Foot and Ankle

Managing Plantar Fasciitis

Plantar fasciitis can humble anyone! From professional athletes to my loving mother, a small problem can turn into an irritating mess quickly. The good news is that it can be prevented and very simply managed. As with many injuries and niggling pains, early action is important to prevent a full blown pain-attack. That is, don’t be the ‘tough guy’ who continually ignores the pain cries coming from your feet and delay treatment.


What is plantar fasciitis?

Plantar fasciitis is inflammation of the plantar fascia which is a ligamentous structure that spans from the talus bone (the heel) to the base of the toes. As with many inflammatory injuries, it mostly occurs due to overuse and/or muscular or structural imbalances.

Plantar Fasciitis


The pain usually increases in magnitude the longer that weight is being placed on the feet after inflammation has started to occur. Of course, it’s much harder to stay off your feet than it would be to rest an inflamed elbow, so we have to be a little crafty with treatment. The idea of early action is to manage the pain and allow for healing without having to sit in a wheelchair for several weeks until it heals.


General Guidelines


Any sort of soft tissue injury that promotes an inflammatory response should be treated initially with the time-tested RICE protocol:

Rest

Ice

Compression

Elevation


Although you might not be able to dedicate 24 hours per day to treatment, it can be extremely beneficial to follow the RICE principle whenever possible.

A sneaky trick for plantar fasciitis specifically is to freeze a bottle of water and roll it along the bottom of your foot increasing downward pressure gradually. Ideally, cold should should be applied for 20 consecutive minutes in an hour.


Specific Management


There are several methods that can directly help with plantar fasciitis as well as the RICE principle above:

  1. Calf Stretches
    • Stand with both toes on the edge of a step and gently lower your heels lower than the level of your toes. Perform both with knee straight (gastrocnemius) and with knee bent (soleus)
  2. Toe Raises
    • Decreasing the tension in the plantar fascia can aid in recovery as well as prevent flare ups. Standing on your toes or lifting your toes from time to time can act as a stretch to the fascia.
  3. Golf Ball Massage
    • While seated roll a golf ball all over the base of the foot. Increase the pressure and progress to standing on the golf ball.
    • Note: this can be quite painful so start with a tennis ball if a golf ball causes too much pain.
  4. Insoles
    • Podiatrists and foot specialists can provide custom orthotics that might help relieve the pressure in the plantar fascia.
  5. Weight loss
    • Increased weight can increase the force through the plantar fascia. Losing excess fat can therefore reduce the impact of plantar fasciitis.


Alternative Exercises During Recovery


The key in recovery is allowing the plantar fascia to recover is to allow 2-4 weeks of rest and recovery. Therefore training emphasis should shift to non-weight bearing exercises.

Don’t let Plantar Fasciitis be an excuse for laziness. Sure, you’re in pain but there are plenty of alternative activities that you can participate in while you manage your plantar fasciitis:

  1. Cycling: Potentially the greatest cardiovascular exercise for those with any lower limb injuries – plantar fasciitis included. It is vital to not sacrifice health and fitness due to a pesky injury. The non weight bearing nature of cycling makes it ideal for those who suffer from or are prone to foot pains.
  2. Swimming: As with cycling, swimming is a great option as it provides the ability to challenge the cardiovascular system while simultaneously engaging in non weight bearing activities. This can therefore allow the plantar fascitis to recover with little impact to overall health and progress.
  3. Strength training: The idea is to continue non-weight bearing exercise while increasing overall strength. The effects of detraining are swift and if you deprive the rest of your body of strength gains due to the plantar fasciitis then you are doing yourself a disservice.


Summary

  • Manage symptoms early and often.
  • Use RICE principle to relieve inflammation.
  • Prevent future flare ups by massaging the base of your foot using a tennis ball/golf ball.
  • Perform regular calf stretches to release the tension at the heel.
  • Don’t let plantar fasciitis be an excuse for not training the rest of your body.

 

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