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Need help on heel care

peregrina2000

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Staff member
Hi, everyone,

Now that my next Camino is less than four months away, I think I should get serious about my heel. Last spring, when I walked from Sevilla, I had to stop in Caceres because of severe heel pain. Though I couldn't see my sports medicine doctor till about 3 months later (and by then my heel was fine), his diagnosis concurred with my web research -- I had a heel fat pad injury.

I have had new, softer orthotics made, which I hope will help. And my doctor says that the best thing I can do is slow down, to reduce the force of the impact of the heel on the Camino. Aside from that, does anyone have helpful tips? I take ibuprophen regularly when I walk (I've gotten some reprimands on that from people here, but my stomach tolerates it and I think it helps). I also ice my feet every night. And whenever the Camino is on pavement, I try to get on the side onto grass/dirt/gravel. What else can I do? I plan to start in Sevilla again and am hoping that this time I'll make it all the way to Santiago. But I am kind of nervous about it.

Thanks much, Laurie
 
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I take it that you currently have no heel pain whatsoever? I suffered from heel pain for a about two years and now I don't have any pain. The way I was able to work out of it was first getting both excellent shoes and orthotics. Second, when not wearing shoes I was extremely careful never to put any pressure on my heel. For example, never prop up my leg by placing my heel on a hard surface.

The ibuprofen is not so much a stomach issue, but rather the impact on your kidneys. When taking it just make sure you take lots of water. Extended use increases the probability of problems developing. Consider using analgesic cremes also.

On days when the path is unusually rocky, make sure you take is slower and parse your day with many breaks and don't walk as far to give your heels a rest. Should you heel begin to give you pain it will be easier to listen to your body. The challenge is to listen and hear what you body needs before you develop pain.

Also, it might be worth taking a few, long hikes over the next few months. Push yourself and see how your body responds. Don't be fearful, but vigilant. As you realize you are not experiencing pain your confidence in your body (heel) will grow.

You are going to have a great Camino and you will have the strength to finish. You will be in our prayers,
 
Hi Laurie,
I had successfully used orthotic inserts with Brasher Superlite boots walking at home on 'soft' Irish ground but got painful heals walking from Santiago to Fisterra-it was the road/hard surface walking that killed my heals.
By changing to boots with a much thicker spongier sole I was able to walk the CF from SJPP and my heals were only sore on a few days and even then it was a tolerable soreness.
The critical factor for me seems to be that sole 'sponginess'-and I do mean spongy. I tested boots by angling my foot so that the tip of the heal was the only point of contact with the ground, bringing my weight down to bear and having an observer on their knees to evaluate 'the give'.
The boots that, in addition to ankle support, had most 'give' (Brasher Towa CTX's) were the ones I went for. Though I had much less 'breaking in time' than I would have liked these boots really worked for me on the CF last April. However they are quite a 'hearty boot' and if I were walking a summer Camino I'd have concerns about the heat aspect.
Festina Lente and enjoy!
Nell
 
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Hello Laurie, I also had severe heel pain when on my first walk, which was only from Roncevalles to Nájera. By the time I reached Nájera I was walking at the rate of about 2 kms an hour and felt that I needed to walk on tip-toes!
As soon as we returned home, I bought a set of gel heel pads and now always use them, even in my regular daily walking boots. I also looked on internet and found various lower leg and calf stretching excercises, especially standing with front part of the foot on a step, with the heels suspended over the back and lowering them, thereby stretching them. These stretching excercises I now do during the last few weeks before leaving for the Camino. I also changed my boots. The following year, we returned to Nájera and walked to Santiago and last year we did the complete Camino Roncevalles/Nájera. The pain never returned. Anne
 
Thanks so much for these responses, and also thanks for the several PMs I've received. I know talking about ailments isn't a fun way to plan for the Camino, but I appreciate the suggestions for ways to extend the life of my feet! It's so nice to find others "of a certain age" who can relate to these issues. Michael, my heel is totally fine now, and I work out on it daily. I don't think lack of training was the problem, but rather that it was more a repetitive stress kind of thing. But who knows.

Thanks, Nell, I am going to start hunting for spongy soled boots. Unfortunately it looks like Brashers are sold only in the UK, so if any US/North America members have any suggestions about brands that might have a squishier heel, I'd appreciate it. When I first started Camino-ing about 10 years ago, I had standard leather hiking boots and have gradually moved to lighter alternatives. Currently I walk with a North Face low hiking shoe and I love it. But I wouldn't say its heel is particularly soft.

Ah, those gel heel pads -- they seem like the logical thing, but my PT says that I need the rigidity in the orthotic to deal with my other foot problems. And he says that cupping the heel might have a bad effect on my problem by preventing the natural splaying of the fat pad. (Sorry, this is probably way more detail than anyone wants to know). But I am going to explore that some more because it seems like a logical thing to do. Like you, Anne, I have incorporated stretching in my daily exercise routine, so maybe that will help some.

You guys are very helpful (not to mention comforting) -- thanks much, Laurie
 
Laurie -

These boots Keen Targhees II mid height I wore for last year's camino and I found them slightly more "squishy" than my previous Garamonts. They required no breaking in and were absolutely wonderful for the Madrid and Ingles - no foot problems whatever...I know they sell them at REI...

I wish you all the best on the VDLP this year.

lynne
 

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Hi Laurie,

I had faced a lot of problems with my ankles and heels, and below were some recommendations I had received :

Orthotics will definitely help, especially if paired with cushioned shoes. Pls try your shoes with the orthotics to ensure a good fit. Sometimes adding orthotics to certain shoes creates over compensation.

You may wish to consider reducing your stride, thereby creating a softer landing on the heel. A longer stride (possibly over reaching) will create greater impact on the heel (heel strike) when your foot land.

Try stretching and articulating your feet each day (1) Point your toes (2) Flex your feet (3) Rotate clockwise and anti. This will minimise stiffness of muscles and tendons around ankles and soles.

If you are using walking poles, try using two poles instead of one. This allows you to maintain a balance body posture with equal weight distribution when moving.

You may wish to consider using Voltaren cream to reduce inflammation and therefore reduce the amount of injury. As you rub the cream into your foot your are also giving it a much needed massage.

Hope the above helps.

Buen Camino
Rebecca
 
Hi

If the previous suggestions don't relieve the pain/discomfort maybe a more radical suggestion is called for - a bicycle? I am a walker myself but, if circumstances dictate, I could enjoy cycling.

John
 
Laurie,

Did your doctor not mention plantar fasciitis? It certainly sounds a lot like it to me. I suffered for two years with it. I couldn't walk two blocks without limping. I tried acupuncture, cortisone shots, ibuprofen, icing, rolling, stretching, etc...what really helped it in the end were orthotics -cheap ones bought from a drug store or a sports store. (The $275 custom orthotics did nothing for me.) It is finally just about gone, thus allowing me to "sign up" for the Camino this year. However, just last month I found some inserts that might suit you to a tee. They are stiff plastic, with three sets of exchangeable arches (low, med, high) and a gel cushion in the heel! Had I found these two years ago, I swear I would've been long cured. They're call WalkFit Platinum and you can buy them at Bed, Bath & Beyond for 20 bucks or so. Google them. You can even order them online if you don't have a BB&B ear you. I still have to be sure I stretch and I still have to have inserts in all my shoes, but I'm virtually pain free now. Keeping my fingers (and toes) crossed for the Camino!
Good luck!
 
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Picking up on a couple of points from Nell on the Brasher Superlites and from Nandy on the plantar fasciitis.

I wore my new Brasher Superlites at Easter 2009 when I made my pilgrimage (with tent) from Winchester to Canterbury in southern England, a distance of a bit under 250km in 9 days walking on a mixture of paths and country roads. The insoles collapsed almost flat under my heels, and as the soles were so thin, there was very little cushioning between my heel and the ground. While I was walking, there was some discomfort, but it was just something that I was aware of, nowhere near enough to make me even consider giving up. But when I returned home, wow! Getting up in the morning, my heels were painful, and during the day, I was very uncomfortable walking especially when getting up from a chair. The pain first thing in the morning is one of the classic symptoms of planta fasciitis. My work colleagues had their suspicions confirmed that this walking idea was for mad-men!

So what did I do? I bought some Sorborthane thin inserts http://www.sorbothane.co.uk/product2217.html?section=47&sectionTitle=Full+Strike+Insoles&preview=1 for my work shoes to cushion my heels while I was at work, and this seemed to work fine. I’ve seen somewhere that Sorbothane claim that their inserts dissipate 94% of the shock on the heel.

I tried their Double Strike inserts http://www.sorbothane.co.uk/producta374.html?section=56&sectionTitle=Double+Strike for my boots, but they did not work for me.

So onto their Sorbo Pro inserts http://www.sorbothane.co.uk/product...tionTitle=Shock+stopper+-+Sorbo+Pro&preview=1, and these were perfect for my feet. I wore them in my Brashers on my pilgrimage at the end of May from my home just west of Birmingham to St Davids [*] in SW Wales. This was again 9 days walking, this time averaging over 35km per day with a tent, walking from early morning until sunset, and later some days. Much of it, certainly towards the end, was on small country roads, hence hard underfoot. I had absolutely no problem at all with my feet. Indeed, at the campsite at St Davids, when talking to the young man in the next tent about what I had done, he commented on how my boots must have been really good to do that without difficulty. He was a 20-something soldier on leave so should know something about yomping long distances with a rucksack, and I was a 51 year-old, then at least 6kg (about a stone) overweight.

I wore these same Brasher Superlite boots, now re-soled with Vibram, and the Sorbo Pro inserts on my 4th pilgrimage of the year (Le Puy-en-Velay to St-Gilles-du-Gard) in October, and again, absolutely no problem. The feet were just there, no blisters, no pain, no nothing!

I can certainly recommend these Sorbo Pro inserts to replace the inserts in similar circumstances, but there are others available, the best known being Superfeet. http://www.superfeet.co.uk

I have no connection with either Sorbothane or Brasher, just a happy user of the two in combination. I have not needed inserts before I bought the Brashers, with boots from Trezeta and Berghaus being fine without special inserts.

Hope that may have given you some ideas
Mike



[*] St Davids is the smallest city in the UK, with a population of under 2,000, and with a magnificent cathedral.


For those of you speaking American English, a city in UK English is, historically, a town (or here a village) with a cathedral. More recently a city can be so named if it has received a royal decree – but it is not just any town/village as in US English.

It was also where a car slowed and I heard a “Hola Peregrino” from another pilgrim to Santiago who had seen my scallop attached to my rucksack!
 

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Hi Mike,
It's interesting that you got your Superlights resoled with Vibram. It reminded me of one of my other concerns re original Superlite soles - they just aren't as 'sticky' as Vibram soles.
The good news is that my Brashers Towa CTX's, as well as being 'spongier', have Vibram soles :D .
But I'm definitely going to try those insoles out Mike and, if they work, the Superlites +insoles combo would provide me with a perfect solution for summer(ish) Caminos.
Thanks
Nell
 
Wow, many thanks for all this good advice. Can I ask those in the know whether Sorbothane provides as good a cushion as silicon gel? The sports shoe shop near my house sells lots of these products and I am going to go and try them out.

And I've found the Keen Targhee boot locally, too, so I am going to have a lot of fun mixing it up with my feet. I've got an appointment with a new podiatrist who is supposed to be great for heel problems, so I'll hold off on my spending spree till I hear what he has to say. All I know is that I will not be wearing my hard plastic orthotics! Thanks for all the suggestions, guys. I'm feeling less nervous about my aging feet. Laurie
 
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