Plantar Fasciitis: Best Treatment to Eliminate it for Good!

When sleeping, the plantar fascia and other soft tissue along the bottom of the foot and back of the leg are in a shortened position for up to 8 hours.  When we stand out of bed barefoot in the morning, our heel and arches drop potentially re-tearing the plantar fascia.  That's often why this condition can last for so long!  People do many things right during the day but undo all the good by re-tearing it in the morning.  It often feels better after walking around for a few minutes but only because it has started to warm up.  Unfortunately, it has already been torn.   Take 30 seconds in the morning and warm-up the bottom of your foot and back of your legs before getting out of bed.  Don't stretch, just rub with your hands or opposite foot.  Put an old running shoe/cork based sandal etc beside your bed to directly slide your foot into (not enough to hobble down to your shoes at the end of the bed - the damage will already have been done).  This is a really important step...pun intended!

Treat the source!  Although plantar fasciitis can occur by pure bad luck with a wrong step or move, it often comes from lack of flexibility/mobility, lack of foot strength or weakness further up the chain, and/or inappropriate footwear.  Try to get in for deep tissue massage or other soft tissue treatment to relieve the strain on the plantar fascia.  In addition, try using a heating pad on your calves for 5-10 minutes before massaging out the muscles.  Use your hands, Yoga Tune Up Balls, Tiger Tails or any other mobility tool. The merits of ice are widely debated these days, so prioritize heating and massaging above and below the injury. Try to avoid rubbing the sore spot (think poking a bear) and also avoid stretching when things are cold as you'll often just re-tear it so only stretch after things are warmed up a bit.  We can't emphasize enough the importance of looking to the source of the problem and your compliance here will depend how long you need to use arch supports that we discuss below. 

Because we often wear shoes with elevated heels (even many 'good' running shoes have higher heels), the tissues along the back part of our lower legs can get really tight and shortened.   When we then drop down to a flatter shoe or barefoot, the plantar fascia and many other soft tissue structures are pulled and potentially torn.  So, in the short term when the plantar fascia is irritated, we recommend trying to wear a shoe that elevates your heel a bit (ideally a running shoe) and even potentially adding a heel lift to shorten and unload the area even more.  But in a perfect world this is just for the short term until the foot has healed.  While wearing the more protective shoes, work on mobility and once the pain is gone, slowly transition back down to lower shoes.  Try wearing the better shoes for as much as you can early in the healing process in order to nip the problem quickly.  If life is getting in the way of your ideal foot health and you go back to those less than ideal shoes, it's especially important to work on your lower leg/foot mobility at the end of the day!

Use arch supports and heel lifts to help unload the plantar fascia and allow things to heal more quickly.  This is especially important first step out of bed in the morning and after sitting for long periods of time.  Because the plantar fascia runs along the main arch of your foot, it stretches out when you stand on it.  Normally this is a good thing but when the plantar fascia is irritated (the 'itis' part of plantar fasciitis), that stretching motion can cause pain.  By using an arch support and/or taping we unload the plantar fascia and prevent it from being stretched out thereby speeding up the healing process.  The more you can unload the plantar fascia, the quicker it will heal.  Custom orthotics, off-the-shelf inserts, and taping are all ways of supporting the arch of your foot.  As long as we're working on the long term fix, we would ideally just use these arch supports until the pain has disappeared and then go back to being barefoot (see our article, To Be or Not To Be Barefoot).  If your compliance to the fix is high, you'll likely only need the arch supports for a short period of time.  If you're not as good with the fix, you may need the arch supports for longer.  No judgement on this, just a matter of being realistic with yourself and taking the best course of action.

Be especially careful to avoid inflammatory foods and try to get sufficient sleep.  We know how much our diet and sleeping patterns affect the overall inflammatory condition of our bodies.  Trying to eliminate foods that are known to increase inflammation can be especially important when dealing with issues such as plantar fasciitis.  Here's an article of the role sleep and nutrition can play in treating and preventing injuries and systemic inflammation.