For those of you who have had a stubborn or severe case of plantar fasciitis, you are well aware of how debilitating it can be. Initial stages of plantar fascia pain can be alleviated with something as simple as replacing old worn-out or improper footwear, or just reducing your activity levels. In more severe cases, other treatment options may need to be explored. So what is the best way to get rid of these painful symptoms?

Stretching tight calf musculature and stretching the plantar fascia itself is recommended before you get out of bed in the morning, or if you have been off your feet for an extended period of time. This will help warm the fascia up before weight bearing and walking. Icing the heel and arch area is also recommended initially to reduce any swelling and numb the painful area, especially immediately following activity. Try freezing a plastic water bottle and rolling it underneath your arch, which gives a cooling and massaging effect. In more chronic cases, sometimes termed plantar fasciosis (tissue degeneration without inflammation), ice does very little to improve symptoms.

When the plantar fascia is damaged, the goal is to reduce the strain as much as possible to allow the tissue to heal. Clinically, orthotics have shown to significantly reduce plantar fasciitis symptoms and recent research has shown that orthotics can actually reduce plantar fascia strain by up to 34% (Ferber, 2011). For some people, with mild symptoms and typical mechanics, an over-the-counter orthotic device may suffice to offload the damaged tissue and improve symptoms. In more significant cases, custom made orthotics may be necessary to accurately match the shape of your individual arch and properly offload the plantar fascia. Also, additions like extra heel cushions can be built directly into your custom orthotics for improved comfort.

Since the plantar fascia is a supporting soft tissue of the medial arch, strengthening other supporting musculature is beneficial to improve overall arch strength and to help reduce symptoms of plantar fasciitis. Tibialis posterior, a muscle on the inside of the shin bone that attaches to the foot, is the primary muscular support of the medial arch as well as the primary decelerator of foot pronation. Thus, adequate strength of this muscle is crucial. There are a few strengthening exercises with Theraband as well as a simple heel raise program, which target tibialis posterior, that can be done in the comfort of your own home. Also, something as easy as gripping a towel with your toes can target some of the smaller intrinsic muscles that support the arch, which can help speed recovery.

Another treatment option may include taping the heel and arch area with some sort of athletic or kinesiology tape, which will temporarily lift the arch up to off-weight the plantar fascia. Taping can be very effective in cases of severe pain and before you exercise.

As a side note, people often confuse plantar fasciitis with heel spurs. A heel spur is actually more common than you might expect however does not necessarily cause pain. A bone spur develops to protect and strengthen a soft tissue attachment to a bone and is your body’s way of defending that area. Many people without heel pain may find a bone spur with an x-ray of their foot. It is rare that the spur itself is the source of heel pain, rather it is usually the attachment of the plantar fascia to the heel that is becomes damaged and painful. Therefore, if you have plantar fasciitis, the treatment will not likely change whether you have a heel spur or not.

As with any type of pain that has been going on long enough, it is very unlikely to go away overnight. However, with proper stretching, strengthening, and arch support, you can expect significant improvement in a matter of weeks. Come in for an assessment from one of our Canadian Certified Pedorthists for more information.http://www.pedorthic.ca/

Ferber et al. Changes in multi-segment foot biomechanics with a heat-mouldable semi-custom foot orthotic device. Journal of Foot and Ankle Research 2011 http://www.jfootankleres.com/content/4/1/18