Plantar Fasciitis Prevention and Treatment

If you have pain in the heel or the arch of the foot in the morning or after sitting a long time, then you probably have plantar fasciitis and/or heel spurs. Plantar fasciitis is the result of bone or nerve irritation from too much tension, inflammation, or scar tissue in the fascia—the ligament on the bottom of the foot. It can also be due to repetitive micro trauma of the plantar fascia, which is connective tissue. The pain often increases with more walking or standing. The pain is usually felt where the fascia attaches to the heel, but it can be felt over the entire bottom area of the foot.

A heel spur is a growth of bone from the heel that is often associated with plantar fasciitis pain. It can develop when you have plantar fasciitis for a long time and a calcium deposit forms where the plantar fascia attaches to your heel bone. The plantar fascia pulls on the bone, and the body responds to the stress by laying down more bone. Treatment for heel spurs is the same as for plantar fasciitis.

Causes

Walkers and runners don't necessarily get plantar fasciitis more often than the general population, although long-distance running may increase the risk. The risk factors include lots of time walking or standing on hard surfaces, exercises that include jumping, inappropriate or worn-out footwear, being overweight, or a significant increase in load (stress) in a short amount of time (such as walking many miles on vacation in flip-flops or taking up a new recreational sport).

Another cause can be weakness in the muscles of the calves and feet. When they tire out and don't do their job, the stress and load of physical activities then goes to the plantar fascia. People with high arches, flat feet, and some types of gait may be more at risk. More women than men experience plantar fasciitis.

Walking or Running With Plantar Fasciitis

Plantar fasciitis and heel spurs are debilitating conditions for people who enjoy walking or running for fitness. Walking through the pain can simply lead to more pain and months of recovery. Often you won't feel as much pain once the fascia has been stretched in the morning. However, it is recommended that you minimize walking and do not run for two weeks while using self-treatment methods. Once the pain is resolved you can slowly build up your walking or running time.

Treatment

Plantar fasciitis might last for just a few weeks, or it can become chronic.

You should consult your doctor or a podiatrist if your foot pain is ongoing. They can recommend specific treatments for your condition, or refer you to a physical therapist for an individualized rehab program.

The usual treatment will be stretching and pain relief. In some cases, a healthcare provider will recommend shock wave therapy, cortisone injection, or surgery.

These are the commonly recommended treatments for plantar fasciitis:

  1. Rest: The foot needs time to heal without further irritation. You should walk and run less once you are feeling plantar fasciitis pain.
  2. Icing: Cold therapy is good for easing pain. Put a cold pack on your foot after walking or massage the foot with an ice bottle. Treat with cold for 15 minutes. 
  3. Self-massage: This will help restore foot flexibility and gently mobilize the fascia. Before you get out of bed in the morning, or after sitting for a long period, use long massage strokes from the ball of the foot to the heel of the foot.
  4. Calf strengthening and foot intrinsic strengthening exercises, such as toe curls: It is important to strengthen these muscles, which will then strengthen the plantar fascia so it can tolerate the stresses of daily activity including walking and standing. Seek a personalized exercise program from a healthcare practitioner if desired.
  5. Night splint: When you sleep, your foot relaxes in a way that lets the plantar fascia tighten up. A night splint holds your foot in the position it would be in when you stand, so the plantar fascia remains stretched out. Then, stepping out of bed in the morning doesn't cause a sudden stretching of the fascia which might re-injure it. A study found that use of the night splint gives you a significantly shorter recovery time than just using stretching.
  6. Custom arch supports and orthotics: A podiatrist can prescribe an orthotic to relieve the pressure on your foot and to correct the gait problems that may have contributed to your condition. However, this should be a last resort vs. conservative care with activity modification, stretching, and strengthening.

Plantar Fasciitis Stretches

Stretches are used once you have gotten over the initial pain and swelling. Doing plantar fascia stretches and stretches for the Achilles tendon can help during rehabilitation and might lessen the risk of recurrence.

Plantar Fascia Intrinsic Stretch

  1. Sit in a chair and cross the sore foot over the other leg.
  2. Pull the toes back on your sore foot using the hand on the same side, stretching the plantar fascia on the sole of the foot.
  3. To check to see if you are getting enough of a stretch, rub your thumb left to right over the arch of the sore foot while you are pulling the toes back. If you have the right tension on it, it will feel firm.
  4. Hold for 10 seconds and release.
  5. Repeat 10 times for one set. Perform at least three sets per day.

Achilles and Arch Stretch

  1. Stand a few feet back from a wall and lean forward against a wall.
  2. Bend one knee while stepping back with the leg with the sore foot and keeping that knee straight and heel on the ground.
  3. You will feel a stretch in the Achilles tendon and foot arch on the rear leg. If you don't, be sure that the knee is straight and the heel is on the ground.
  4. Hold the stretch for 10 seconds, then relax. Repeat 20 times.

Stair Step Stretch

  1. Stand on a stair step facing upstairs with your heels off the back of the step.
  2. Gently lower your heels to give your arch a stretch.
  3. Hold to 10 seconds. Return to level. Repeat 10 times.

Calf and Foot Strengthening Exercises

Stronger muscles in the calf and foot will support the plantar fascia. Consult with a physical therapist or podiatrist, who may recommend exercises such as these.

Short Foot Exercise

  1. Sit in a chair with feet flat on the floor.
  2. Lift toes while keeping the balls of the feet on the floor, causing the arch to rise.
  3. Lower toes down while holding the arch in the higher position.
  4. Pull the big toe toward the heel (this is the "short foot"), while keeping toes flat. Hold for 30 seconds.

Toe Spreading

  1. Sit in a chair with feet flat on the floor.
  2. Spread all your toes out and apart as far as you can, holding for 5 seconds.
  3. Repeat 10 times.

Calf Raises

  1. Sit in a chair with feet flat on the floor.
  2. Lift right heel as high as possible, keeping toes on the floor and engaging the calf muscle.
  3. Hold briefly, then lower heel to the floor.
  4. Repeat 10 times with right foot.
  5. Perform the same movement with the left foot, again repeating 10 times.
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