Dealing with Plantar Fasciitis
The plantar fascia, as seen above, is the flat band ligament that connects your heel bone to your toes. It supports the arch of your foot. If your plantar fascia is subject to stress, it can become inflamed. (This is where the ‘itis’ comes in.) The inflammation typically begins where the fascia attaches to the heel, causing heel pain, especially when weight is placed on the heel after resting. The pain can also involve the ball of the foot. Plantar fasciitis (PF) is the most common cause of heel pain.
This condition is common in middle-aged people, but it also occurs in younger people such as athletes or soldiers who are on their feet a lot. It can happen in one foot or both feet, but is typically much worse in one foot.
Plantar fasciitis is caused by cumulative trauma (repetitive strain) to the ligament that supports your arch. Repeated strain can cause tiny tears in the ligament. These can lead to pain and swelling. This is more likely to happen if:
• Your feet roll inward too much when you walk (excessive pronation).
• You have high arches or flat feet.
• You walk, stand, or run for long periods, especially on hard surfaces.
• You are overweight.
• You wear shoes that don’t fit well, or are worn out.
• You have tight Achilles tendons Achilles tendons or calf muscles.
Most people with plantar fasciitis have pain when they take their first steps after they get out of bed or sit for a long time. You may have less stiffness and pain after you take a few steps. However, your foot may hurt more as the day goes on. It may hurt the most when you climb stairs or after you stand for a long time. If you have foot pain at night, you may have a different problem, such as arthritis, or a nerve problem such as tarsal tunnel syndrome.
The first thing to do is to get a diagnosis. Once this has been done, treatment can begin. Treatment can involve any of the following suggestions:
- Rest- This is an inflammatory condition; therefore, the more active you are, the more the foot can become inflamed.
- If possible, cut back on activities that make your foot hurt.
- Avoid walking on hard surfaces.
- At the end of the day, or when off your feet, put a cold gel pack on your heel for 10 minutes, or roll your foot over a frozen water bottle.
- Do toe stretches, calf stretches, hamstring stretches and towel stretches several times a day. (see below).
- Consider massage therapy. A massage therapist can assess your condition, and offer specific stretches and home-care suggestions for you to adopt.
- Ultrasound therapy, combined with manual therapy is very effective in treatment of PF
- Be sure that your shoes have good arch support and a cushioned sole. If not then consider purchasing new shoes.
- Diet plays an important role. Foods that you eat are either pro-inflammatory, or anti-inflammatory. For more on this topic read my post on anti-inflammatory diet.
- Consider taking an over-the-counter anti-inflammatory medication if the condition worsens (consult your pharmacist first) or ask your doctor about a prescription anti-inflammatory medicine.
- Heel cups or orthotics can help in the treatment of this condition. (Use them in both shoes, even if only one foot hurts)
- If this condition is persistent, consider wearing night splints
- If your foot does not respond, a last resort would be a steroid injection from your physician.
As a massage therapist, I have had tremendous success with ultrasound therapy, followed by Soft Tissue Release©. This approach, combined with anti-inflammatory medicine and regular stretching at home will dramatically shorten the duration of this stubborn condition.
Below, you will see several exercises that can help with self-treatment of this condition.