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Tell me how to cure plantar fasciitis in one week.

I would love to tell you how to cure plantar fasciitis in one week.  However, it is not actually possible.  Good news though!  It can get a lot better in one week with proper treatment.  In fact, I plan to give it a try.  I have had plantar fasciitis in my right foot for four month,s and it has not really improved.  So what have I done to get rid of it?  Nothing.  The problem is that I know exactly what it is so I don’t feel the need to take time out of my busy schedule to treat it.  Physical therapists are terrible patients.  However because I have let it go so long, I am now having knee pain from the abnormal way I am walking.  Looks like it is time to start treatment.  Read on to learn more about plantar fasciitis and how to treat it.

So what is plantar fasciitis?

Plantar fasciitis is an irritation of the plantar fascia that attaches to the bottom of the feet.  It attaches to an area on the bottom of the heel bone (the calcaneus) and travels to the base of the toes.  It is a very thick band of fascia or connective tissue that is important in supporting the arch of the foot and providing shock absorption.  See the video below for more information.

“U.Br.Columbia – Drawing Superficial dissection of the sole of the foot – English labels” by A.G.L. (Nan) Cheney, UBC and K.S. Morton, UBC, license: CC BY-NC-SA. Source: website Clinical Anatomy, http://www.clinicalanatomy.ca

What causes plantar fasciitis?

Plantar fasciitis is a common overuse injury that is caused by a repetitive strain on the plantar fascia.  This repetitive strain causes micro-tears in the tissue.  There are several risk factors which contribute to plantar fasciitis.  These include:

  • Decreased ankle dorsiflexion range of motion (decreased ability to lift your foot with the heel on the ground)
  • High or low arch of the feet
  • Overpronation (flattening of arch) when walking or running
  • Increases time spent standing on your feet (walking, running, standing)
  • Shoes that do not fit properly
  • Overweight or obese
  • Diabetes
  • Different leg lengths
  • Tightness and/or weakness in the calf muscle

I have a few of these risk factors including increased time spent standing and walking.  My right leg is about ½ inch longer than my left and I do overpronate my right foot when walking and running.  I have had plantar fasciitis pain on and off for the past 2 years but have been able to keep it at bay.  However, it began to run amuck when I was running on uneven ground this past fall.  I have been a runner for most of my life but typically run on pavement.  I ran with my kids for their cross-country practices this past summer and fall.  Apparently, that was the straw that broke the camel’s back.  The plantar fasciitis got the upper hand and took over.

How do I know if it is plantar fasciitis or some other type of heel pain?

So I knew it was plantar fasciitis when I woke up and took my first step of the day.  It hurt.  More specifically it hurt on the inside of the bottom of my heel.  It wasn’t like I was screaming in pain but it definitely got my attention.  I also have pain if I have been sitting for awhile and then get up and walk.  The pain is worse when walking barefoot or with shoes that have very little support.

What do I do now?

So I have done a few things for it including wearing only shoes with good arch support.  I even bought some house slippers that have good support because my house has hardwood floors.   This helps but I also still stand most of the day which is the real culprit.  I noticed that my foot felt better during the holidays when I was off from work but the pain increased again when returning to work.  I work long hours in the clinic and stand much of the time while treating my patients.  This is exacerbating my pain.  

To really help decrease the pain, I would need to spend less time on my feet.  However, I need to work and perform other daily tasks so decreasing standing is not really an option.  So if I have to stand, I need to make sure that my shoe wear is up to the challenge of supporting my feet all day.  Athletic shoes are best for people who stand and walk a lot.  Many running stores can now scan your feet and give you recommendations on the type of athletic shoe that would work the best.  There are many dressier shoes from several different brands that offer good arch support. However, it would not be as supportive as an athletic shoe.

Since I have to work, I need to find solutions other than decreasing time of my feet.  Icing the area several times a day using a nice ice pack would be a good start.  This will help calm the pain and decrease inflammation.  Next, grab a golf ball and roll it on the bottom of your foot.  This will feel uncomfortable but will break up restricted tissue and adhesions.  It will help trigger a healing response that will decrease swelling and inflammation.  This should be done for about 3 to 5 minutes.  Take breaks and work up to 3 to 5 minutes if it is too painful.  Next, stretch the calf muscle.  This can be done at a step.  Hold the stretch about 30 seconds and repeat it a few times.  If it is not too painful, walk on your heels for a minute or two and then follow it up with some heel raises, about 3 sets of 15 repetitions.  Doming exercises are also beneficial to help strengthen the smaller muscles in the foot and maintain an arch while running and walking.  See the videos below for further instruction.

A night splint can also be helpful in decreasing the pain and inflammation from plantar fasciitis.  This splint looks similar to a boot and keeps your ankle in a neutral to slightly dorsiflexed position.  This means that the foot is not pointing down and might even be flexed up a little.  This keeps the plantar fascia from tightening up.  It also helps stretch out the calf muscles (gastrocnemius and soleus).  When these muscles are tight, they limit how much the foot can flex up or dorsiflex.  Remember that decreased dorsiflexion is a risk factor for plantar fasciitis.

A night splint is to be worn preferably all night.  However it can get uncomfortable after a few hours.  I usually tell my patients to work up to wearing it all night.  It is okay to take the night splint off if the discomfort is waking them up.  It is better to get some sleep than keeping the night splint on all night.  Plus their tolerance for the night splint will increase over time.

So what to do if none of this works?

If nothing I have mentioned resolved your pain then it is time to see your local physical therapist.  They will look at your gait (how you walk) and how the joints in your foot and ankle move.  They will also determine the strength in your hip, knee, ankle, and foot.  Based on what they find, they can prescribe a much more detailed and specific plan of care for you.

Just keep in mind that plantar fasciitis does not go away easily.  It can linger for several months or years if not treated.  It will clear up faster with treatment from a medical professional, (aka physical therapist) but still can take several months to alleviate the pain.  Also it can lead to other pain as the body compensates for the foot pain.  It was my knee pain that really caused me to start treating my plantar fasciitis.  Don’t be like me.  The faster you treat it, the quicker it goes away.

In review

  • Plantar fasciitis is caused by a repetitive strain on the plantar fascia which is a thick band of tissue on the bottom of your foot.
  • A tell-tale sign of plantar fasciitis is pain with the first step of the day.
  • There are many different risk factors.
  • How to treat
    • Give your feet a break – stop standing, walking, or running so much.
    • Ice several times per day.
    • Stretch the plantar fascia and calf muscle.
    • Strengthen around the ankle and the foot intrinsics.
    • Use a night splint.
    • Wear good shoes – don’t stand on hard floors without any shoes.
  • Go to physical therapy if it isn’t going away.

As always, if you have questions about the content of this post or any other musculoskeletal questions, please e-mail me.

Additional resources

https://www.physio-pedia.com/Plantar_Fasciitis?utm_source=physiopedia&utm_medium=search&utm_campaign=ongoing_internal

https://www.choosept.com/guide/physical-therapy-guide-plantar-fasciitis

https://www.ncbi.nlm.nih.gov/books/NBK431073/#:~:text=Plantar%20Fasciitis%20-%20StatPearls%20-%20NCBI%20Bookshelf.%20Plantar,segments%2C%20all%20of%20which%20arise%20from%20the%20calcaneus.