see a steady stream of blood flow, compared to other parts of the body. Also, any running or jumping can undo the progress from anti-inflammatory medication and physical therapy.

Surgery Viewed As A Last Resort, But Is Often Needed To Defeat Foot Foe

With surgery, recovery can last up to a year. Yet, that investment is well worth it for players who feel their talent has been seriously compromised by trying to get healthy for so long. Former LA Angels outfielder Tim Salmon said it was often hard to focus on the game with the constant throbbing.

“It is absolutely one of the most painful things you’ll experience outside of a kidney stone because you’re putting all your weight on it, and it feels like you’re walking with a nail in your heel,” he told the LA Times.

For a while, he tried the closest thing to a “silver bullet” — an injection — but even that was really painful and still put him out for three or four days at a time. Salmon said it was a constant barrage of icing, taping and mental games. He eventually settled on having surgery done — first on his right foot in 1998 and then on his left foot in 1999. Plantar fasciitis surgery involves the snipping of the plantar fascia ligament to reduce tension and inflammation.

According to WebMD, the surgeon may detach the plantar fascia from the heel bone or make small incisions on either side. He may remove and smooth out bone spurs, take out a wedge of damaged tissue, or free the thicker part of the foot muscle from the surrounding nerves.

Is Plantar Fasciitis An Epidemic?

It seems more and more pro athletes, in addition to regular people like us, are succumbing to crippling heel pain these days. Many trainers in the field speculate that intensive sports specialization at younger ages is leading to a lack of cross-training and a greater number of overuse injuries. In the past, young athletes often participated in football, basketball and baseball. Nowadays, stand-out athletes are playing their sport of choice year-round, traveling with the team, joining all-stars, working with trainers in the off-seasons, and competing for scholarships.

Other theories exist, of course. Perhaps athletes aren’t stretching and strengthening their calf muscles enough. Maybe modern footwear is partly to blame, with new trends eliminating much of the cushioning in shoes for more minimalist designs. Many athletes should be wearing sneakers with high arches, since flat-footed people are more prone to plantar fasciitis. Whatever the case may be, plantar fasciitis is a condition that is best assessed by a professional podiatrist who can help you choose the right course of treatment to defeat the evil of heel pain once and for all.


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.