The pain of plantar fasciitis can seriously crimp your style if you like to walk or work out on your feet. Plantar fasciitis is an athletic injury to the soft band pushing up your arch on the bottom of your foot, called the plantar fascia. The tear in the tissue and the resultant inflammation causes heel pain and may be associated with heel spurs.

Treating plantar fasciitis can take months. There is no one remedy - it takes a host of remedies to deal with it. It took me up to a year to treat mine. I blitzed my foot with an array of treatments - including icing, stretches, exercises, massage, foot taping, and wearing shoes with good arch support - and did manage to get rid of it, but it took me nearly a year of exploring treatment options until I was completely pain-free.

Unless yours is an especially bad case, it probably won't take you that long if you follow the main points of healing. If I'd had all this information when I began - and if I'd skipped my doctor's recommendation of heel cups, which didn't help at all - I might have managed to get rid of my heel pain sooner.

Below are common non-invasive plantar fasciitis treatment options and key points to a successful healing regimen. To get rid of plantar fasciitis, you'll quickly learn it's not just what you do, it's how and when you do it.

The plantar fascia is the stretchy, shock-absorbing band of fibrous tissue that runs from the base of your toe to your heel and supports your arch. The "itis" suffix refers to inflammation--so plantar fasciitis is the inflammation of your plantar fascia. Plantar fasciitis typically comes on gradually, while playing a certain sport or doing a certain physical activity.  It typically affects only one foot at a time and causes heel pain. It is not the same as a heel spur, but is often associated with heel spurs.

Plantar fasciitis causes pain in your heel and along the bottom of your foot due to the inflamed bands of tissue being torn or overstretched. Typically, the pain begins when your foot first bears weight, then eases off, then may get worse with additional weight-bearing strain. According to the Sports Medicine Bible (HarperPerennial, 1995), standing on your toes or heel worsens the pain.

Although it hurts to walk, be aware that, unless your doctor advises you otherwise, you should not stop walking altogether. While some rest is necessary, plantar fasciitis doesn't benefit from an excess of rest. Don't walk when it hurts, but do walk as much as you comfortably can. You need to get your foot muscles limber and strong in order to heal.

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Plantar fasciitis can be persistant and cause your heel pain to last many months. This is caused by constant reinjury of the plantar fascia. Here's how it works:

During a rest, the muscles in your foot tighten up because they are not being used. So when your injured foot suddenly bears weight, such as first thing in the morning when you get out of bed, the torn or injured part of your plantar fascia takes the strain - rather than your more elastic muscles - and gets reinjured. This frequent reinjury can prolong your plantar fasciitis pain.

A special trick to prevent the occurrence of reinjury is to massage the foot and stretch your calf prior to standing up. Then your muscles are elastic enough to take a lot of the strain required to stand and your plantar fascia won't shoulder all the burden of your body weight.

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When you assess treatment options, be aware that you won't be picking only one remedy. Rather, you will need to tackle the problem along several fronts, as part of a general regimen of remedies. There are four main parts of a healing program to get rid of the heel pain of plantar fasciitis.

You need to:

1. Reduce inflammation (such as with rest, icing)
   
2. Stretch (typically by judicious walking, calf stretches)
   
3. Strengthen (using foot strengthening exercises)
   
4. Prevent re-injury (with well-timed massage and stretches)

Many find that while they can handle the first three, the fourth eludes them. Pay special attention to the tips on how to speed up your recovery by preventing reinjury of the tissue of the plantar fascia.

Disclaimer: Before you begin your treatment plan, be sure to get the advice of your regular physician or podiatrist. Don't let the advice in this article substitute for medical advice--it's based on my research and my personal experience, but may not apply to you.

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When you first get a plantar fasciitis injury, most doctors will advise you to stop the activity you were doing that caused it. Rest for a couple of days to bring the inflammation down.

Some kind of arch support is needed to help prevent the plantar fascia from being overstretched any more than it already is. As much as possible, you should wear shoes with serious arch support.

As an alternative to arch support built into your shoes (or in shoes with only moderate arch support) it's well worth it to replace the existing footbed with special footbed inserts and insoles. Heat-moldable insoles feature a "custom arch" that arch that adjusts to the shape of your feet when you warm them up. I found the $45 heat-moldable orthotics made by Sole to help me, especially when I wore athletic shoes. The thinner model helped make my flat dress shoes tolerable during "maintenance periods" (I wouldn't recommend wearing dress shoes in the acute phase of plantar fasciitis, especially if you are overweight). After my years of positive experiences with these shoe inserts, I cannot see myself ever going back to standard-shaped inserts.

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Calf Stretches

Stretch your calf frequently in either a sitting or standing position.

While sitting, extend your leg and tip up your toes toward your face until you feel a gentle stretch in your calf. Hold it for a few seconds.

Or, standing facing a wall, lean both hands against the wall and put one leg forward, bent at the knee and foot planted on the floor. Keep the other one straightened and extended behind you, just far enough to feel a gentle stretch in your calf.

Some schools of thought advise you to hold a stretch for thirty seconds or longer; others advise repeated slow stretches of no longer than two seconds. Do what works for you, but avoid overstretching. I stretched my calf before rising and before and during extended walking.

Foot Exercise

Sitting on a chair with your feet flat on the ground and a folded towel at your feet, use the toes of the affected foot to unfold the towel and move it around. This exercise is great for strengthening the tiny muscles of the foot. I did this once a day.

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Walking, Swimming, Stationary Bike

Your doctor will probably recommend that you stop doing your regular exercise activity while you're still injured. However, for athletes in particular, the American Academy of Podiatric Sports Medicine recommends you keep your cardio fitness up by temporarily switching to a new exercise routine.

Walking is a great aerobic exercise, as well as helpful for treating plantar fasciitis. Walk slowly at first. It may hurt a bit initially, but if it eases up, continue walking long enough to give your feet a good stretch, then stop if it starts hurting again. The idea is to stretch your muscles but avoid reinjuring the plantar fascia.

Other good exercise options include swimming, using a stationary bicycle, or doing seated or lying weight lifting.

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Frequent massage is an important part of the treatment. Massage loosens the muscles of the foot and thus the already-overstretched injured bands along the sole of your foot won't be forced to stretch even further.

Before you get up from bed in the morning, massage your injured foot with your fingers, the side of your hand, or a knobby massage instrument for at least five minutes to prevent reinjury. Massage the bottom of your foot gently and slowly. Massage all the soft tissue as deeply as is comfortable.

Tip: Avoid motorized massage machines, which can be more vigorous than is good for this sports injury.

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Taping your foot with 1 1/2" sports tape is an effective and inexpensive way to provide therapeutic arch support, especially for those times you have to wear flat shoes that don't have adequate cushioning or support. Some people also tape their feet at night.  Depending on your foot size, you may also find 1" or 2" athletic tape works.

The World Wide Web abounds with pictures and videos for how to tape your foot if you have plantar fasciitis.

Here is a terrific set of step-by-step plantar fasciitis taping instructions with great pictures.  And here are more instructions for taping the foot for plantar fasciitis. And here's yet another set of taping instructions.  Between these and the video below, you should find it easier to get on your feet again without causing repeat trauma to the fascia.

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The application of a cold compress brings down the inflammation on the bottom of your foot. Since this part of the foot is very sensitive, if you can't handle the cold of an ice pack, here's a method of icing your foot that one doctor recommended.

Keep a couple of cans of soda in the refrigerator. After you've exercised or been on your feet, take out a cold can and sit down on a chair. Place the can on its side on the floor. With the bottom of your bare foot, roll the ice-cold can firmly up and down the arch for 10-15 minutes. This technique has the added advantage of combining massage with cold therapy.

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Some doctors advise the use of heel cups, also called heel lifts, which raise your heels and ease the strain on the plantar fascia.

Heel cups, if you use them, are usually for temporary use only. In the long run, they may make your pain worse, since they may cause you to overpronate or make you susceptible to achilles tendonitis. The best advice is to follow the advice of your podiatrist.

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The Sports Injury Handbook by Levy and Fuerst (John Wiley & Sons, 1993) states that a 10-20 pound weight gain can cause plantar fasciitis. In my experience, weight gain doesn't play a role--at my fattest, my plantar fasciitis has given me no trouble. In my case it was a sports injury that caused it.

Sports injuries in which you move from side to side, such as when running on jagged ground, playing tennis or playing racquetball, are particular culprits.

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Most cases (80%) of plantar fasciitis resolve themselves by one year with conservative treatments. Medical doctors may recommend anti-inflammatory medications, foot exercises and stretches, icing, night splints and inserts to add arch support to shoes.

Some cases take longer, even years, to resolve. For stubborn cases, treatment options your doctor will consider include:

• corticosteroid injections
  
• cast boot for the leg
• surgery
• shockwave therapy
  

But again, most cases do not require these more extreme and sometimes painful therapies and get better on their own.

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Some alternative treatments used to treat pain in the heel include acupuncture, trigger point release (myotherapy), reflexology, and chiropractic treatments. Depending on the particular cause of the injury, these techniques may work, or they may not.

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The best footwear for plantar fasciitis pain is footwear that supports your arch and corrects your stride. To supplement the right shoes, you may want to wear arch supports, special insoles, or, if your podiatrist recommends it, heel lifts (in both heels). See my article, Best Shoes for Plantar Fasciitis, for specific recommendations.

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