Nothing will stop you in your tracks quite like a stabbing pain in the heels. If you have never experienced plantar fasciitis, consider yourself lucky. Plantar fasciitis is one of the most common causes of foot and heel pain. It involves the inflammation or irritation of the band of tissue on the underside of the foot, causing considerable pain and discomfort. Unfortunately, plantar fasciitis is a common issue, especially among runners and those on their feet often, and one that’s tricky to treat. For those have dealt with it, the best way to combat it is to equip yourself with a full arsenal of proven methods of prevention and treatment, so we talked to Body Mechanix, Inc. CEO and physical therapist David Nota to get his advice.
The plantar fascia is a band of tissue that runs from your heel to your toes and forms a support for the arch of the foot, and thereby taking on great stress with repetitive and weight-bearing activities. Inflammation, irritation or damage to the plantar fascia can cause considerable pain in the foot, most often in the heel. Patients typically report pain in the foot first thing in the morning after getting up from their bed, as well as with prolonged weight bearing, particularly on hard surfaces and with dynamic activities that involve running, jumping and navigating steps.
Factors that may increase your risk of developing plantar fasciitis include:
Occupations that require you to remain on your feet: Prolonged weight bearing on hard surfaces is problematic. Teachers, tour guides, athletes, factory workers, and others who spend most of their work hours walking or standing on hard surfaces can irritate or damage their plantar fascia. Attention to footwear, arch support and internal cushioning is critical for these professions.
Particular types of exercise: Activities that place a lot of stress on your feet and attached tissue, such as long-distance running, dancing and step aerobics, can contribute to an earlier onset of plantar fasciitis.
Age: Plantar fasciitis is experienced at all ages from teen years and beyond but most commonly between the ages of 40 and 60.
Faulty foot mechanics: Being flat-footed, having a high arch or even having an abnormal walking pattern can adversely affect the way weight is distributed when you’re standing and put added stress on the plantar fascia. As humans we have a tendency to compensate for pain and discomfort, and by doing so, issues in the feet can, in turn, become issues in the ankle, knee, hip, pelvis and low back.
Obesity or Pregnancy: Extra pounds put extra stress on your plantar fascia. The natural hormonal release with pregnancy will also affect soft tissue throughout the body including the plantar fascia.
Ignoring plantar fasciitis may result in chronic heel pain that hinders your regular activities. If you change the way you walk to minimize plantar fasciitis pain, you might also develop foot, knee, hip or back problems.
What can you do?
If foot pain persists, seeking medical advice may be necessary and could include a referral to a specialist who is specifically trained to address your symptoms. Additional tests may be recommended to rule out other problems, such as a stress fracture, nerve irritation or bone spurs.
While most patients who have plantar fasciitis recover with conservative treatments, it may require a few months. Courses of treatment may include use of over the counter pain meds such as Ibuprofen and Naproxen. Physical therapy techniques such as stretching, soft tissue mobilization/trigger point work and taping may be very helpful. At times, night splints are incorporated into treatment. These splints stretch the plantar fascia and calf muscles while you sleep. The application of orthotics, heel cups and specific shoe inserts to aid with arch support and foot positioning may also be helpful. If these methods or the taping method below don’t work, your doctor may recommend other treatments like steroid shots or sound wave therapy.
Plantar Fascia Taping Method
Taping techniques have proven a good way to reduce stress on the plantar fascia allowing healing or more comfortable address of the specific symptom causes. The tape in the photos is kinesio tape for demonstration purposes, but use standard athletic tape for this technique.
1. Begin taping by placing anchor strips around the ball of the foot. Be cautious to lay the tape down gently without overly compressing the forefoot as that can cause nerve compression and pain on the outer edge of the foot.
2. Next, use a strip to wrap from the inside of the foot near the big toe, cross it diagonally across the arch of the foot, loop it around the heel and diagonally across the arch in the opposite direction, attaching it to the anchor strip near the little toe. There should be an X on the bottom of the foot. Add another strip of tape reversing the start and end points, then repeat these steps two more times, building up support.
3. Last, place additional strips laterally across the wrapped area of the foot to close up gaps and to reinforce the taped area. This may feel tight at first but should stretch and loosen to a comfortable fit.
Pain due to compression of the foot or changes in coloration indicating possible reduction in circulation should be addressed by loosening or cutting the tape. It’s not unusual to have to practice this a few time before becoming comfortable with just how much pressure or compression will be comfortable.
Reducing Plantar Fasciitis Pain
To reduce the pain of plantar fasciitis, try these helpful tips:
- Choose supportive shoes. Avoid high heels, or at least don’t wear them frequently or for extended periods. Shoes with a low to moderate heel, good arch support and shock absorbency are preferred. Avoid going barefoot, especially on hard surfaces particularly when you have symptoms.
- Replace worn-out athletic shoes. Replace your old athletic shoes and inserts before they stop supporting and cushioning your feet. As a general rule, buy new shoes after about 300 – 500 miles of use.
- Change your sport. Try a low-impact sport or switch high impact training sessions less pounding ones, such as swimming or bicycling.
- Maintain a healthy weight. This can minimizes the stress on your plantar fascia and prevent compensatory and improper positioning of the feet
- Apply ice. Hold a cloth-covered ice pack over the area of pain for 15 to 20 minutes three or four times a day or at least after activity. Ice massage is also very helpful. Freeze a plastic water bottle and roll it under your foot while applying gentle pressure to particularly sensitive points for eight to 10 minutes to help reduce pain and inflammation.
- Stretch. Stretching exercises can help your plantar fascia. Specifically stretching the achilles tendon, plantar fascia itself and calf muscles can have a significant impact on tolerance and sensitivity of these tissues.
It may take time, but by staying diligent most cases of fasciitis can be cleared up in a few short weeks. After it has cleared up, it’s vital to continue with proper stretching and avoid risk factors that caused your fasciitis in order to prevent it from returning in the future.
Body Mechanix, Inc. is a Charlotte, NC-based company specializing in injury prevention, workplace ergonomics and physical therapy. Led by certified ergonomics assessment specialists, BMI provides on-site ergonomics analyses, injury prevention programs, wellness programs, and other services to large and small companies across the US.