Plantar Fasciitis Treatment Options: Stretches, Exercises and More to Heal Your Heel Pain
Who I Am - Big Disclaimer
I'm not a medical professional; I'm a writer. I have had plantar fasciitis - badly, twice - and gotten rid of the pain and have been pain-free for years. Between writing about it and treating myself, I've researched the subject to death. Consider my advice as that of a neighbor or friend - take it with a grain of salt, get the professional advice of your own podiatrist, and, as with everything you learn online, verify your facts.
The Best Plantar Fasciitis Remedies for Me...
As a fellow sufferer of heel and arch pain, I know just how badly plantar fasciitis can crimp a person's style. Walking and working out become horribly painful and you feel old before your time.
Treating plantar fasciitis can take months. It can even persist for years in some cases. There is no one, single catch-all remedy - trust me, it takes a host of remedies to deal with it.
It took me up to a year to treat mine at home the first time I got it about fifteen years ago. I blitzed my foot with an array of natural and therapeutic treatments - including icing, stretches, exercises, massage, foot taping, and wearing shoes with good arch support. I did manage to get rid of it, but it took me nearly a year of exploring home treatment options until I was completely pain-free.
In 2011, I had a recurrence and it was worse than ever. I could hardly walk for months. I finally managed to get rid of it again by trying new (to me) home therapies. After getting rid of it that time, it stayed gone.
Unless yours is an especially bad case, and you need surgery or other medical treatment, it might not 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 - "cure" it, if you will (though keep in mind it may recur at some point if there has been permanent loss of collagen fibers in the foot's tissues) you'll quickly learn that it's not just what you do - it's how and when you do it.
What is Plantar Fasciitis?
Basically, it's an athletic injury to the soft band that supports your arch on the bottom of your foot. That band, a stretchy and shock-absorbing fibrous tissue that runs from the base of your toe to your heel and supports your arch, is called the plantar fascia. The "itis" suffix refers to inflammation.
The tear in the tissue and the resultant inflammation cause heel pain that can make walking crippling. The disease usually affects only one foot at a time. It causes heel pain. It is not the same as a heel spur, but is often thought to be associated with heel spurs.
According to recent research, plantar fasciitis is thought to be the inflammation of the plantar fascia, though the underlying pathology involves the degeneration of collagen.
Slow and Insidious
Plantar fasciitis typically comes on gradually, starting as a nagging pain and then worsening over time, over the course of playing a certain sport or doing a certain physical activity.
Why Does It Hurt So Much to Walk With Plantar Fasciitis?
As I said before, plantar fasciitis causes pain in your heel and along the bottom of your foot due to the sprained or strained bands of tissue being torn or overstretched and then getting inflamed. The pain has a peculiar consistency. Typically, the pain begins when your foot first bears weight after rest, 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 my own doctor told me not to stop walking altogether. He said that 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.
How to Identify the Pain of Plantar Fasciitis
You'll typically feel pain where your heel meets your arch on the inside of the foot. You may also feel numb on the outer edge of your foot.
Plantar fasciitis pain tends to feel like a deep ache rather than a sharp stabbing.
You may notice that the pain is especially bad first thing in the morning, or after sitting or lying down. Whenever you first put weight on your foot after a rest, you're likely to wince.
Most commonly, plantar fasciitis pain occurs on only one foot at a time, but it can occur on both feet.
Poll: Have You Tried Night Splints for Plantar Fasciitis?
Do Night Splints Help Your Plantar Fasciitis?
Can't Get Rid of Plantar Fasciitis? Here's Why
Plantar fasciitis can be persistent 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.
An Array of Treatment Options
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:
- Reduce inflammation (such as with rest, icing)
- Stretch (typically by judicious walking, calf stretches)
- Strengthen (using foot strengthening exercises)
- Prevent re-injury (with well-timed massage, stretches, correct footwear, and possibly a night splint)
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.
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.
Arch Supports and Shoe Inserts (Insoles) for Plantar Fasciitis
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 two-layer, made-for-athletics to help me, especially when I wore athletic shoes. The thinner leather 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. heat-moldable orthotics made by Sole
Although not enough in and of themselves, some socks also provide extra arch support.
Plantar Fasciitis Insoles and Support
I used this product, Sole heat-moldable orthotic inserts with extra cushioning, in my hiking boots and athletic shoes. They also carry inserts for dress shoes. I have three pairs of Sole insoles and still use them religiously. They last me a long time--years.
Stretches and Exercises for Treating Plantar Fasciitis
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.
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.
How to Get Cardiovascular Exercise With Plantar Fasciitis
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 weightlifting.
Frequent Plantar Fasciitis Massage Treatment
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. One tool that's helped some plantar fasciitis sufferers is a cheaply priced but effective piece of equipment called the . Massage the bottom of your foot gently and slowly. Massage all the soft tissue as deeply as is comfortable. Happy Company Foot and Body Roller Massaging Fingers
Tip: Avoid motorized massage machines, which can be more vigorous than is good for this sports injury.
Plantar Fasciitis Massage Tool
Reviewers with plantar fasciitis rave about this inexpensive and seemingly simple massage tool for the feet and body. It's a great way to massage the affected foot before rising, thus loosening tight foot muscles and preventing reinjury upon standing.
Night splints, also called night braces, are recommended by some doctors to help with heel pain. Morning is one of the worst times for plantar fasciitis pain. This is because when you sleep, your feet relax and your Achilles tendon shortens, and this can cause your plantar fascia to bear more strain. Night splints keep your foot from straightening out and your calf stretched at night while you sleep. In the morning, your foot is likely to feel better.
I personally was lucky enough to heal without night splints; the other treatments took care of my pain.
UPDATE: Life is so unpredictable! After years of having it good, recently I started having a painful recurrence of my plantar fasciitis, worse than ever. So I tried the Strassburg Sock instead of a hard night brace. Read my review to find out how it helped me. If you don't want to read the long version - it did help, very much.
Plantar Fasciitis Night Splint
Plantar Fasciitis and Taping
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'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.
How to Tape the Foot for Plantar Fasciitis Video
Poll: Does Taping Really Work for Plantar Fasciitis?
Does taping the arch of your foot help your plantar fasciitis?
Ice and Cold Packs for Plantar Fasciitis
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.
Heel Cups or Heel Lifts
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 tendinitis. The best advice is to follow the advice of your podiatrist.
Heel pads did not help me at all, for what it's worth.
Poll: What's the Verdict on Heel Cups for Plantar Fasciitis?
Have you experienced relief using heel cups for plantar fasciitis?
What Causes Plantar Fasciitis?
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. Runners might experience plantar fasciitis when they run too far, run on very hard surfaces, wear less-than-ideal shoes for their feet and activity, overpronate, or have a shortened Achilles tendon.
Plantar Fasciitis Medical Treatments: Surgery, Steroids and More
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:
But again, most cases do not require these more extreme and sometimes painful therapies and get better on their own.
Alternative Treatments for Plantar Fasciitis
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. I recently had very good results from doing home trigger point therapy on my calf on the affected side.
This book has helped me with a lot of pain conditions, PF included. Specifically, the trigger points on the calf are directly implicated in plantar fasciitis pain, because they can keep the gastrocnemius (big calf muscle) too knotted to relax.
Recommended Shoes for Plantar Fasciitis
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 articles, Best Shoes for Plantar Fasciitis for running shoes, dress shoes, sandals and more, and Shoes for Plantar Fasciitis (which has more specific recommendations for boots, athletic shoes, sandals, and more.) You might also be interested in plantar fasciitis slippers and flip-flops.
© 2009 Chris Telden