Plantar fasciitis is a very common foot problem that affects many individuals. In simplest terms plantar fasciitis is inflammation involving the plantar fascia band which extends from your heel bone to the bones of the forefoot. Some contributing factors for plantar fasciitis include flat feet or high arches, excessive time on your feet, obesity, muscle imbalances, improper footwear, walking barefoot, etc. Classic symptoms involve heel and/or arch pain, muscle tightness, and morning pain when taking your first few steps. The medical literature states that plantar fasciitis is the most common cause for heel pain1 and approximately 10% of individuals will experience plantar fasciitis at some point during their lifespan.2 Given that I am a runner with a lower arch profile I have dealt with plantar fasciitis several times and this is a problem that can periodically resurface. The key to properly managing and recovering from plantar fasciitis is to develop a comprehensive treatment program which includes the following:
1. Stop wearing inappropriate footwear. This includes avoiding tight fitting shoes, high heeled shoes, flip-flop sandals, and any other flat or narrow fitting shoes. Dress shoes typically do not have adequate arch support and usually lack enough room for your toes.
2. Start wearing proper footwear with good arch support. There is a wide variety of tennis shoes that offer adequate toe room and good arch support. Certain styles of work boots can also provide adequate support as well. When buying a new pair of shoes you should always make sure that you buy the correct size to allow enough room for your toes. A simple reminder when trying to find the correct size shoe is to follow the “rule of thumb”. Basically when you buy shoes you should have a thumb width of space from the end of your big toe to the end of the shoe. This will make sure you have adequate room for your toes. You can also find certain brands of sandals that provide good arch support. If you have difficulty finding the right type of shoe for your foot try to find a shoe store that has a pedorthist on staff. Pedorthists are individuals that are trained to provide the correct type of shoe based upon a person’s walking mechanics and foot profile.
3. Try to avoid barefoot walking as much as possible. Walking barefoot puts more stress and pressure on your feet. Many of my patients prefer to walk barefoot inside their home so a simple solution is to purchase something similar to Crocs shoes or a clog type of shoe which are easy to get on and off. If you purchase these types of shoes it is important to find one that has adequate arch support that is also comfortable to wear.
4. Start doing self-massage and stretching exercises. Ideally before you get out of bed in the morning sit at the edge of your bed and cross the involved foot over your other leg. Then with one hand gently pull up on your toes until you feel a stretch in the arch of your foot. Next use your other hand and apply some Vaseline or cheap massage cream on your arch and use your knuckles or fingers/thumb and massage the arch and heel of your foot while you maintain the stretch. Do this for 5 to 10 minutes twice a day. An alternative to the self-massage is to roll a tennis ball under your foot or keep your sock on and use a cold/frozen water bottle.
5. Start applying a cold agent several times a day. When using an ice pack or cold gel pack you need to have at least one barrier protecting your skin such as a pillow case. Apply the cold agent to the involved area for 20-30 minutes at a time and do this several times throughout the day. A bag of frozen vegetables, such as peas or corn, also works well as long as you shake it up. Simply place the bag of frozen vegetables in a pillow case and let your foot rest on top of it when sitting in a chair. You can also take a frozen water bottle and roll it under your arch and heel to act as a cooling massage for 8 to10 minutes but keep your sock on to serve as a protective barrier for your skin. If you do not have an ice pack you can easily make a gel pack by using a 3:1 ratio of water to rubbing alcohol. Simply put 3 cups of water and 1 cup of rubbing alcohol in a sealed Ziploc bag and place it in your freezer until it turns into a soft solid.
6. Take it easy for a while and give your body time to heal. The human body has great capacity for healing if an individual helps facilitate this process. This means that when you are experiencing more foot pain it is beneficial to take it easy for a few days and try to minimize time on your feet. This doesn’t mean you have to turn into a “couch potato” because that isn’t beneficial but basically do activities to your tolerance based upon your pain level. As you start to feel better and experience less pain then you gradually increase the weight bearing activities that you are doing in order to help avoid flare-ups.
1. Stephen Barrett, D.P.M. and Robert O’Malley, D.P.M. Plantar Fasciitis and Other Causes of Heel Pain. American Family Physician. 1999 Apr 15; 59(8): 2200-2206.
2. Mohammad Ali Tahririan, Mehdi Motififard, and Babak Siavashi. Plantar Fasciitis. Journal of Research in Medical Sciences. 2012 August; 17(8): 799-804.
1. This information is only intended for general medical advice and is not intended as a substitute for personalized medical care.
2. If you are experiencing foot pain that does not resolve within a few weeks you should see a physician or a licensed physical therapist.
3. If you are experiencing any symptoms that include numbness, tingling, burning, or shooting pains this may indicate the presence of nerve involvement. If this is occurring you should see a physician as soon as possible.