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Plantar Fasciitis Treatment Guide

We can all agree there is a lot of misinformation about the best plantar fasciitis treatment options out there.

But what if I told you:

There are plantar fasciitis treatments out there that actually work? What if I told you that there is a plantar fasciits cure?

Have I got your attention now?

Great, so what is the best treatment for plantar fasciitis? What is the best plantar fasciitis pain relief?

Those are great questions, and we will answer those in detail, but first we must get everyone on the same page and answer the question:

What is Plantar Fasciitis anyway?

What is Plantar Fasciitis?
What is Plantar Fasciitis?

Plantar fasciitis, by way of its name, is an inflammation of the plantar fascia.

Which sounds ok:

Until you learn that many people who have plantar fasciitis – have it without any inflammation at all. So where does that leave us?

Well Look:

If inflammation is just a symptom of the condition, then what is plantar fasciitis?

According to the smart people over at e-med, Plantar fasciitis is a degenerative process, caused by poor circulation of the calf, achilles, heels, and all the tendons in between. Affecting 10% of people everywhere, Plantar Fasciitis is usually felt as a sharp needle like pain in the middle of your heel – most commonly felt in the morning, or after sitting down, at rest, for a number of hours (think heel pain on your coffee break.)

Alright,

Now we’re getting somewhere! Tell me more!

While you walk, the arches of your feet, specifically the tendon called the plantar fascia, stretches. On impact, when these tendons stretch out the most, they act as shock absorbers for your body, taking a lot of the impact away from your knees. What also tends to happen is that the connective tissues attaching the fascia to the heel bone will begin to tear away. On a very small scale,

This is normal.

These micro tears happen all over your body when you work out, its what causes the pain in the following days of a workout. When the tears heal, that is your muscle growth.

But:

When those “microtears” in your heel don’t heal naturally, that is what we call plantar fasciitis. The microtears can’t, won’t, or don’t heal for a number of possible reasons, the most common cause is poor circulation and overuse or over doing it during your workout routine.

Think about these:

Common Causes of Plantar Fasciitis include:

  • Overly tight footwear,
  • Running more than you should every day,
  • Unsupportive footwear,
  • Dietary problems,
  • Physical stress,
  • Emotional stress,  
  • Leg trauma
  • Heel trauma
  • Minimal footwear (before you’re ready for them)
  • Running / walking on concrete without cushioned shoes
  • Running / walking on inclined surfaces
  • Overuse, overdoing it, introducing more demanding workouts before you’re ready

These risk factors can all lead to Plantar Fasciitis, whether you run every day, or just walk every day, you are at risk.

Luckily, most people won’t get plantar fasciitis and those risk factors aren’t something to worry about, I mean come on, I listed walking on inclined surfaces – who doesn’t walk uphill every now and again?

For those of us who do get Plantar fasciitis:

What treatments can cure plantar fasciitis?

Cure is perhaps the wrong word, I’d prefer to call it “plantar fasciitis healing” as it is closer to a wound that needs to heal on its own than a disease that needs curing.

The best treatments for healing plantar fasciitis fall into two categories,

Heel pain relief, and plantar fasciitis prevention.

I think everyone agrees prevention is the best medicine – So I’ll start with that. But feel free to jump straight to our list of best treatments for immediate pain relief, just

Be aware:

Without preventing plantar fasciitis and the root causes, you may never recover fully using pain relief techniques alone.

Preventing Plantar Fasciitis

Preventing plantar fasciitis, is actually pretty simple, and we will cover a lot of this stuff here. But if you prefer you can follow these links right now to learn more about each method in their own article – or just keep reading for a quick overview of each prevention method below.

Choosing the right shoes to prevent plantar fasciitis

Is choosing comfortable shoes really that difficult? Of course not,

But what if I told you comfortable shoes aren’t always the best shoes for treating plantar fasciitis.

Why not?

Because plantar fasciitis is a condition caused by poor circulation and poor support of the arches.

Pillows make for comfortable shoes, but that doesn’t make them good, or healthy shoes to wear for your feet.

Comfortable shoes also tend to wear out faster, leading to higher costs, and further damage – and if you’re a cheap ass like myself that is quite likely. The most common thing that makes a shoe feel comfortable is going to be the removable insole used inside the shoes, these comfortable insoles are generally quite cheaply made and don’t last long until they need replacing.

Okay, so what makes a good shoe then?

Generally shoes with fitting form, solid arch support, solid heel support, and an air cushioned sole.

Before you ask –

Solid arch support and solid heel support means a firm insert or sole design that supports the arch of your feet keeping it from completely flattening on impact. The design should also prevent the fatty pad in the heel of your foot from getting too squashed.

You might be wondering:

A soft foam insert would be good for those things but in-fact it can make matters worse, your arch and heel muscles need strengthening and the best way to do this is to not take all of the impact away, simply support and reduce the heavy blows from walking / running.

Are there any other issues to worry about?

Tight toe boxes, worn cushioning, low/zero drop minimalist shoes before you’re ready, can all be symptoms of improper shoes for plantar fasciitis.

While changing shoes when they wear out and lessening stress on your feet can reduce the risks of Plantar Fasciitis a great deal on its own. Pairing your good shoe selection with the right insert is another really important task when dealing with plantar fasciitis.

Leading us to..

Orthotic Inserts with arch support

Orthotics? Inserts?

These are thin to thick foam inserts you put inside your shoe either on top of, or replacing the existing inserts.

What do they do?

Everyone’s feet are different, high arch, low arch, no arch, flat feet, wide feet:

Orthotic Inserts for plantar fasciitis offer support where your shoes often lack it most; they can offer a customized molded fit where your shoes may be falling short; and they can still add long term comfort where there is often none.

Enough about shoes!

What about those calf stretches?

Reclined Leg Stretch - Step One
Reclined Leg Stretch – Step One

Wait, the pain is in the heel of my foot? – Yes, the pain is there.

But here’s the deal:

The pain in your heel is actually just a symptom, the plantar fascia is connected to tendons that reach all of the way up the back of your leg, and the main issues usually arise from tightness in your muscles further up your leg – not the arch of your foot, or the heel.

This is crazy.

So what are the stretches? Well that’s going to need to be another article as it’s really hard to describe the stretches without pictures or videos, I will however embed this video I feel is an absolute MUST WATCH for plantar fasciitis sufferers:

These stretches work especially well when you pair it with massaging both the calves and your feet.

The Plantar Fasciitis Sock Treatment

You mean plantar fasciitis socks?

No, Sock.

The Sock.

Erm, ok, what is the sock?

Its the Strassburg Sock, a special sock which is essentially a night splint in sock form, it works by pulling your toes upwards attempting to correct and stretch the plantar fascia.

Sounds painful – Can we go back to socks?

Ok, there are actual “socks” out there which are purposely designed for plantar fasciitis, but they’re essentially just your common compression sleeve or compression socks. They aim to improve circulation by holding your feet in a healthy form / position.

The principle behind compression socks is the same for sports taping for plantar fasciitis.

Sports Taping? for Treating Plantar Fasciitis?

Yes, funnily enough, you can tape up your heel like you would a knee, elbow, or wrist.

Well,

Not quite like that, but it is a similar principal, give muscle support and hold tendons in their proper positions to allow for good, healing circulation.

Most people will use Kinesio taping (KT Tape for short), for plantar fasciitis taping or strapping.

I won’t try to describe the method here, much like the stretches for plantar fasciitis, its hard to describe, but easy to demonstrate with pictures or a video, you’ll just have to jump over to our Plantar Fasciitis Taping post.

So what was the next thing on the list? Night splints you say?

Right,

Brace for Plantar Fasciitis, Night splints, Night Boots, Supports

These things are Ugly.

But a lot:

And I mean more than 2000, 5+ star reviews on amazon type a lot of people swear by them and wear them every night in hoping to cure plantar fasciitis.

These heel braces have a lot of names, the most common is “brace” or “night splint” because you generally wear them overnight, and in bed.

Yes.

A boot.

To bed.

Okay then, so how do they work?

Remember the circulation thing? Well they hold, or brace, your foot in a pronounced way that promotes circulation, they also claim to stretch the plantar fascia out to elongate it and in doing so, reduce stress from impacts while walking or running.

That sounds painful, do I really need to do this?

A lot of people won’t, but some do, and will find it useful. People with morning heel pain might find this nighttime treatment helpful to relieve that early pain in the morning.

But at the end of the day,

Its up to you and your health care professional to decide how to treat your plantar fasciitis.

What I have done for you is:

Compile a list and review some of the best night braces around and detail the pros and cons of each so that you can make an informed decision about how to treat plantar fasciitis.

Plantar Fasciitis Pain Relief:

Treatments for plantar fasciitis pain relief are simple to grasp, and easy to carry out on a daily basis.

One problem:

Many people find it difficult to keep up with the daily regimen, resulting in many falling back to heel pain after their next run, hiking trip, or walk.

The real key to plantar fasciitis treatment is to simply keep up with the exercises regularly.

You’re kidding right?

No, I’m serious – most people give up after a few days to a week, this is what leads to the vast majority of cases that last end up lasting 10 to 20… MONTHS. Yes, a lot of people out there try something new each week – don’t get the results they want – and then try something new next week.

Ridiculous.

Okay, I gotta see these treatments, they must be really painful or something,

What are the best treatments for plantar fasciitis pain relief?

Sometimes the best treatment options are also the simplest!

The tennis ball roll

Tennis Balls
Tennis balls are one of the more common things used to treat Plantar Fasciitis

If you wake up with that pain in your heel, it is usually due to the plantar fascia tightening throughout the night. When you wake, sit up and roll a tennis ball or melt method ball back and forth from the heel to the ball of your foot.

Simple yes?

Heat pack in the morning, Ice pack in the evening

A heat pack first thing in the morning will warm your plantar fascia up like an engine on a cold day. Likewise, a cold ice pack in the evening helps cool things down after a hard days standing or walking around the office.

Simply place the heat pack in the microwave for a minute or two (as directed), wrap it in a light towel and place under the arch of your foot and alternatively up over your achilles tendon. The heat pack should be held in place for around 5 to 10 minutes in order to be effective.

The ice pack should be taken out of the freezer, wrapped in a light towel placed under the arch of your foot and … you get the idea. The ice pack works to reduce inflammation and swelling allowing proper circulation.

RICE, well, minus the Ice.

Rest, Ice, Compression, Elevation, the RICE method helps warm or cool the tendons at the right time and promote proper circulation.

If you are suffering from Plantar Fasciitis, your plantar fascia ligament will require time to heal, so it is important to stay off your feet as much as possible to allow the healing process to occur as quickly as possible. If your pain is not severe, simply reducing your level of activity may be sufficient to see improvements. Those with more severe pain may require total immobilization.

Massages!

Foot massage
Foot massage

Who doesn’t like those right?

Well apparently, quite a lot of people. :\

You see,

When you have plantar fasciitis you’re also going to have inflamed tendons / muscles, and likely a lot of tight pressure points, when you rub these tight spots out – its going to hurt.

It sucks, and it huts, but you need to do it, and the only way to relieve the pain and prevent further damage is to put up with a little bit more –

Trust me:

Its worth it in the long run.

Acupuncture and plantar fasciitis treatments

God, its like the hunger games, in here, first uncomfortable shoe inserts (they’re not), then painful massages, and now you want to stick needles into my feet!?!

Well yes

and no

Acupuncture for plantar fasciitis will be different for everyone – plantar fasciitis has many causes – and depending on where the problems are coming from in your specific case will change where the acupuncturist will place the needles – In my case, I only get a couple of needles in the heel, the rest go into my calves.

So let me just put this out there – I’m not an acupuncturist.

But,

My father-in-law is an acupuncturist, so when he tells me he needs to put needles half way up my legs, and even some in my back – all to cure my heel pain – I trust him.

And the results?

Promising. With any treatments you’ll find for plantar fasciitis, the key is to keep them up until your heels have healed enough that you can begin strengthening your arches again.

You know the funny thing about acupuncturists?

They really like their natural remedies and essential oils

Essential oils for pain relief.
Essential oils for pain relief.

Essential oils come in all shapes, sizes and forms, you rub them into your skin which aims to relieve pain and some even promise to cure the underlying circulation issues to prevent plantar fasciitis from ever happening.

I’ve tried some, but had mixed success.

However,

what works for me won’t always work for you, and what works for you won’t always work for me. So with that and the fact that

– There is documented evidence out there –

I wanted to take the unbiased approach and cover the top remedies and essential oils  that are out there, their methods, and their success rate for treating plantar fasciitis

I’ve got too much more to cover in this article, so I’ll let you read the full post to find out more!

Anti-inflammatory medications

Non-steroid anti-inflammatory medications (NSAIDs, ibuprofen etc) will not treat the cause of Plantar Fasciitis, but can be useful to help control the pain while it is being treated with stretching and strengthening exercises. Most people don’t need anything stronger than this to manage the pain.

However:

It is important to note however, that NSAIDs should be used with caution in elderly patients, and avoided altogether during pregnancy.

Cortisone-steroid injections

Cortisone is a powerful anti-inflammatory. When injected directly into the heel, most patients find almost immediate relief.

But here’s the kicker:

Like NSAIDs, cortisone injections do not address the root cause of the plantar fasciitis, and will need to be repeated every few months. The injections can also be quite painful, so it may be best to try less invasive options before giving cortisone a go.

Shockwave therapy

ESWT (Extra Corporeal Shockwave Treatment) is a relatively new technology used to treat chronic Plantar Fasciitis. This therapy involves administering shockwaves to the heel, stimulating a healing response in the area. This treatment may take several months to be fully effective, as the healing response reduces the pain and inflammation of the affected area.

ESWT is a non-invasive treatment, and is recommended for people who have found little relief with other treatments.

Resolution of Plantar fasciitis

You mean you really can cure plantar fasciitis?

Many cases of Plantar Fasciitis cure themselves within as little as 3 weeks –

Although

Some cases can take months to resolve. (Or around 18 months in my case…) , the healing process can be slow, and still manages to result in over 1 million visits to the doctor and costs the USA a ballpark figure of $290 million per year.

Ridiculous.

I hope this and the other resources on on this site can help you resolve or even cure your heel pain quickly.

Just keep in mind, any treatment will fail, if you don’t stick with it.

So Keep it up! And You WILL get through this.

References

  1. Plantar Fasciitis.. or not? View.
  2. Thomas JL, Christensen JC, Kravitz SR, et al. The diagnosis and treatment of heel pain: a clinical practice guideline-revision 2010. J Foot Ankle Surg. 2010 May-Jun;49(3 Suppl):S1-19. View.
  3. Young CC, Rutherford DS, Niedfeldt MW. Treatment of plantar fasciitis. Am Fam Physician2001 Feb 1;63(3):467-74,477-78. View.
  4. Cole C, Seto C, Gazewood J. Plantar fasciitis: evidence-based review of diagnosis and therapy. Am Fam Physician. 2005 Dec 1;72(11):2237-42. View.

Disclaimer: I am not a doctor and this is not medical advice. I am someone who suffered from Plantar Fasciitis off and on for 3 years before my heel pain fully subsided. The following information is based off my own experience and research into what works best for plantar fasciitis.

Jeremy