The agony of de-feet: how to deal with plantar fasciitis

You’re feeling good, in your exercise groove, running or doing your boot camp class, when after a few months, it starts: that throbbing, aching in your heel, the first painful step out of bed in the morning…. Whaaat?! This CAN’T be happening! Then it gets worse. The doctor tells you, “Stop running and high-impact activities.” But you love working out! What are you supposed to do?
images-4I’m a doctor, so the last thing I expected was that I would have to heed my own advice. But that’s exactly what happened. At my exit physical from the military, the pain in my left heel was killing me. I had the same symptoms as patients I had once treated. I remember giving out the “No running” orders. “I can’t stop running,” my patients often replied. Now I had plantar fasciitis, myself, that inflammation of the tissue on the bottom of the foot. And suddenly I was in the patient’s shoes. Now I had to listen to my own recommendations.

Here are five steps to dealing with the agony of de-feet:

  1. Healing = “tincture of time” (This is the most importanimages-2t element for body repair.)
  2. Proper supportive footwear to avoid over-pronatio
  3. Ice massage after exercis and at the end of the day
  4. Achilles/calf stretching (both before and after exercise)
  5. Rehabilitation orthotic

Number 5, rehabilitation orthotics, is a novel approach to treating plantar fasciitis that I heard about from a marathon-running colleague. The hypothesis is that these types of orthotics strengthen the intrinsic foot muscles, thus changing arch height and foot length, which, in theory, reduces tension on the plantar fascia tissue. A higher arch and less pronation of the foot alleviates tension on the plantar fascia and lowers the tendency to cause micro-tears in the attachment of the fascia to the heel bone. Evidence is suggestive, but not definitive, showing trends toward benefit.

Personally, I’ve found benefit with these types of orthotics. And, anecdotally, I’ve seen patients do well with them, too. Placebo effect? Maybe. But I was pain-free after 2 months of using them. However, please note that I took all of the other conservative measures (steps 1-4) as well.

Finally, I must point out that I didn’t completely stop exercising. Rather, I changed my activity. You can switch out high-intensity exercises with low-impact options. (If you’re not sure how to do this, ask your Body & Soul instructor about it. They will be happy to show you how to go about it!)

In closing, follow the above measures and you should be able to recover from the agony of de-feet. And keep this one truth before you, which I now live by: support your feet and they will support you!images-3

3 Comments on “The agony of de-feet: how to deal with plantar fasciitis

  1. It really is amazing as to how much our feet go through. If we subjected any other body part to the stress they experience, I’m sure that whatever part it is wouldn’t last long. I’d have to agree that it’s quite important to wear proper supportive footwear. I’m sure that we wouldn’t go running in flip flops or snow boots.

  2. Even if the orthotics you mention in step five work well I agree that it is probably a bad idea to skip steps 1-4. The first step probably being the most important. However, it is hard to wait for the healing process. Are there any tips for what kind of stuff I can do while waiting for plantar fasciitis to heal?

    • Excellent question, J.B. Again, anecdotal, but this helped me: 1. Stopped running and changed from high impact/plyometric activities (jumping) to low impact (ie, jumping jacks became side step out, for example). When pain completely resolved, then I gradually added back my running and high impact activities. 2. Never walked around barefoot. I bought supportive sandals (firm plastic spa-type sandals-Sensi, with the smooth soles that conform to your foot-with arch support, heel cup, and toe grips). Using these sandals around the house (and I got a pair for outside) GREATLY diminished my pain (and I didn’t even notice the pain when I would wear them). 3. I did ice massage for my heels, especially at the end of the day or immediately after exercise. 4. Bio freeze or similar (Salon Pas, icy Hot) may provide temporary relief. 5. Per my podiatrist and also my own experience, the foot sling at night does not help. It has the potential to overstretch the plantar fascia causing more micro tears at the attachment site on the talus (heel bone). 6. Before you get your custom or rehab orthotics, taping the arch with KT tape (at running stores) can help. Let me know if this helps you. With me, I noticed gradual improvement over a few months (and within 2 months, complete resolution when I used the BFS orthotics–the ones with arch support that changes height, ie, rehabilitation ortjotics)Hope this helps!

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