Plantar fasciitis

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It’s easy to find out what plantar fasciitis is by just googling it, but it can be difficult to wade through the multitude of devices, orthotics, medications, exercises, and other means by which people attempt to alleviate their foot pain. I’m going to share with you some of what I find to be the most impactful tools for plantar fasciitis pain. They tend to be great to use for the majority of musculoskeletal conditions from the feet to the hips (barring tendon ruptures and bone fractures), but it’s always best to get the opinion of your health care provider if you aren’t sure whether something is safe for you to do.

For every single one of these suggestions, the most important thing is to stay within your pain tolerance. If you find yourself wincing, holding your breath, or being generally uncomfortable, you are probably pushing your body too far. Although it may be frustrating to stay within this limit, know that it is far more effective to do a stretch, exercise, or ice without pain than it is with pain. That being said, many of us are familiar with that “good kind of pain” which can feel very satisfying. Just keep tabs on that sensation because the “good pain” may be masking your approach to the “too much” type of pain.

Things to do:

  1. Go barefoot as often as you can. However this is a rule with many caveats. A lot of people with plantar fasciitis can’t put their weight on their feet without pain and can only walk around when wearing certain footwear. If this is the case for you, your barefoot time could at least be whenever you are lying down or sitting. Anytime you are barefoot, you are allowing the muscles and bones of your feet more freedom to work as nature intended.DSC_1001

 

  1. Avoid shoes with heels. Again, this might not be immediately possible if your feet have adapted to only be comfortable in shoes with heels. Try playing within what your body can handle, making sure to only make small adjustments over time so your feet aren’t shocked by the change. Other things to avoid are flip-flops and clogs, and shoes that squeeze your toes together. Why? These are all characteristics of shoes that make feet work in ways differently than the body was built to do. While not a problem if worn only on occasion, certain aspects of shoes, especially heels, can have huge consequences on the work environment of structures like the plantar fascia.

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If you’ve read any of my other posts, you’ll have heard me say that muscles don’t like to be constantly held in a long position or a short position, and that continuous pulling or squeezing of a muscle can make it very unhappy. Heeled shoes put the plantar fascia and associated muscles in a short position—for every step you take. The higher the heel, the shorter the tissue.

  1. Stretch. The plantar fascia is connected through the heel to the Achilles tendon, and thus to the calf muscles. The calf muscles are connected fascially to the hamstrings. And the hamstrings pull on the pelvis and everything connected to the pelvis (i. e. basically everything). So if your plantar fascia is upset because it’s in a short position, stretching the calves and hamstrings can help provide some much needed length.

hamstring stretch              calf stretch (2)

  1. Maintain your ankle’s range of motion. The position in which the plantar fascia and calves are shortened is called plantarflexion. The opposite position, in which the foot points up toward you, is dorsiflexion. As stated earlier, if your feet are constantly plantarflexed, the muscles and connective tissue that are shortened by this position will be sad. Therefore, it’s a good practice to be mindful of the positions your feet commonly adopt and play with increasing the range of motion they get to experience. A great exercise to do is to alternate dorsiflexion and plantarflexion—that is, pull your feet up as far as you can and then point your feet away as far as you can—back and forth several times whenever you think of it. This is a really nice way to gently mobilize these muscles in the morning while you’re still lying in bed and haven’t yet taken those first (possibly painful?) steps.

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A common product used for plantar fasciitis pain is a boot that keeps your ankle in dorsiflexion. It is usually worn at night when people tend to let their feet get pushed into plantarflexion by the blankets or their sleeping position. Alternatively, you can use a pillow or rolled up blanket to bolster your feet in a dorsiflexed position.

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  1. Standplantarfascia on things. Besides the plantar fascia, you also have a ton of muscles, tendons, and joints in the foot. Giving them work to do that is more than simply sitting squished in shoes or plopping along on hard, even surfaces, will encourage mobility within the foot, which helps increase circulation and thus the function of healing processes.

 

You can roll your foot on a ball or anything not flat cement-like. Walk on stuff, like pebbles, sticks, and bark chips, or just lumpy clothing. A couple of my favorites are big exposed tree roots and pet toys lying around the house, such as a rope bone. Again, only do what your body is ready to do without complaint.

  1. Use ice or cold within limits of pain. The purpose of icing an area is to decrease pain, so if the temperature or duration becomes such that your foot hurts more, it’s probably time to take a break. A milder but effective method is to soak your feet in cold water and wriggle your toes, or walk along a pebbly stream bed.

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