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Plantar Fasciitis

Plantar Fasciitis is one of the most common causes of heel pain. It happens when the thick band of tissue that connects your heel to your toes (Plantar Fascia) gets inflamed. There are many conservative treatments that can help reduce the inflammation, which we will detail below. 

Proper Shoes and Insoles

One of the easiest fixes for Plantar Fasciitis is changing the shoes you wear. Many of our patients come in with shoes that are flimsy and flat, with virtually no support. When looking to buy shoes, there are a few criteria you want to meet. 

 

  • The first is that the shoe is stiff through the shank, and flexible at the toe. You don't want the shoe to bend at the midfoot, because your foot doesn't bend there, and you need the support in your arch. 

  • Another criteria is a small heel to toe drop, usually 1" to 1.5". This is because it holds the plantar fascia in a more relaxed position, which relieves pressure.

  • We also recommend a shoe that has a removable insole, so that you can replace it with a more supportive insole. We recommend a pair of heat moldable insoles, as they are easy to break in and provide good support. 

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There are several types of running shoe that are specially made to accommodate different feet. Call and make an appointment today to find out the perfect shoe for your foot. 

Stretching and Splinting

A common cause of Plantar Fasciitis is tight muscles in the calf and hamstrings. There are many different options for treating this, but they all involve a good, prolonged stretch. 

At-Home Stretching:

To start, you may want to try a few stretches at home. Take a moment to watch the video on this page for some of the most effective stretches for plantar fasciitis. 

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Some things to remember:

  • Hold the stretches for 45-60 seconds for each leg

  • Stretching exercises should have a "pulling" feeling, but should not cause pain. If you feel any excessive pain, contact your doctor and have them evaulate you to provide the best stretches.

  • Remember to hydrate. Being dehydrated can lead to increased muscle cramping. 

Yoga

For some people, remembering to do an at home stretching routine for 1 hour, 3 times a week can be hard. For those people, we recommend a yoga class. Check with your local gyms or just google "yoga classes near me" to find a class time that works for you. The added benefits of taking a class include more accountability, and all over flexibility and strength that can help prevent future injuries.

Night Splinting

Sometimes, vigorous stretching routines are not a viable option. In those cases we recommend using a night splint or Strassburg Sock. There are a few differences in the two, but they both mainly work to  stretch the calf muscle while you rest or sleep.

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A night splint is a hard boot that you wear over your foot and calf that holds you foot at a 90 degree angle. They can be very effective if worn while sleeping or resting on a daily basis. You cannot walk in a traditional night splint, it must be removed before putting weight on your feet. Some patients also complain that the bulky size makes them hard to sleep in.

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Another option is a Strassburg Sock. The idea behind them is similar to a night splint, however they are a good option for if you've tried the night splint but have trouble sleeping in them due to the bulk. Another pro to wearing these is that you can put weight on them, which is more convenient for people who wake up many times in the night to use the restroom. Some people have complained of pain in the big toe joint from wearing these. Also, many insurances will cover the cost of a traditional night splint, but not a Strassburg Sock. 

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Whichever option you choose, know that there may be a window where you want to break the product in. Start slow with 1-2 hours a day and work your way up to 5-6 hours of sleeping in the splint, as that is when you will get optimal results.

Massage

After all of that  stretching, you may need to massage your muscles out. There are a few products we recommend for that exact purpose! For an at home remedy, you can use a golf ball or tennis ball to roll along the arch of your foot. Other options include spiky massage balls and The Stick. These all help increase circulation and help with muscle tightness. 

Reducing Inflammation using Anti-Inflammatories

Sometimes proper shoes and stretching just don't cut it, and you need a little extra help with managing the pain that comes with severe Plantar Fasciitis. That's where anti-inflammatories come into play. These can vary from icing your feet to getting cortisone injections, and often prove to be very effective with managing and even curing your pain. It is important to consult your doctor before starting any new medication protocols. 

Icing

The first place to start with reducing inflammation is icing. When done correctly, icing can help significantly with reducing pain and swelling in the plantar fascia. 

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A few things to keep in mind with icing your feet:

  • Don't apply the ice directly to your feet. Make sure you use some type of thin barrier, like a towel, washcloth, etc. 

  • You should only be applying ice for around 10-20 minutes at a time. Wait 1 hour before starting another round of icing. 

  • If you begin to feel any loss of sensation or "pins and needles" stop icing immediately. If you don't recover feeling, or warmth does not return to your skin within 45 minutes, contact your doctor. If you have circulation issues, consult a doctor before icing. 

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There are many products that you can use to ice your feet, we recommend either reusable ice packs, or you can just freeze a water bottle and roll it along your arch and heel. 

Other Anti-Inflammatories

If icing isn't enough relief, it may be time to consult a doctor about starting a prescription strength course of an NSAID like Ibuprofen or Naproxen,  or beginning a round of cortisone injections. These are proven and useful treatments best left to professionals to prescribe. Don't hesitate to make an appointment to begin treatment today at Pacific Coast Podiatry

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