Relieving the pain of plantar fasciitis

Mrs. Cad is nearly crippled with the pain. One arch support salesman wanted to sell her supports for a couple hundred $ which she hesitates to buy not knowing the long-term benefits. The rolling a frozen water bottle is not helping.

What sort of stretches can she do and what should she know about arch supports and her PF?

Custom orthotics can work wonders for all sorts of foot problems (I’ve got some to deal with foot and ankle problems including a neuroma and post-traumatic arthritis, resulting in a non-bendy ankle). But they have to be properly fitted. My ortho prescribed mine; insurance covered 90% of the cost. Beats the hell out of pain and/or surgery and/or daily prescription anti-inflammatories.

I’ve also had planar fascitis, though thankfully it’s gone now; Icy-Hot provided temporary pain relief.

She has my sympathy. I’m having a flare-up right now. It’s not insufferable, but I’m looking for a job in an industry where the working conditions rarely permit sitting. Not good timing. The Achilles’ heel stretch is the only thing that works for me. Are the cortisone shots out of the question for her for some reason?

I had been a long time sufferer of Plantar Faciitis. I tried everything to get it cured: Seeing podiatrists… custom made inserts… stretching techniques… night splints for my feet to keep them flexed… and nothing worked until I saw a physical therapist.

In my case, the problem was not with the Plantar Fascia tendon that runs the length of the bottom of my foot, but rather with the Anterior Tibialis Tendon in my leg having gotten weak due to a long recurring and unknown back problem I have had.

What fixed it for me was lots of strengthening exercises that ultimately kept my foot from flattening (pronating). The exercises I did were as follows:

  • Standing normally and trying to curl my toes repeatedly under my feet.
  • Taping the foot from the bottom of my heel up to the inside of my ankle to help hold it in place and let the tendon heal.
  • Extremely painful foot massages to release the plantar fascia tendon and help it relax
  • Doing a flexing technique with a Thera-band to help strengthen the Anterior Tibialis Tendon.

Wearing “Powerstep” brand inserts in my shoes also helped to a degree, but now I wear them mainly for preventative maintenance. They provide great arch support and will insure I don’t have more problems in the future. They range from $20 to $30 depending on where you buy them, but they work just as well as any of the custom jobs my podiatrist gave me.

My experience with plantar faciitis taught me that not all podiatrists are able to fix it and that sometimes the problem is more than just in the feet. My physical therapist was amazing in curing my foot problem. It took about 6 weeks of PT to get it completely cured. That is what I did to get rid of plantar faciitis, but what your wife may need to do may end up being different. Have her see a good physical therapist and go from there.

Good luck.

Mrs. **CC **had plantar fascitis something fierce a few years ago. Orthotics helped for a while, but what really did the trick was some guy she found who massaged and manipulated her foot. I guess it’s what someone above called physical therapy. It was not pleasant while he was doing it, but apparently that did the trick. In fact, she hasn’t had a flareup since. I second that prescription.

My general schemes for treating plantar fasciitis:

  1. foot stretching exercises
  2. Anti-inflammatory meds like naproxen or ibuprofen
  3. Taping the feet
  4. Orthotics
  5. Physical therapy, including ultrasound
  6. Steroid injections.

That’s sort of the hierarchy I follow, 1-6, but not rigidly; depending on the severity, patients’ needs, availability of things like PT and orthotics, and considering the nearest syringe and steroids are only a few feet away from me. So’s the tape, but that actually takes longer to put on that just injecting the feet. Limber folks can be taught to properly tape their own soles.

Steroid injections generally do give immediate, long-lasting relief. Results for the other modalities tend to be variable, but taping tends to give quick relief for most folks also.

Interesting! I believe I just discovered why my feet have been hurting for the past several weeks. I guess it’s time to see my doctor about that, eh?

What is the proper way to do this? Can you point me to a web site with pics?

Is this why my feet were killing me after walking on the treadmill at a measly 3.8 mph? I’m over the excrutiating part, but I have foot pain all the time, to one degree or another. I feel much better in shoes than barefoot.

Let me describe my own (rather mild) case. For several weeks, I had pain in one foot. My family physician first tried an injection of cortisone (at least I think it was cortisone) right in the soles. Helped but wore off. Then he sent me to a podiatrist. He fitted me with orthotics (expensive, but I have been using them for maybe ten years now and have had no recurrence). But he also gave me “waking up” exercises. He explained it as follows. The plantar tendon has pulled away from its point of attachment on the heel. During the night, it begins to heal. But I wake up and retear it on my way to the bathroom. To avoid that, I have to loosen up the foot muscle. There are two exercises to do. The first is to use a towel and gently pull on the ball of the foot. A yoga belt also works well. The second is to “do an alphabet”. Make an “A” with your toes. Then do a “B”, then a “C”, right through to “Z”. The object, obviously, is to put the foot through a range of movements. All this with a full bladder, since it is important not to walk till the exercises have been performed. It worked! And no problem since.

Did the explanation make any sense? Not really, but what do I know about it?

I wore one of those boots/splints at night religiously for about 6 months. It completely cured me.
I was very dubious, but it worked for me.

Once it heals, she might want consider spending more time barefoot. There’s a growing amount of evidence that many foot problems are related to footwear. While orthotics may help relieve the pain, they are probably not helping to resolve the underlying cause.

Keep in mind, though, that I am not a doctor. I’ve become interested in the topic of shoes and the incidence of repeated or chronic lower leg injury due to fitness-related research. Note that Qadgop, who is a doctor, recommends stretching and strengthening exercises as well as pain relief remedies, and puts orthotics pretty far down his list of preferred remedies.

A few links:
The painful truth about trainers: Are running shoes a waste of money?

What Ruins Running?

Sports Science research literature review on the topic of barefoot running.

For me, Plantar Fassciitis is one of the most painful things I experience. It feels like an ice pick being shoved into my heel bone from directly underneath.

There are two stretches that work well that every ankle and foot doctor and physical therapist have recommended or agree with:
The standard “toe touch” done by relaxing into it, not pushing or pulling in to it
The toe-pull - pull back on the big toe in order to stretch the very bottom of the foot

Doing them has kept the pain at bay. I get the pain about once a month, and it’s usually after I have been not stretching as regularly. Stretching makes it go away again.

Yeah - treadmills are supposed to be pretty bad for PF, per the family podiatrist.

I had an ultrasound treatment just the other day for pain just behind the base of the little-toe joint (basically right behind the ball of the foot, though I think of that as more in the middle). Previously my PF had always manifested in the heel area, but this was another area that’s sometimes affected. I think it’s there, nowadays, as a result of the development of tailor’s bunions on both feet now.

Anyway - the ultrasound treatment from the other day seems to have helped quite a bit, which is a welcome surprise. The pod did one a couple of months ago which didn’t help, but that time he was concentrating on the bunion specifically.

Custom orthotics are a good idea for general management and to help prevent some of the aggravation/injury/inflammation/pain processes from getting started or getting worse. The ultrasound, NSAIDS, and injections are for when things get more acute.

Ice is also good when things get painful - not an ice pack (that won’t get the skin cold enough), but fill a small paper cup with water, freeze it, and apply directly to the surface of the skin, moving it around over the affected area. Obviously don’t do it in one place too long or you’ll risk damaging the skin due to frostbite! This technique was shown to me by a physical therapist (for the knee), and the podiatrist endorses it as well.

The cortisone shots do work wonders but I won’t lie, they hurt like a motherfuck. I’m usually holding onto the chair arms with a death grip, rigid, and chanting SHITshitshitshitshitShitshitshit the whole time.

I had this in my left foot. When I woke up and first walked on it the pain was excruciating.

I read up about it at the time and it generally takes between 6-18 months to go away (according to what I read). It took the full 18 months with me but that was maybe 2 years ago now and it hasn’t come back, just the very occasional mild spasm.

So it might be just a waiting game with this one - be patient and it will eventually go away. And wearing arch supports etc in the meantime.