Got plantar fasciitis? There are a bazillion websites that’ll tell you what it is. I’ll start with what the Mayo Clinic says it is and then I’ll give you real-world suggestions from clients and friends who suffer from it and have found what works for them.
According to the Mayo Clinic
Plantar fasciitis (PLAN-tur fas-e-I-tis) is one of the most common causes of heel pain. It involves pain and inflammation of a thick band of tissue, called the plantar fascia, that runs across the bottom of your foot and connects your heel bone to your toes.
Plantar fasciitis commonly causes stabbing pain that usually occurs with your very first steps in the morning. Once your foot limbers up, the pain of plantar fasciitis normally decreases, but it may return after long periods of standing or after getting up from a seated position.
Plantar fasciitis is particularly common in runners. In addition, people who are overweight and those who wear shoes with inadequate support are at risk of plantar fasciitis.
Plantar fasciitis typically causes a stabbing pain in the bottom of your foot near the heel. The pain is usually worst with the first few steps after awakening, although it can also be triggered by long periods of standing or getting up from a seated position.
Under normal circumstances, your plantar fascia acts like a shock-absorbing bowstring, supporting the arch in your foot. If tension on that bowstring becomes too great, it can create small tears in the fascia. Repetitive stretching and tearing can cause the fascia to become irritated or inflamed.
Factors that may increase your risk of developing plantar fasciitis include:
Age. Plantar fasciitis is most common between the ages of 40 and 60.
Certain types of exercise. Activities that place a lot of stress on your heel and attached tissue — such as long-distance running, ballet dancing and dance aerobics — can contribute to an earlier onset of plantar fasciitis.
Faulty foot mechanics. Being flat-footed, having a high arch or even having an abnormal pattern of walking can adversely affect the way weight is distributed when you’re standing and put added stress on the plantar fascia.
Obesity. Excess pounds put extra stress on your plantar fascia.
Occupations that keep you on your feet. Factory workers, teachers and others who spend most of their work hours walking or standing on hard surfaces can damage their plantar fascia.
Ignoring plantar fasciitis may result in chronic heel pain that hinders your regular activities. If you change the way you walk to minimize plantar fasciitis pain, you might also develop foot, knee, hip or back problems.
Preparing for your Appointment
While you may initially consult your family physician, he or she may refer you to a doctor who specializes in foot disorders or sports medicine.
What you can do
You may want to write a list that includes:
- Detailed descriptions of your symptoms
- Information about medical problems you’ve had
- Information about the medical problems of your parents or siblings
- All the medications and dietary supplements you take
- Questions you want to ask the doctor
- What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. For instance, your doctor may ask:
- Do your symptoms tend to occur at a particular time of day?
- What types of shoes do you usually wear?
- Are you a runner, or do you participate in any sports that involve running?
- Do you have a physically demanding job?
- Have you experienced any injuries to your feet in the past?
- Besides your foot, do you feel pain anywhere else?
- What, if anything, seems to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
Tests and Diagnosis
During the physical exam, your doctor checks for points of tenderness in your foot. The location of your pain can help determine its cause.
Usually no tests are necessary. The diagnosis is made based on the history and physical examination. Occasionally your doctor may suggest an X-ray or magnetic resonance imaging (MRI) to make sure your pain isn’t being caused by another problem, such as a stress fracture or a pinched nerve.
Sometimes an X-ray shows a spur of bone projecting forward from the heel bone. In the past, these bone spurs were often blamed for heel pain and removed surgically. But many people who have bone spurs on their heels have no heel pain.
Treatments and Drugs
Most people who have plantar fasciitis recover with conservative treatments in just a few months.
Pain relievers such as ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve) may ease the pain and inflammation associated with plantar fasciitis.
Stretching and strengthening exercises or use of specialized devices may provide symptom relief. These include:
Physical therapy. A physical therapist can instruct you in a series of exercises to stretch the plantar fascia and Achilles tendon and to strengthen lower leg muscles, which stabilize your ankle and heel. A therapist may also teach you to apply athletic taping to support the bottom of your foot.
Night splints. Your physical therapist or doctor may recommend wearing a splint that stretches your calf and the arch of your foot while you sleep. This holds the plantar fascia and Achilles tendon in a lengthened position overnight and facilitates stretching.
Orthotics. Your doctor may prescribe off-the-shelf heel cups, cushions or custom-fitted arch supports (orthotics) to help distribute pressure to your feet more evenly.
Surgical or other procedures
When more-conservative measures aren’t working, your doctor might recommend:
Steroid shots. Injecting a type of steroid medication into the tender area can provide temporary pain relief. Multiple injections aren’t recommended because they can weaken your plantar fascia and possibly cause it to rupture, as well as shrink the fat pad covering your heel bone.
Extracorporeal shock wave therapy. In this procedure, sound waves are directed at the area of heel pain to stimulate healing. It’s usually used for chronic plantar fasciitis that hasn’t responded to more-conservative treatments. This procedure may cause bruises, swelling, pain, numbness or tingling and has not been shown to be consistently effective.
Surgery. Few people need surgery to detach the plantar fascia from the heel bone. It’s generally an option only when the pain is severe and all else fails. Side effects include a weakening of the arch in your foot.
Lifestyle and Home Remedies
To reduce the pain of plantar fasciitis, try these self-care tips:
Maintain a healthy weight. This minimizes the stress on your plantar fascia.
Choose supportive shoes. Avoid high heels. Buy shoes with a low to moderate heel, good arch support and shock absorbency. Don’t go barefoot, especially on hard surfaces.
Don’t wear worn-out athletic shoes. Replace your old athletic shoes before they stop supporting and cushioning your feet. If you’re a runner, buy new shoes after about 500 miles of use.
Change your sport. Try a low-impact sport, such as swimming or bicycling, instead of walking or jogging.
Apply ice. Hold a cloth-covered ice pack over the area of pain for 15 to 20 minutes three or four times a day or after activity. Or try ice massage. Freeze a water-filled paper cup and roll it over the site of discomfort for about five to seven minutes. Regular ice massage can help reduce pain and inflammation.
Stretch your arches. Simple home exercises can stretch your plantar fascia, Achilles tendon and calf muscles.
In Addition My Clients Recommend the Following:
Here are some other suggestions given from a Facebook post I started on this.
The Graston technique (several recommend this – see a chiropractor )
Active Release Therapy
KT Tape and custom shoe inserts
Orthaheel vionic shoes, sandals and sneakers (highly recommended by several)
I taped my foot for well over a year and wore good inserts. That with stretching, massage and icing finally got it to heal. Special hard orthotic insoles from my podiatrist and switching to wearing Dansko shoes and Orthaheels sandals (now called Vionic)
A Doctor of Physical Therapy client of mine says …
Please, please, please, wear good supportive shoes. Luckily, shoe companies have gotten on board and designed some good looking shoes (ones that don’t look like shoes your Grandma wore) that are supportive. Flip flops are NOT supportive shoes. There is an orthopedic flip flop of sorts called Orthaheel which aren’t bad and have a big arch support (too much for some people). The flip flops that are really bad are the thin little ones that are really cheap in the store.
For the summer, Teva, Alegria, Naot and some Clarks are good sandal options. Don’t walk barefoot in the house – especially if you have hardwood floors. I have a pair of supportive slippers/sandals that I only wear in the house.
I use slipper/clogs made by Europedica and ordered them from FootSmart.com Another brand I like is Teva – they are really a sporty sandal for outside, but I have had patients purchase them to be used inside the house and could be worn with socks in cooler weather. They are velcro adjustable. I use those for sandals in the summer.
You can also freeze water in a water bottle and put your foot on top of it and roll it with some pressure – kind of a hurts so good type of thing. Most importantly, if you are unable to get the pain to subside within 3-4 weeks, please seek out a PT. There are things we can do to help resolve the pain.
Losing weight has helped big time. Finding and consistently using beneficial stretches is a must. Avoiding high impact activity until completely healed is important. Never going barefoot, always having a well fitted, arch supported shoe and house-shoe. I also bought a home use ultrasound therapy device that I believe helps, if used on a regular basis. I bought mine several years ago from MendMeShop. I see a similar one at the following: UltrasoundCure.com. It’s called the Xyliss Ultrasound Pain Therapy Rocore Thermal Systems
Extracorporeal Pulse Activated Therapy (EPAT)
Take those cheap inserts out of your athletic shoes and replace them with GREEN Superfeet. I had plantar fasciitis for two years. Tried everything including cortisone shots. What finally helped resolve it was using GREEN Superfeet cushioned insert in my shoes. Sure enough… I’ve never had any problem since.