Plantar fasciits advice: Looooooong

[Wahine]

I decided to post this because a lot of people have been asking questions about this particular problem or related problems of the lower leg/foot. So here's something I wrote up in another context that might help with understanding how to manage plantar fasciitis. Sorry it's long but hey, it's not a simple problem.



PF (plantar fasciitis) is definitely not the kiss of death. You treat it with ice, stretching+++++, exercise, anti-inflammatories and massage. It’s generally related to muscle imbalances in the lower leg and biomechanical issues in the way the joints of your foot move. It is very treatable.

Here are some things you can do to try to ease/heal PF:

Calf stretches (gastrocnemius and soleus muslces). This one is for the gastroc (upper calf):

http://www.row2k.com/physio/achilles.html

This next description tells you how to modify the stretch above for the soleus muscle:

For the soleus muscle:

As above, but your body positioned 2-3 feet away from the wall. Bend the knees until you feel the stretch--again, keep your heels on the ground.

I recommend that people hold a stretch for 20 seconds and repeat it 4 times on each side. That's a rehab schedule. If you didn't have a problem and were working on prevention it would be adequate to do it once a side but better yet to go 2 times a side.

Strengthening exercises:

Anterior Tibialis Strengthening Exercise
In standing, support yourself against the wall and flex your feet upward, ball of the foot towards the shins. Hold this position for 5 to 10 seconds, emphasizing on your endurance. Repeat 30 to 90 times with breaks as needed.

Intrinsic muscle strength
Place a towel on the ground and try to scrunch it up with your toes. Scrunch and release, scrunch and release….. Do this for 2 to 5 min.

Some people also advocate walking barefoot to increase muscle strength. This is OK for people who do not have severe biomechanical problems with their feet but it should only be done when the foot is not actively inflammed.

Here’s a device to help with icing and/or contrast treatments:

http://www.footsmart.com/P-Hot-N-Cold-Roller-10145.aspx

But you could do the same thing much cheaper with 2 small bottles of water. If you use small plastic bottles of water, stick one in the freezer. Then when you're ready, take the frozen one out, place it on the floor and put a damp face cloth (or similar) over it and start to roll back and forth. Do this for 1 minute then switch to a bottle with hot water in it for a minute. One of my client's came up with the brilliant idea of putting an old sock over each bottle and wetting it down. Got back and forth for 10 to 15 minutes. Finish with cold if your treating it right after a run or activity that may have irritated the area. Finish with warm if you plan on doing a lot of stretching afterward.

And of course there's good ol' Aleve or ibuprophen (Advil) for over the counter anti-inflammatories. As with any medication, check with your pharmacist before taking it, even if it’s available without a prescription.

Massage works well to help to get your shortened muscles to co-operate and lengthen. But be forewarned, this type of therapeutic massage is painful and not for the faint of heart.

As for orthotics, many people can get by with stretching regularly and may avoid orthotics altogether. Some people need more help with controlling the biomechanics of the foot. Superfeet make a great over the counter insert that is worth trying before you dole out the cash for a custom orthotic. Go to a reputable running store to pick these up and ask questions. There are different models and one will likely be more appropriate than another.

Taping works well for some people. But taping long term is a PITA, so if you need help with biomechanics over the long hual, try to find an orthotic that will work.

Please feel free to add to this. I hope this helps round out the picture for some people.

[Jenn]

Thank you so much for the information. This PF is a real PITA, and I was ALMOST at my breaking point but it's calming down. I just hate the fact that I have this massive heels spur on my heel, which I'm assuming will never go away.. My podiatrist just said to me "you'll never run again" and that made me sick.
Thanks again for the info, I am definately going to try some of the other things I didn't know about that you posted!!

[Tuckervill]

The only thing I would add is try not to sleep with your toes pointed--if your covers are tucked in tight and make your toes point, pull the covers out.

My left foot is hurting pretty bad in the mornings after 2 weeks of sleeping in hotel beds, which are not always simple to get loose.

Karen

[Wahine]

The only thing I would add is try not to sleep with your toes pointed--if your covers are tucked in tight and make your toes point, pull the covers out.

My left foot is hurting pretty bad in the mornings after 2 weeks of sleeping in hotel beds, which are not always simple to get loose.

Karen

That's a really good point Karen. Enter the Strassberg sock:

http://www.thesock.com/

[mimitabby]

That's a really good point Karen. Enter the Strassberg sock:

http://www.thesock.com/

wow! that is so much nicer than the Hard plastic cast my DH was supposed to wear to bed!!!


and what excellent advice too!

[Jenn]

I told DH this sock is what I want for Mother's Day! I told him you just know how sexy I'll look coming to bed with that on~~I'm willing to try ANYTHING at this point. Thank you so much for the link.

[Bklynmom]

Stretching is like a magic cure for this problem! My podiatrist taught me the same stretch recommended here.

Orthotics also helped me a great deal. The podiatrist measured my legs, and she found out one is 1/8 inch longer. She adjusted the orthotics to compensate for this and that made a huge difference. Orthotics are expensive, but my insurance covered them after only a bit of a fit on my part. They last for 3 years.

Lisa

[Susan Campbell]

I suffered greatly and a long time.
I did end up getting an air cast (can be taken off) and wore it steady for 2 weeks. I also found a special night cast was a great help and Orthotics.
Super Feet and Sole have been the best non perscription brands I've found.
For a year I didn't get out of bed without some kind of orthotic/foot support in everything I wore. Now if I actuallyventure into a dress shoe for too long, I get the pain/inflammation again.
Prescription anti inflammatories and a new topical Anti Inflamatory worked really well called "Pensaid". Over the counters didn't work for me.
REST was the best cure, although they told me with orthotics in my bike shoes I could bike. Which meant I worked alot harder at making it up all the hills.
good luck...