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Jenna Siracuse, DPT

10 WAYS TO MANAGE PLANTAR FASCIITIS

Updated: Aug 18, 2020


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If you have ever suffered from plantar fasciitis, you know it can be one uncomfortable problem. The symptoms can linger for a long time and seem to never go away. I myself suffered from plantar fasciitis for about 2 years of my life, and I can say from experience it is not fun. Prevention is a huge piece of the puzzle, but what happens if you do develop a case of it? I wanted to give you my top tips for dealing with this pesky problem. Keep in mind, nothing is ever a quick fix. It takes repetition and consistency to see your symptoms decrease, so stick with it!

First, a little background. What exactly is plantar fasciitis?

The plantar fascia is a thick tissue covering the bottom on the foot. It helps to maintain alignment and proper mechanics in the foot and ankle. Because it helps support the weight of our bodies, it is subject to a lot of stress on a daily basis. Plantar fasciitis occurs when this thick tissue becomes inflamed, which usually is caused by some form of excessive stress. Causes could be anything from having a job that requires you to stand for long periods of time, repetitive exercise such as running and jumping, improper footwear or obesity. Once the pain and inflammation starts, it can be very difficult to manage because we cant exactly stop using our feet. This makes it extremely important to address plantar fasciitis at the first sign of it, preventing it from snowballing out of your control.

Signs and symptoms of plantar fasciitis may include:

  • Pain in the bottom of the foot, typically near the heal bone

  • Pain that is worst in the morning or after a period of inactivity

  • Stiff feeling in the bottom of the foot or calf muscles

  • Pain after standing for long periods of time

So you think you might have plantar fasciitis, now what? Here are 10 tips for helping you better manage it:

1. SEE A PHYSICAL THERAPIST

Don't let it just linger! There are many things a PT can help with, such as making sure you have proper movement mechanics in the lower body. Your primary doctor or podiatrist is often not the best person for you to see first, because they really can only prescribe you medication or give you a referral to a PT anyways. Your PT will actually be able to prescribe you helpful exercises and conservatively treat the cause of the problem. (Keep in mind not all states have direct access to PT, you may need to see your PCP first if you live in one of these states. Lucky for me- VA has direct access!)

2. STRETCH BEFORE YOU GET OUT OF BED

Plantar fasciitis tends to hurt the most after you have been immobile for a period of time (such as while sleeping) because the tissue starts to tighten up. The first few steps you take causes the fascia to stretch back out and become irritated all over again. If you stretch before you get out of bed to get the tissue moving, that first step won't be so painful.

3. STRETCH THROUGHOUT THE DAY. Like, every single day. Seriously.

The plantar fascia has connections to the Achilles' tendon and calf muscles, so it's important to not only stretch the foot, but also the calves. It will help relieve tension and excess stress in the foot. Remember, it takes muscle a long time to elongate so consistency with stretching is key if you want to see a lasting change.

Want to learn all the best stretches? Download the FREE GUIDE!


4. FOAM ROLL

Based on our biomechanics, the plantar fascia is affected by what is happening in the calf muscles. Increased stiffness in the calf can result in altered mechanics of the foot and contribute to your pain. You don’t need to spend all day rolling either. About 5 times should do the trick, just make sure you stretch right after!!

5. MASSSAGE

If this has been a chronic problem for you, scar tissue has probably started to build up which means those layers of fascia are not gliding like they should. Massage to the bottom of the foot helps restore gliding between the layers of the plantar fascia and reduces pain. The best way to self massage is by rolling a tennis ball on the bottom of the foot. *Bonus, freeze a water bottle and then roll your foot on it. You get ice and massage all in one!


6. STRENGTHEN THE FOOT INTRINSICS!

Seriously can’t stress this one enough, because it tends to be the most overlooked step. The foot intrinsics are small muscles within your foot that help support and stabilize the shape of the foot. Strengthening them will help reduce stress on the plantar fascia by restoring proper foot mechanics and relive pain in the long run. Massage and stretching is all well and good for symptom management, however if you want to actually see a lasting change you must implement strengthening.

Here's a video of one of my favorites:



7. STRENGTHEN THE CALVES

Strengthening the rest of the leg is JUST as important. Try some eccentrics, which help build even more strength and control in the foot and leg. Here's how to do it:


8. Take a look at your foot wear

You want to make sure your footwear is not contributing to the problem. I want to stress something here- wearing arch supports can be helpful but won't solve the problem. They really will only help with symptom management. When you wear a supportive shoe, you are basically telling those foot instrinsic muscles that they do not have to work as hard any more. So the stipulation with this one is: wear supportive footwear AND work on foot instrinsic strengthening regularly! If you are unsure what is the best type of footwear for you, always see a professional.

9. Activity modification

As a therapist, I very rarely tell my patients to stop activity altogether. If your therapist tells you to stop you should probably run the other way. I will say, however, that in a problem such as plantar fasciitis it is important to control the amount of stress that you are placing on the tissue. It is unrealistic to stop walking or standing, but if there are other activities that you are doing to aggregate the tissue it may be best to briefly limit that activity. Not forever, but just enough to break the cycle of inflammation that is causing your pain so you can then build back up tolerance to the aggravating activity. For something such as running, maybe reduce your mileage temporarily. Dancers, maybe you need to temporarily use a dance sneaker for support while you dance. The modifications are that need to be made are always depending on your individual case, so it is best to speak with a professional about what is right for you.

10. RINSE AND REPEAT.... AND BE CONSISTENT!!

Hopefully I have really driven this point home by now so you understand the importance! Plantar fasciitis can be tricky to deal with, and if you are not consistent with any of the above treatment ideas they won't work! It takes our tissues around 4-6 weeks of consistent exercise (both stretching and strengthening) to see a lasting change in the muscle, thats a long time if you think about it!! Moral of the story? Don't get frustrated and give up, it takes more than 2 or 3 times of doing this stuff before you start to feel it working. Most importantly, doing these simple steps on a daily basis will help keep your symptoms under control so you do not need more invasive treatments like injections or oral medications- no one wants that!!

I know first hand what it feels like to deal with plantar fasciitis, and there is hope for you!! Whether you are currently struggling with this or just looking to prevent it in the future, I hope that you will implement these tips into your routine and start to see a change! Of course, these are only 10 ideas and each person is different. I can't stress enough to ALWAYS seek help from a professional in your area to make sure you are doing what is best for you situation!

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