What can I do for plantar fasciitis?

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Jane Milliff
Physical Therapy

There are numerous ways to treat plantar fasciitis and some you can easily initiate yourself.

  • Ice massage: Rub an ice cube over the area of discomfort in a circular motion for 5-7 minutes.
  • Stretch: Calf stretches against wall:  straight and bent knee, plantar fascia stretch insert video
  • Proper shoes are essential. Be sure to replace running shoes after 300-400 miles of running, depending on your size.
  • Self massage the plantar fascia with tennis/golf ball or tubing
  • Deep tissue massage to calves
  • Decrease training intensity and cross train if possible
  • Strengthen your core and overall lower extremities
  • Wear a Strassburg sock at night.

What’s the next step?

If you have done all you can and still have pain, what’s next? How do you get back on the trail, back up to your running intensity, on skis again, or simply walking around the block without pain?

A recent study in the Journal of Orthopedic and Sports Physical Therapy looked at 60 patients suffering from heel pain. Half were given the stretches mentioned above; the other half underwent the stretches and received manual therapy. The group that received both manual treatment and self-stretching experienced greater improvement in physical function and a greater reduction in pain compared to those performing self-stretching alone.

 Manual treatments can include such things as trigger point dry needling, myofascial/deep tissue release, joint mobilization and manipulation, and manual stretching. All of these, in addition to various taping techniques, specific strengthening exercises addressing foot impairments and weakness of the hip and low back will help eliminate pain. 

Also, your therapist can determine the need for a foot orthosis to improve the biomechanics of your lower leg, decreasing strain on the plantar fascia. A full biomechanical evaluation by your therapist will determine the cause of the irritation, so you can eliminate the factors creating the aggravation. Getting to the CAUSE of the tightness is the key to its resolution and is what keeps it from coming back. Physical therapy is the detective work that teases out all contributing factors and helps you recover.




Brian Yee
Physical Medicine & Rehabilitation

Pain in the arch or heel of your foot is commonly diagnosed as 'plantar fasciitis'. However, there are several reasons that can cause pain at the bottom of the foot.

Plantar fasciitis: Usually due to an over-stretched arch. Treatment by taping, manual therapy, orthotics, and use of night splints can provide short-term relief. Long term prognosis is based not only treating the plantar fasciitis itself, but also restoring proper mechanics of the entire leg.

Nerve Pain: The tibial nerve, which is a branch of the sciatic nerve can cause symptoms in the bottom of the foot. The key to treatment in nerve injuries is to determine why and where the injury occurred and treat the nerve accordingly.

Muscle Trigger Points: According to Travell and Simmons, muscle trigger points in the calf and foot muscles can cause referred pain to the foot. Soft tissue techniques and intramuscular manual therapy can be used.

 

If you have plantar fasciitis, you should perform a combination of flexibility and strengthening techniques to expedite the recovery process. Begin by foam rolling (a form of self-massage) your calves. This can help relax tight muscles before you stretch them. Hold the tender spots for 30 seconds so that your muscle can relax and release the knots that are causing tension in the muscle. You can also place the foam roller or a tennis ball on the bottom of your foot and roll back and forth in order to help increase range of motion of the foot. Once you have prepared your muscles, then you can statically stretch your calves. Hold the stretch for 30 seconds to allow your muscles time to relax and elongate. Next you will perform strengthening exercises for the foot and ankle. Towel scrunches are great for strengthening the muscles in the bottom of the foot. lso, you can do single-leg calf raises with your toes turned in to help strengthen the muscles that support your foot and ankle. Lastly, perform a single-leg balance exercise, ensuring that the arch of your foot is lifted while performing the exercise. Perform 1-3 sets of 10-15 repetitions of each of these exercises.   

Continue Learning about Plantar Fasciitis

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.