What The Heck Is Policeman's Heel?

So many things can go wrong with your feet, especially if you are a runner or an athlete. I’ve had my share of foot-related injuries and conditions that have caused pain, discomfort, and time off from training, which is always frustrating! For this reason, I’m passionate about sharing the ins and outs of foot health so you can recognise and address troublesome symptoms early enough to avoid interruptions to your training.

Here, we’re tackling a foot condition with a pretty odd name… Policeman’s Heel. You may have heard of this condition before, but keep reading if you’re curious to know what it is, how to manage it at home, when to visit the doctor, what treatment options are available, and of course, why it has such a strange name.

At The Feets, we’re all about preventative, active foot care to keep your feet healthy and avoid training-ending injuries – you can read more about our mission in our article; Why Active Foot Care?

What is Policeman’s Heel?

The medical name for Policeman’s Heel is actually plantar fasciopathy. This is a common foot condition that can cause pain and inflammation in the band of tissue running along the bottom of the foot, connecting the heel bone to the toes. This area is known as the plantar fascia, and it helps to support the arch of your foot and absorb any shock while walking. With or without inflammation, plantar fasciopathy can occur due to chronic degeneration as a result of repetitive microtears in the plantar fascia which are caused by excessive stresses.

Why is it called Policeman’s Heel?!

Good question! There is no definitive reason as to why this condition is colloquially referred to as Policeman’s Heel, but the general consensus (based on the symptoms we’ll discuss below) is that police officers were likely to develop this condition due to spending long hours on their feet during patrols, which caused strain and heel pain.

Nowadays the official name – plantar fasciopathy – is more accurate since it is not only police officers that suffer from the condition. Instead, anyone with an occupational hazard of prolonged standing could be at risk of developing plantar fasciopathy. This could be athletes and runners, military personnel, sales associates and cashiers in retail environments, nurses and doctors working in surgical theatres, and more.

How common is it?

According to research, 1 in 10 people will experience plantar fasciopathy in their lifetime, and it’s thought that the condition mostly affects only one foot. That said, an estimated 30% of patients report bilateral symptoms, meaning the pain is felt in both feet.

This could be one of the reasons for your foot pain from running.

What does it feel like?

Plantar fasciopathy can cause a dull ache or sharp, stabbing pain on the underside of the heel or along the bottom of the foot, where the arch is. It may feel tender or swollen, which can cause some people to alter their gait in order to reduce weight on the affected area, and therefore reduce pain.

Plantar fasciopathy pain tends to be worse when taking the first few steps in the morning after waking up, or the first steps after sitting down for a long period of time. As you increase your movement, the discomfort may start to ease, but it can be difficult to lift your toes off the floor due to the placement and nature of the pain.

Plantar fasciopathy could also be the culprit if you feel your foot pain gets better during exercise, and comes back after a period of rest.

What causes plantar fasciopathy?

This condition is thought to develop as a result of repetitive stress to the plantar fascia. By placing too much tension and stress on this area (for example, while standing for a long time) small tears can develop and cause irritation, inflammation, and pain or discomfort.

Plantar fasciopathy can also develop due to having poor foot structure or shape, choosing the wrong shoe shape for your foot, suddenly increasing activity levels (such as starting a running program or another high impact sport), or if you have other medical conditions, such as lupus or rheumatoid arthritis.

Who is most at risk of developing plantar fasciopathy?

Aside from athletes, runners and those who stand for long periods of time, some other people have a higher risk of developing plantar fasciopathy. You are at a higher risk if you are:

• Over the age of 40 (it’s most common in those aged 40-60)
• A women
• Have reduced ankle mobility
• Have tight calf muscles
• Have irregular foot mechanics (reduced fat pad, flat feet, high arches or an atypical walking pattern can affect weight distribution and add stress to the plantar fascia)
• Have a high BMI (over 30)

How should you manage it if you have it?

If you have identified that plantar fasciopathy is the problem you can try to manage it yourself, reduce pain, and get back to your training as soon as possible. The best ways to manage plantar fasciopathy are:

• Rest your foot often and avoid prolonged standing (if you stand a lot for work, ask your employer to adjust your workspace or schedule to allow for rest)
• Apply an ice pack to the painful area for up to 20 minutes every 2-3 hours to reduce inflammation (you could also use anti-inflammatory supplements like curcumin/tumeric or propolis – I do)
• Get cushioned shoes with good arch support, and/or use orthotic insoles or heel pads for comfort
• Switch to gentle exercise (ideally something that doesn’t put too much weight on your feet), such as swimming
• Manage pain with over-the-counter painkillers
• Maintain a healthy weight to avoid overloading the foot

Stretches can also help to alleviate tension in the plantar fascia and other areas of the leg that can impact the foot. Try doing calf stretches, or some more specific ones such as:

• Rolling stretches – Spend around 2 minutes rolling a small object like a golf ball or a water bottle back and forth on your foot while sitting (I find this really helps to reduce pain, and make the foot more ‘walkable’)
• Seated foot stretches – While sitting down, cross the injured foot over your opposite leg and pull your toes up towards your shin to stretch the arch of your foot
• Towel curls – While seated, place a small towel between your feet, grasp the towel with your toes and curl it towards your heels (everyone should be doing this regardless, it’s so great for general foot strength – more to come on that in another blog soon)

How can you prevent plantar fasciopathy?

At The Feets we’re all about prevention, so by addressing plantar fasciopathy early and taking a few easy steps to prevent it developing in future, you can continue to smash those PBs on your runs and not have to worry about injuries and other conditions getting in the way of your goals.

To prevent plantar fasciopathy, you need to start considering the strain you put on your feet each day. Although rest is not strictly necessary, you may want to take a short break from high impact activities like running or jumping in order to reduce the load and stress on your feet where possible. You may also want to:

• Wear highly cushioned footwear every day
• Ensure your BMI is within a healthy range
• Work on your ankle mobility and calf strength
• Increase your training volume and intensity gradually (never start doing lots more training overnight) and do regular preventative stretches as described above
• Avoid overusing the same muscles by regularly cross-training with different exercises, such as cycling or swimming
• Avoid walking or standing for prolonged periods of time
• Avoid wearing high heels, flip-flops or backless slippers

When should you see a medical professional?

If a short amount of rest and some of the above home remedies do not lead to a reduction in pain and discomfort after 2 weeks, then it may be time to consult a medical professional. You can see your doctor about this, but a podiatrist should be your first choice to identify the cause of your foot pain and provide treatment.

You should see a medical professional sooner if:

• Your pain or discomfort is interfering with your daily activities and impacts you getting around
• You develop redness, swelling or bruising on the heel
• The area feels tingly or numb
• The pain gets continually worse, or keeps coming back

Important: If you suffer from diabetes, you should not delay seeing your doctor about potential issues with your feet as these could be more harmful. 

What treatments are available?

A podiatrist can first rule out any other conditions or injuries, and would initially recommend similar remedies to the ones mentioned above to try yourself at home. If you do not feel an improvement, they may discuss other treatment options with you such as:

• Taping – This method uses tape to help reduce stretching and moving in the ligaments to give plantar fasciopathy an opportunity to heal.
• Stretching – This treatment recommends a regiment of stretches to help loosen muscles and ease pain.
• Individualised education – This includes footwear recommendations and load management techniques relevant to each person’s own foot posture and symptoms.
• Shockwave therapy – This has been shown to be the most effective method of reducing pain and speeding up recovery. Patients who do not optimally improve may be offered shockwave therapy, followed by custom orthoses.

Research suggests that with treatment, 80% of plantar fasciopathy patients see their symptoms improve in 12 months, so if you are experiencing the pain of plantar fasciopathy and are worried it will stick around for the long term, know that with early intervention and some TLC directed at your feet, you can start to see symptoms improve in no time, and get back to smashing those goals.

Go get it.

Logan

We’re The Feets. We know what it’s like to set the alarm for 5am, drag yourself out of a warm bed, lace up the shoes that are starting to show the miles, and head out in the grey morning to clock a few Ks before work. We’ve been there, we are there, and we’ve got your back. Follow us on Instagram for stories, motivation, tips and tricks, or just to be part of the growing community of those wanting to make something of themselves.