If you ever suffered from heel or foot pain, you likely jumped into the diagnosis of plantar fasciitis. The uncomfortable nature of this condition and the strain of the fascia on the bottom of the foot typically make this condition not only painful, but also frustrating and difficult to treat. Those suffering from this condition are quick to search out clues in hopes that the Internet will provide the answers needed. In milliseconds you will stumble across countless exercises that are aimed at alleviating the pain. Having treated (and once suffered) this condition numerous times, I have noticed that patients searching for answers are often engaging in self care that may be doing more harm than good.
The Basic Symptoms
- Stiffness and tightness with first steps in the morning
- Pain that is sharp and/or warm at the bottom of the foot
- Mild improvement with movement
- Improvement or exacerbation with specific footwear
- Pin point pain
- Difficulty pushing off the foot
Dos and Don’ts of Treatment
Don’t Over Stretch the Calf! While mild stretching the calf may actually be necessary, most patients believe if some is good then more is better. Patients should avoid overstretching the calf.
Why? The calf becomes the Achillies tendon and inserts to the heel and plantar fascia. In order to properly stretch the calf you need to extend (dorsiflex) the foot. Performing this stretch can pull on the plantar fascia and overdoing it can further irritate the tissues.
Do foam roll, and provide self-myofascial release the gastroc and soleus muscle. Various forms of massage therapy (ART, Graston, etc) can provide relief passively, which will allow the tissue to lengthen without doing too much harm to the bottom of the foot. Give some special attention to the Soleus muscle!
Don’t Foot Roll! This one will appear 873,232,564 times on Youtube but don’t repeat it! Likely the most common form of self-care is rolling a tennis ball, lacrosse ball, or frozen water bottle along the bottoms of the foot. The idea is that you can break up scar tissue on the bottom of the foot and release the tissues, thus making them relax and reducing symptoms.
Why? Having seen this ton of times, you are better off using the tennis for another condition! Keep in mind this is tissue is already irritated, possibly inflamed, and is very sensitive tissue. High load compression to the area will more than likely contribute to further pain, inflammation and sensitivity.
Do use an ice bucket. I mean it! Grab a bucket and fill it with ice and cold water. Make sure it is at least higher than your ankle and spend 10 minutes with the affected foot fully submerged. This may not be comfortable but it will be worth it. The first step in any injury is to control the pain and inflammation.
Don’t immediately order orthotics! Orthotics are typically aimed at supporting the arch, which can benefit a lot of patients. You should be hesitant to jump into something that seems so perfect since poor arch support is not always the biomechanical cause of plantar fasciitis.
Why? You should first figure out if your postural (intrinsic muscle) are weak and not firing properly. Exercise/rehab and adequately strengthening your muscles should always be an integral part of an injury recovery or prevention.
Do strengthen the intrinsic muscles by “grounding” and using barefoot training. One method is to curl your toes in sand and/or curling your toes using a towel. You should also notice how you feel with certain shoes and avoid shoes that are likely to exacerbate the symptoms. Having a specialist tape your foot can save a ton of money and reduce the dependency on orthotics while providing the foot support you need.
If you find yourself suffering from a condition similar to this make sure you give these methods a try and be sure you consult a professional.
In your health,
Dr. Jagoda
Certified Chiropractic Sports Practitioner