September 2, 2011

6 Tips for Treating Plantar Fasciitis

About two months ago I develop a nasty case of plantar fasciitis in my right foot. Since then I have tried many different ways to help it heal. Today was the first day since this started that I can say my initial steps in the morning were without pain and that my run today was without pain. So I think I am almost out of the woods.

I wanted to write a post to describe the treatments that I found most useful during my recovery from plantar fasciitis. I received a lot of good suggestions from readers and I tried just about every one of them. I also tried some products sent to my from manufacturers and purchased some additional products on my own. Of everything I tried, I can narrow it down to the following six tips for treating plantar fasciitis.

Tip 1. Stop Running

OK, this first tip is almost a no-brainer. If it hurts to walk, don't run. Pretty simple! And once the pain subsides, start out with short runs and build gradually. When I figured out that I had developed plantar fasciitis I took a couple of days off and then tried a couple of short runs. But my foot still hurt, so I took a full week off and then tried a few short runs. Still hurt so I took more time off. I think I probably would have recovered quicker if I had more patience and allowed more time to heal between test runs.

So my advice is to stop running on it until the pain goes away. Then start back up with very short test runs every other day and then gradually build your mileage back up. If it starts to hurt again, drop the miles or stop complete. Bottom line, the more time you give it to heal the faster you can return to training.

This doesn't mean that you have totally stop exercising. Just switch to a sport that has less impact on your feet like biking or swimming.

Tip 2. Ice, Ice, Baby

This one is also an almost no-brainer. Ice is the default treatment for most running-related aches and pains, including plantar fasciitis. I typically do not ice after runs, even after my long training runs and races. In my mind, I'd rather let my body recover naturally than to aid the recovery through external stimuli like ice. However, in the case of injury, I really felt that the ice helped.

After each run I fill a bucket with ice and water and soak my feet in it for as long as I can stand, usually about 10 minutes. Then I'd take my feet out for about 10 minutes and then repeat the process. I usually get about three soakings before the ice melts totally and the water starts to warm up. I really think this helped with my recovery. It certainly made my feet feel better after each run.

Tip 3. Get Some Balls

This tip is probably the most useful but also the most painful. Rolling your foot on a ball massages the tissue and aids in recovery. However, IT HURTS LIKE A $%#@!!! I tried different sizes of balls and different types. Probably the most effective was a golf ball. I even tried freezing it so that I could ice and massage at the same time, but I don't really think I was able to get much of an icing effect with this approach.

However, one thing I also tried was freezing a water bottle and then rolling my foot on it. That worked. Was able to get ice on my foot and massage it at the same time. After my foot started to recover the massage produced by the water bottle wasn't deep enough, so had to switch to the golf ball. But the water bottle approach might be a good start when you are first treating plantar fasciitis.

Tip 4. That's A Stretch

My doctor explained that the plantar muscle and calf muscle work together like a pulley system. As a result, a calf muscle with limited flexibility adds strain to the plantar muscle. So his advice was to stretch the calf muscle, not just after a run, but also at regular intervals throughout the day.

So that's what I started doing. Every time I would think about it I would stretch my calf muscles. If I was at the counter making toast, I'd stretch while waiting for it to pop up from the toaster. On a phone call? Stretch. Watching TV? Stretch. I even developed a pose to stretch while standing still (stay flat footed and bend your knees, kinda like you're standing there trying to go potty!).

Also see a guide to 10 basic stretches.

Tip 5. Let It Hang Out

This one might sound strange, but it really does help! Plantar fasciitis is most noticeable when you take your first steps in the morning. This is caused in part because of the contracted calf muscle position that we sleep in. Whether you sleep on your back, side, or stomach, your feet will tend to point away (like you are standing on your toes). This contracts your calf muscle and puts additional strain on the plantar muscle when you take your first steps.

The solution is to keep your feet pointed at a 45 degree angle to your legs (like the position they are in when you are standing). But how do you do that?

One solution is to purchase a plantar fasciitis splint or a Strassburg Sock. I even tried to make my own splint but that didn't work out so well. So another solution is just to sleep with your feet hanging out over the end of the bed. This works great for someone like me who likes to sleep on his stomach and does not have a foot board at the end of the bed. Otherwise, you probably need to purse the splint or sock idea.

Tip 6. Support It

Typically I walk around in my bare feet when the situation is appropriate. I feel like this helps to strengthen my feet. However, in the case of recovering from plantar fasciitis you must provide your feet with arch support in order to reduce the strain. That means wearing shoes--all the time--everywhere you go. If you do not have shoes with good arch support, or prefer waking around bare footed or in sandals like me, you need to add support.

I've been using a product that was sent to me by the manufacturer to test and I absolutely love them. It's a product called Strutz Sole Angle. It's basically a pad that you slide under your arch. You can wear it under or over your sock (I wear my under, directly on my skin). I can say when I first started using it that it hurt my feet big time--just like the deep tissue massage described above. So I would only use it for about 10 minutes initially, then increased the duration, and now I wear it all the time, except for when I run (because my trail running shoes have good arch support).

Alright. I'm done. Those were the six tips I found most useful for treating plantar fasciitis. For more information on treating plantar fasciitis, see http://www.aafp.org/afp/2001/0201/p467.html

Now it's your turn! What tips do you have for other readers? What have you found useful for treating your own case of plantar fasciitis?


10 comments:

  1. I do the frozen water bottle as well, tennis ball, racquetball, and one of those wooden nobby things. But one thing I really love is to find a playground or something with little rounded pebbles on it. Take off your shoes and socks and walk around. Painful but very effective. There is one on the path that I usually run on. I wish it was closer to my house but sometimes I take a break to walk the pebbles, then put my shoes back on and continue home.

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  2. I had chronic PF for a year. Tried all of your great advice above and that helped, but it didn't fully heal until I got Graston work done on it by a Chiropractor. It's a fairly new technique, but studies show it can be very effective in treating PF (google has great info on it). I'm back up to running 3 days a week and I'm thrilled (now if I could only get my speed back!). Thanks for the great tips!

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  3. Thank you for the great tips. I will be saving this article and refer back to it in the future... Better advice than the doctor I saw "Tape it and run" Ya I don't go to that one anymore. Thanks again.

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  4. Thanks for this. I have done Physical therapy, Graston, laser, and acupuncture is the only thing that helps... but then it comes back after a week or so. Have also had 3 cortisone shots over the last year.
    I am at my wit's end (and running out of money). Anyone else have any suggestions? Or any suggestions for doctors around Charlotte NC?

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  5. I started wearing my crocs around the house 24/7 and all my foot pain is gone - no tendinitis, no plantar, nothing. I can't believe how those ugly rubbers helped.

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  6. Thanks for this! I have been going through the same thing at the same time. I find that the night splint, icing, stretching, and lowering mileage have all done a lot to help. Another thing I tried after much research was an ankle brace. It might be unnecessary for most, but I really rotated my ankle five years ago. Same foot, weak ankle. Seems to have helped my case of PF. Man I hate not being able to run!

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  7. I have had this for years due to using safety shoes at work for years, I had a series of sports massages that worked great, only to get a quad injury a couple of weeks ago from training in the snow and it is now back with a vengeance!!! I am back having the sports massage and doing the ball exercise, only I have to say I haven't given up the training mainly because I am scared too.....I still run, militry train and the the occasional gym class but find once I start going I am fine and the pain goes. I do have an appointment at our best local running shop on Wednesday though to see about orthotics for my shoes.....though am going to look up the Strutz you have mentioned :D...........although we love it I don't think this exercise thing is good for us haha!! Sarah :)

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  8. Might look into discalced (barefoot) running or running in Vibram FFs as ability to run returns. VFFs seem to work for my wife who was sidelined with PF from March to Aug 2011. Used a treadmill desk at 1.5 mph to gradually get back into using the feet without inflammation in around Jul 2011. Built up to normal training. Finished LA and Boston Marathons in Mar-Apr 2012. Trains pretty exclusively in VFFs.

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  9. Thanks for this! I have been going through the same thing at the same time. I find that the night splint, icing, stretching, and lowering mileage have all done a lot to help. Another thing I tried after much research was an ankle brace. It might be unnecessary for most, but I really rotated my ankle five years ago. Same foot, weak ankle. Seems to have helped my case of PF. Man I hate not being able to run!

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  10. Thank Thomas for these helpful tips. With my experience, the two best methods that works well are stretching and massage with a ball.

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