10 Ways to Fix Your Plantar Fasciitis—for Good!
Learn how to fix your heel pain when nothing else works.
When I was diagnosed with plantar fasciitis, I wasn't particularly worried. Treatment is pretty simple, after all, and not necessarily even very expensive.
A year later, after a round of anti-inflammatories, months of physical therapy, and some pricey custom orthotics, I was starting to get a little worried. My plantar fasciitis was mostly under control—as long as I didn't run. But as soon as I did anything that involved a little extra impact—running, jumping, even a long hike—the plantar fasciitis flared up. I worried that I wouldn't ever run again, and the reading I did suggested that if I wanted to avoid surgery, I might need to spend six weeks completely off my feet. And let's get serious. What were the chances of that?
What is plantar fasciitis?
Plantar fasciitis emerges when the plantar fascia, the long ligament that runs from the heel bone to the forefoot, develops tiny tears that produce pain and inflammation. Most times, this feels like an ache or stabbing pain under the heel, but if you aggravate that ligament enough, you can also feel a sharp pain along the sole of your foot.
Lots of things can cause plantar fasciitis, but they all boil down to some combination of overuse and inelasticity. If your plantar fascia can't stretch enough to comfortably absorb whatever pressure you're putting on it, you're at risk of tearing. And once you starting tearing the fascia, it gets inflamed, and pain ensues.
The usual treatments.
Since the onset of plantar fasciitis is usually accompanied by inflammation, standard treatments address that. If you turn up at your doctor's office complaining of heel pain, you'll likely be told to take some ibuprofen, ice the area, and stay off your feet. For some people, that's enough. The inflammation settles down, the plantar fascia heals, and they're good to go.
If that doesn't solve the problem, your doctor or physical therapist will probably set to work on combating the overstretching of the ligament. For starters, you might be given a night splint, which holds your foot in a flexed position during the night. This keeps your plantar fascia from tightening up while you sleep which, in turn, prevents you from re-tearing it when you hop out of bed and put weight on it in the morning.
For some people, the night splint is an instant cure. If your plantar fasciitis is a bit more stubborn, however, the next step might be orthotics—and again, for some people, these can produce an instant cure.
But if you are not one of those lucky people, you're starting to run low on options. You might get some physical therapy, you might be told to stay well off your feet, and—if things get bad enough and go on for long enough—you might start considering surgery.
This is not a happy place to be.
The little-known secret to treating plantar fasciitis.
If this is your situation, you're probably at the end of your rope. I know I was. I started seeing an acupuncturist, a reflexologist, and a chiropractor, all in hopes that something would make a difference.
See, the problem at this point is not inflammation. The problem is that ligament that keeps getting aggravated. Inflammation and pain are the symptoms, not the cause. So icing your foot and popping Advil isn't going to help after a certain point, and orthotics and night splints can only help so much.
What you need is flexibility—not just in that ligament, but in all the muscles near it (plus all the muscles near those muscles), so that your whole foot and lower leg is flexible enough to absorb whatever impact you subject it to.
So really—and I know this will be hard to believe if you've been fighting plantar fasciitis for a long time—you need a good, consistent stretching program. And that's it. There's other stuff you can do, of course, but if you're really good about thoroughly stretching multiple times every day, that's (probably) all you need.
The trick, though, is to stretch every day, multiple times, for 4-5 minutes per session. None of those 20-second calf stretches will do—you've got to hang out in each stretch for at least a minute.
And chances are, you'll have to keep up that routine. I'm not great about keeping up with mine, and I can tell the difference. When my calves start to tighten up, the plantar fasciitis flares up. But, on the flipside, I can also prevent flare-ups by being careful about stretching. So I (finally) started running again, did yoga after every run (lots of downward facing dog!), and s-t-r-e-t-c-h-e-d every muscle I could get to in my feet and legs, voila! No heel pain.
I had tried just about everything before I stumbled on the stretching secret. I had night splints, acupuncture, reflexology, yoga toes, foot massagers, the works. Some of it helped (and much of it helps in conjunction with good stretching), but nothing did the trick until I ran across Jim Johnson's book, The Five-Minute Plantar Fasciitis Solution.
Johnson does a nice survey of the research on plantar fasciitis and makes a pretty compelling case for treating it as a problem of tight muscles rather than chronic inflammation. And he gives you a little stretching program that has been tested and demonstrated to work in clinical trials. The book is a bit pricey for its size (though, since I credit it with teaching me to manage my plantar fasciitis, it was quite a bargain), but if you're interested in a layman's overview of the science or the details of a specific stretching program, by all means check it out.
But if you're willing to wing it and design your own treatment program, read on!
Your treatment program.
So, before I launch into this, let me just say that I'm not a doctor, or a physical therapist, or anyone with any medical expertise. I don't think I'm going to suggest anything that will hurt you, but be advised that any steps you undertake are taken at your risk. These are things that worked for me, but they may or may not work for you. You are advised to consult with a professional.
The centerpiece of your plantar fasciitis treatment is the basic calf stretch:
- Face a wall and place your hands on it at about shoulder height.
- Stretch one leg behind you, heel to the ground. Find a position that gives you a nice stretch in the calf of the back leg. You might need to lower your hands a bit, or change your distance from the wall.
- Hold...hold...hold. For at least 60 seconds.
- Then pull your back leg forward a bit, bend your knee, and sink your weight onto that leg. This should move the stretch from your upper calf to down around your Achilles' tendon. Again, hold for at least 60 seconds.
- Repeat the whole process with the other leg.
- And then run through the whole shebang again on each leg. Do it a third time if you're feeling motivated.
- Repeat three times a day.
As I said, the real trick here is consistency and duration. If it seems like it's not working, do it more often and for longer duration. And give it at least a few weeks to start working. I bet it'll help.
Nine other things you can try.
Basically, anything that warms and/or loosens your muscles can help. Play around and see what works for you. Here's some stuff I've had luck with, organized roughly from cheapest to most expensive.
- Stretch the bottoms of your feet.
Kneel on the ground. Tuck your toes so the bottoms are pressed against the floor and settle your weight back onto your heels. Depending on how flexible your feet are, this will range from intense to excruciating. But it's really good for your feet.
- Use a tennis ball to release tight muscles.
Easy version: Sit on the ground, place a tennis ball under your calf, and roll it around with your leg. If it hurts, you've hit a tight spot—keep it at that location for as long as you can stand it.
Harder version (but worth it!): This is a trick I learned from my yoga teacher. Along the outside of your lower leg, there's a place where the muscles on the front of the leg meet the muscles on the back. That meeting forms a little bit of a trough that runs the length of your lower leg. Get the tennis ball into that trough, put as much of your weight on it as you can, and roll the ball up and down under your body. (This involves a certain amount of writhing on the floor, but it's so worth it.) It will probably hurt, but the more it hurts, the more good it's doing. If you get the tennis ball in the right spot, it will release those muscles like nobody's business.
- Soak your feet (and as much of your leg as you can) in hot water.
This is self-explanatory, right? Damp heat relaxes muscles. Add some Epsom salts if you want to get fancy.
If you have access to a hot tub, it'll probably do wonders. I don't, so I use a dishpan of hot water. Livin' the high life.
- Use a heating pad on your calves. Follow with a calf massage.
Again, heat = looser muscles. It's nicer and more fun it you can get someone else to massage your calves afterward, but you can do it yourself too. Just remember: When you find a spot that hurts, that's the place you need to be focusing on.
- Make yourself a rice bag.
You can buy a rice bag, but most are small and designed for use on the neck. Look for something big enough to rest both feet on, or (even better) big and squishy enough to envelop your feet and Achilles' tendons.
If you possess some basic sewing skills, you can make yourself a better rice bag for way less. (My grandma used to make them for me.) You're going to sew a bag out of some fabric (something basic, like muslin). Add some rice—regular rice not instant—and sew the bag closed. Don't overdo it with the rice: You want the bag fairly full, but not so stuffed that it won't conform to the shape of your body. You can get pretty fancy with this—my grandma always made covers out of old towels, which kind of put me off using a cover on my rice bag. But you can also make attractive covers if you're crafty in that way.
To use, you'll heat the bag in the microwave. How long depends on how big you made your bag— a smallish bag (6"x10" or so) would need two or three minutes. I have an extra-big bag that I heat for seven minutes. Play around with it, just be careful not to scorch the rice.
The rice bag works on the damp-heat principle. As the rice heats, it releases moisture, so you end up with a nice, heavy heating pad. (Really, a warm rice bag is just so comforting.) Plus it retains heat for a quite a while, so you can take it to bed with you and it'll stay warm for much of the night.
- Buy a pair of YogaToes.
YogaToes are high-end toe separators, kind of like what you use between your toes when you paint your nails, only YogaToes are made with a soft, slighty tacky medical-grade gel, so they're a bit more comfortable and stay put.
YogaToes are designed to stretch all the tiny little muscles in your feet that don't get adequately stretched and worked when you're in shoes all day. You start out wearing them for 15 minutes or so and, and as your feet adjust, you'll build up to an hour or so. I often sleep in my YogaToes with my feet resting on a rice bag.
True, YogaToes are surprisingly expensive (but totally worth it, as far as I'm concerned). There are knock-offs, but I haven't tried them and don't know how they compare.
- Take a yoga class.
Yoga makes you stretchy, and stretchy is good.
- See a reflexologist.
Depending on where you live, it might be hard to find a good reflexologist. But if you find a good one, it's worth every penny. This might be a personal preference, but I like a reflexologist with a lot of muscle. I want her to be able to dig right into the muscles of my feet. As with so many things, it seems to work best when it hurts a bit. Or a lot.
- Get a massage.
You know the song about how all the bones are connected: "the thigh bone connected to the backbone / the backbone connected to the neck bone"? Well, the same is true of your muscles. If your neck is stiff and your back is achy, guess what? Your legs will probably be tight, too. A good massage can help address all that, especially if you can afford it regularly.
- Get some acupuncture.
If you have the cash or the health insurance for it, get thee to an acupuncturist! A couple sessions on your calves and feet can turn your calf muscles to butter. Nothing, nothing, nothing will fix you up as quickly as this will. (You'll still need to stretch, but the stretching will be easier and you'll see the results much faster.)