What is Policeman’s Heel?

Policeman’s heel, medically known as plantar fasciitis, is a common and often painful foot condition that affects the heel and the bottom of the foot. The term "Policeman’s heel" originates from the early 20th century, when policemen patrolled streets on foot for long hours. The condition was notably prevalent among them due to prolonged standing and walking on hard surfaces, leading to chronic stress on the foot’s connective tissues.

At the core of this condition lies the plantar fascia, a thick band of connective tissue that runs from the heel bone (calcaneus) to the toes. This fascia supports the arch of the foot and absorbs the stresses and strains we place on our feet. When excessive pressure is applied over time, tiny tears can develop in the tissue. Repetitive strain and inflammation lead to the characteristic pain of plantar fasciitis.

Common causes and risk factors include prolonged standing or walking, especially on hard surfaces (which is what Policemen on the beat do); obesity, which increases the load on the feet; flat feet or high arches, which alter natural weight distribution; inadequate footwear lacking proper support; sudden increases in activity levels, particularly running or walking. Though more frequent in middle-aged individuals, it can also affect younger people, particularly athletes or those whose jobs require long periods on their feet.

The hallmark symptom of policeman’s heel is a sharp, stabbing pain in the heel, especially noticeable with the first steps in the morning and after periods of rest or inactivity. It can also be painful following long periods of standing or walking Interestingly, pain often diminishes with activity but returns after exertion or when the foot is at rest again. Some patients may also experience tightness in the Achilles tendon or calf muscles, which can exacerbate the problem.

Diagnosis is usually clinical, based on patient history and a physical examination. Physicians may palpate the heel to localize pain and assess tension in the plantar fascia. While imaging is not always necessary, X-rays or ultrasound can help rule out other causes like heel spurs, fractures, or tendonitis.

Treatment for Policeman’s heel is typically conservative, with over 90% of patients improving without surgical intervention. Key strategies include reducing standing and walking time helps alleviate the pressure on the fascia; applying ice to the heel for 15–20 minutes, especially after activity, can reduce inflammation; stretching and strengthening exercises focusing on the plantar fascia, calf muscles, and Achilles tendon. Exercises like toe stretches, towel stretches, and rolling the foot over a frozen water bottle are often effective. Wearing shoes with good arch support and cushioned soles is essential. Custom orthotics may also redistribute pressure more evenly across the foot. Medications like ibuprofen can reduce pain and inflammation. If conservative measures fail after 6–12 months, more advanced treatments may be considered such as corticosteroid Injections for pain relief and Extracorporeal Shock Wave Therapy (ESWT) to stimulate healing. Surgery, such as plantar fascia release, can be thought of as a last resort.

Policeman’s heel is more than just a minor foot nuisance—it can significantly impact quality of life if not properly addressed. Fortunately, with early intervention, lifestyle modifications, and proper footwear, most people recover fully. As with many orthopedic conditions, a mix of patience, consistency, and care is the key to overcoming plantar fasciitis.

Craig Payne is a University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger and a dad.