A young athlete is found to have a depression of the longitudinal arch of both feet. He complains of bilateral heel pain. The rest of his foot is normal and he has continued with his activities. What could be recommended for his heel pain?

• A. An X-ray of the foot is needed first.
• B. He needs some heel support in his shoes.
• C. NSAIDs should be used initially.
• D. Rigid orthotics could be ordered for his shoes.

Answer: (B)

The main idea is that heel pain in a young athlete with a depressed foot arch is often due to overuse from flat feet causing increased strain on the plantar fascia. The quickest, most effective way to relieve that mechanical stress is to provide heel support in his shoes. Adding heel cushions or a supportive insert helps distribute pressure more evenly, supports the arch, and reduces the pulling on the plantar fascia during activity, which typically lessens pain and allows continued sport participation.

Imaging isn’t usually needed first unless there are red flags or persistent, worsening symptoms. Nonsteroidal anti-inflammatory drugs can help with pain but don’t fix the underlying mechanics. Rigid orthotics are a more definitive intervention and can be considered later if simple heel support does not adequately control symptoms.