Plantar fasciitis is a common cause of heel pain that affects one in ten people during their lifetime. This condition causes extreme discomfort, what many patients describe as a “stabbing” sensation that is most intense first thing in the morning and after extended periods of sitting or standing.
Plantar fasciitis is treatable, but it takes time, rest, and certain lifestyle changes. Habits and activities that aggravate heel pain are only going to prolong your recovery—and you certainly don’t want to do that. Let’s talk about what not to do if you have plantar fasciitis.
The plantar fascia is a ligament just beneath the skin that runs along the bottom of the foot. This strong, fibrous band of tissue supports the arch of the foot and connects the heel bone to the toes.
The plantar fascia serves another important purpose. It absorbs the strains and stresses of our daily activities: standing, walking, jumping, and any other physical activities we do. However, overuse or excess pressure and tension can cause microtears in the tissue, resulting in heel inflammation, stiffness, and foot pain. In fewer cases, trauma to the foot can also cause plantar fasciitis symptoms.
For many people with plantar fasciitis, the first few steps of the day are the most painful. As they move around and begin to walk, the pain may ease a bit, only to recur at the end of the day or again the next morning.
If you have severe heel pain from injury or overuse, the goal is to avoid re-injury and promote healing. Here is a simple checklist of what not to do with plantar fasciitis:
A “wait and see” approach sometimes makes sense for some minor health issues—but not for plantar fasciitis. If you continue to walk, run, and exercise with an inflamed plantar fascia, you will worsen micro-tears and increase your pain. Consult with your physical therapist to see if you should limit walking with plantar fasciitis.
Prompt treatment can help you avoid more complex and costly interventions down the road. Discuss your concerns with your healthcare provider and ask about a referral to physical therapy for your symptoms sooner than later to start the path to healing. Evidence supports early physical therapy intervention recover faster.
Flip-flops, flats, and other shoes that don’t have good support are only going to make your condition worse. Also, avoid high heels and other footwear that puts abnormal pressure on your feet. If you have flat feet or high arches, pay extra attention to your shoes, as these conditions increase your risk of plantar fasciitis.
It’s especially important for runners to wear high-quality, running shoes designed for their individual needs because of the constant pounding of their feet against the ground. Each individual has a different foot type that has different requirements for optimal function. Removable orthotic inserts designed to alleviate the heel pain associated with plantar fasciitis are also available to make shoes more supportive.
Tight muscles in your feet and calves can aggravate plantar fasciitis pain. And as you change your gait to compensate for this muscle stiffness and tightness, you may develop new aches and pains.
A physical therapy (PT) screening is the best way to assess your condition and combat heel pain and other issues through exercise, massage, and manipulation. For patients, the worst thing to do with plantar fasciitis in skip your stretches. It’s common for patients to get “homework.” Homework typically involves stretches targeting the calves and plantar fascia.
Stretching is possibly the most effective way to relieve heel pain associated with this condition. Put stretching at the top of your “to-do” list and be sure to do it as often as your physical therapist recommends.
Once pain and discomfort subside, it can be tempting to go back to training right away. But that will only increase your chance of plantar fascia reinjury. To resume physical activity, start out slowly if you are coming off a bout with plantar fasciitis.
If you run, begin with short jogs, stopping at markers you identity along your route—trees or telephone poles, for example. Take a few seconds to stretch your calves at each stop. Gradually, increase the distance between stops. Apply this approach to whatever exercise or physical activity you prefer. Start out slowly and increase intensity over time.
Pain is an important messenger. It lets us know when something in the body or mind needs attention. You can’t simply push through heel pain from plantar fasciitis. Well, you can, but you’ll only end up with more pain and a longer recovery.
In some cases, non-steroidal anti-inflammatory medications like ibuprofen provide temporary relief. They can mask the main problem and convince you that you are healed. But even if you don’t have pain, you don’t want to go back to running or other intense physical activity right away. Pain is your reminder to slow down and let your body rest and recover.
After treatment has been effective and heel pain has subsided, you can be proactive about preventing plantar fasciitis going forward. Lifestyle changes can reduce your risk of future damage to the plantar fascia.
First, make modifications if you have a job that requires you to stand on your feet for long periods of time. For example, if you work in a factory, ask about working from a seated position or take additional breaks for rest.
If that isn’t possible due to the nature of your work, be sure to wear sturdy, comfortable shoes with thick soles that support your arches and cushion the heels. Ask about adding a shock-absorbing rug or mat to your workspace. If exercise is the culprit, consider taking up a sport or activity that is less-demanding on your legs and feet. Swimming and cycling are good options.
Next, incorporate stretching into your daily routine, especially if you are a high-intensity athlete or have a physically demanding job. Follow-up with your physical therapist as needed whenever symptoms arise.
Finally, it’s important to maintain a healthy weight. Excess weight puts added pressure on the bones, muscles, and joints. It also leads to inflammation of the tendons connecting bone to bone. If you are experiencing obesity, talk to your healthcare provider and physical therapist about safe and practical weight-loss solutions
Plantar fasciitis is a complex condition that often responds to a treatment plan consisting of natural, noninvasive therapies like:
Treatment typically begins with more conservative methods. Surgery is possible when relief is not achieved through nonsurgical therapies.
Relief from severe heel pain is not immediate, but it is possible. Approximately 90% of patients find relief within 3-6 months of conservative treatments. A small percentage of patients require surgery to be followed by several weeks to months of recovery. If chronic heel pain is keeping you from doing the activities you enjoy, you don’t have to suffer any more.
