It’s that time of year again. Spring has finally arrived and we are ready to get outside. For many, it’s a time to lose that winter weight and get into summer shape. You may have started a walking or running program on your own, but now you have a sharp pain in your foot causing activity to be quite difficult. It could be plantar fasciitis. Fortunately, help is available and you may be able to manage this on your own.
The most common signs of plantar fasciitis include: sharp pain with your initial steps upon waking, or increased foot pain after sitting for a long time. Another sign is pain when pressure is applied to the bottom of the foot near the heel.
Individuals who have a high BMI, have limited dorsiflexion (difficulty lifting the toes up at the ankle), or have recently increased activity and noticed heel pain are more likely to develop plantar fasciitis. As a physical therapist, I see this quite often in patients and more times than not, the individual had been dealing with symptoms for quite some time.
The American Physical Therapy Association (APTA) has developed a clinical practice guideline to help in treating plantar fasciitis. What that means, is the APTA has done the dirty work and reviewed hundreds of articles to summarize the best treatments for your plantar fasciitis.
Here are some treatments that can be performed at home.
Focus on stretching the muscles of the calf (gastrocnemius and soleus), as well as plantar fascia specific. My general recommendations would be to perform these stretches twice per day, hold for 20-30 seconds and 3 times per set. See the pictures below for each of these stretches.
Self deep-tissue mobilizations
This can often be difficult to perform on yourself and is not the most pleasurable experience. I have performed this on many patients in PT and it is commonly described as a “good hurt.” You will not enjoy this massage, but you will like the benefits! Also, you can use a foam roller or even a rolling pin to apply pressure along the calf.
I will recommend my patients to roll a tennis ball/baseball on the floor using their mid foot to help massage the plantar fascia. Better yet, pour out an ounce or two from a water bottle, stick it in the freezer, and roll this water bottle on the ground using your foot. This can help provide the anti-inflammatory properties of ice in addition to mobilizing the plantar fascia.
There are two options that may help manage your plantar fasciitis pain. The first is referred to as low-dye taping or anti-pronation taping. There are instructions available on how this can be performed all over the Internet. This essentially works by helping take the stress off the plantar fascia by providing more support to the arch of your foot.
The second option is kinesiotape or elastic taping. This is the tape you see athletes wear that has all kinds of crazy designs, patterns, and colors. This type of taping includes two pieces of tape: One for the calf and one for the bottom of the foot.
For the calf, measure the distance between the lateral malleoulus (big ankle bump on the outside of the ankle) and the fibular head (a smaller bump just below the knee and to the outside) and cut it in half. This gives you your first length. This piece of tape will be cut in half, leaving an anchor of about 1-1.5 inches in length. You will place the “anchor” of this tape to your Achilles’ tendon at a level between the bones of the ankle (malleoli), and stretch this 3/4 of the way up the length of the calf. The second piece will be measured from the back of the heel to the tip of your big toe (again cut this in half). You will cut this piece into 4 “fingers,” again leaving a 1-1.5 inch anchor. Your anchor will be placed at the heel, and will be stretched the length of your foot, just before your toes. See the pictures for more details.
Custom orthotics are available, although they can be quite expensive. Luckily, you can begin with an over-the-counter orthotic. Now, when you purchase these, I am not referring to the $10 soft/gel inserts. You should be looking for an orthotic with a firm arch support, likely costing between $30-$60. If you have tried the low-dye taping and have responded well, orthotics may be the best option for you!
These will typically be used for 1-3 months. They work by applying a constant stretch to the plantar fascia while you sleep, and will make you look like you are wearing elf shoes. This can be especially helpful for those who have the most pain first thing in the morning.
I encourage you to ask questions, share your experience, and leave suggestions for future topics in the comments below. I will do my best to respond to each as timely as possible!
Bryon Renwand, PT, DPT, CSCS, works with ProMedica Total Rehab and received his Bachelors of Science in Exercise Science from the University of Toledo, where he also received his Doctorate of Physical Therapy. For his full bio and other articles, please click here.