The Plantar Fascia is a fibrous connective tissue on the bottom of the foot that stretches from the heal bone to the base of the toes. It causes the bowing of the arch. When it is overstressed micro tears can form causing inflammation (the “itis” of Plantar Fascitis). It does not have a good blood supply and heals very slowly. If not treated properly this acute injury can become chronic due to scar tissue build up and restricted blood flow.
During the Acute Phase – First 2 Weeks
It’s important to remove the stress for at least 2 weeks if possible. Meaning if you are a runner you need to stop running and find another activity such as swimming.
2. Loosen and Warm Up
- Manually warm up your foot with a roller, tennis ball or manual massage. This warms up the tissues and gets them ready for stretching and also breaks up scar tissue and increases blood flow. Self massage or professional massage is very effective. Do this before getting out of bed in the morning, and a total of three times per day
- Use elastic kinesio-tape for support. For instructions click here.
- Get new shoes
- I don’t recommend the use of orthotics as a primary treatment
4. Reduce Inflammation
- Ice: 20 minutes at a time, four times per day
- Ibuprophen: take two, four times per day
After the Acute Phase and for the Next Year
1. Loosen and Warm Up
As above. Do this before getting out of bed in the morning, and a total of three times per day for three months and once a day for the next nine months.
Do the following stretches right after loosening up, three times per day for three months and once a day for the next nine months.
3. Activate and Strengthen
Do the following exercises right after stretching, three times per day for three months and once a day for the next nine months.
- The Short Foot or (aka Doming) exercise is the most important thing to do if you want your Plantar Fascitis to go away permanently. It will strengthen your arch muscles so the fascia can hold up to the demands placed on it. Standing and walking on two feet needs to be done actively instead of passively. Most of us don’t use the muscles actively and rely on the ligaments and fascia to hold us up. This results in improper biomechanics and stress on those structures. When standing do the Short Foot at all times. When walking do the short foot as you stride forward and begin to push off with the forefoot and toes. Using the foot muscles actively with each step is essential to the long term cure of Planter Fascitis. It will take you at least a year of diligent concentration to retrain your body to use your arch muscles correctly.
- Do the Toe Exercise gathering up a towel
- Foot Wakers are an effective tool for strengthening the foot.
- One of the biomechanical problems said to cause Plantar Fascitis is Excessive Pronation, where the heal rolls inward and the feet flatten. Pronation is often a result of not activating the Short Foot muscles, overly tight Peroneal muscles and weak Gluteus Medius muscles. Do the Peroneal stretch above, and the Gluteus Medius exercises progressions in these 8 videos daily (start with video 1 and progress to number 8).
4. Support with tape when exercising on your feet.
5. Reduce Inflammation
- Ice: 20 minutes three times per day for three months, and once per day for nine months, especially after exercise.
- Diet: Many people have success reducing inflammation by changing their diet to one that produces less acid or that avoids chemical sensitivities. If the body is sensitive to certain food chemicals it can develop leaky gut syndrome of which the end result is inflammation. (stress can also cause leaky gut). An anti-inflammatory diet consists of increasing fruit and vegetable intake while decreasing grain, meat, dairy, sugar and alcohol. I recommend an elimination / challenge diet such as the Diet Blast where those foods are eliminated and then added one at a time to check for chemical sensitivity.
Written By: John Hoeber, MS, RD, CSSD, CPT
John Hoeber is a Personal Trainer, Registered Dietitian, Certified Sports Dietitian and Personal Health Coach with 25 YEARS EXPERIENCE. He specializes in weight loss, exercise programs for beginners and older exercisers, those with injuries, and recreational athletes, especially tennis and golf. He's a Titleist Performance Institute Certified Golf Fitness Instructor.