Re: Riding Technique / Heel Spur

[flemmerl@rcbhsc.wvu.edu (Flemmer, Linda)]

> Kate Denisar wrote:

> I am starting to experience significant pain in my left heel <SNIP>  When I am in the saddle, I relieve the pain in my ankle and heel by dropping my stirrup and rotating my ankle.  It tends to hurt more when walking, when trotting and cantering I don't feel any pain at all.
> the pain in my heel is persistent.  Last night I iced my heel all night, with little effect. 

You are describing plantar fasciitis - an inflammation of the fascia on
the bottom of the foot.  If it goes on for long enough, you probably
will develop bone spurs.  This condition is characterized by aching
heels (or heels and instep), usually unilateral (although it might
switch sides), feels worse after sitting for a while or when you first
get up.  Given time & a chance to move around, the pain improves.

Dropping stirrups and moving your foot periodically is good, getting off
periodically will help.  Even better - just don't ride the walk much
:-)  More top tens that way?  :-)

 My questions are as follows:
> 
> 1)  Has anyone else suffered from this and if so - what hints for pain mediation and for pain elimination?

You need to take an anti inflammatory regularly for a while to break the
cycle of inflammation.  I alternate between Aleve and Motrin.  Not
riding for a while also helps, but that's not much of an option for most
of us.  The icing is good. Also consider some exercises after icing that
my PT gave me to do for the same problem.  Lay a hand towel on a
tile/vinyl floor.  Sit in a chair & use your toes to "inch" the towel
towards you.  Repeat X2 for each foot, and do that 2-3 times per day.   
Then, apply warm moist towels to your feet for 10-15 minutes. Then,
stand on some stairs or a curb with the balls of your feet, rest of foot
hanging over the edge.  SLOWLY lower your weight into your heels.  This
will help the tendon to stretch gradually without some of the
inflammation present.

Often an orthotic heel cup can relieve some of the discomfort.  (I'm not
talking Dr. Scholls - you need a heavy duty one made for this.  Ask your
pharmacist or podiatrist.  I'm using a brand called Tull's.)  I've also
added Ariat's gel footbeds to all my riding shoes with quite a bit of
relief.  (I don't wear the Ariat shoes though - too narrow for my feet.)
> 
> 2)  Is it my riding technique that is causing this? <SNIP> When I was 10-12 I took hunter/jumper lessons and I tend to really crank my heels down and keep my leg in perfect position at all times - which may not be optimal for endurance . . .

That riding position will do more to aggravate your problem than almost
anything else (besides 4" spike heels)! :-)  Some of it can be
conformational, too - high arches!  (I wouldn't pass the prepurchase vet
exam, I guess.)  Try relaxing at the ankle and allow the foot to fall to
a natural position.  You will probably find that it is level to
<slightly> down at the heels.  Think loose ankles, toes up (NOT heels
down).  Try this no stirrups and see where your heels fall - this is a
good test since you won't have any stirrups to brace against the ball of
your foot.

Let me know if you have questions.  I've lived with this for nearly 7
years.  For me, it is a chronic condition that I have to manage.  If I
let it get away from me, I'm literally on crutches when I get up in the
morning!

Linda Flemmer