Plantar Fasciitis

Heel pain caused by plantar fasciitis is very common. It often affects people who run, jump, or stand for long periods. Most people who get this type of heel pain get better within a year even if they do not get treated.
What are the symptoms of plantar fasciitis?
The most common symptom is pain under the heel and sole (bottom) of the foot. The pain is often worst when you first get out of bed in the morning. It can also be bad when you get up after being seated for some time.
Is there anything I can do on my own to feel better?
Yes, you can:
Rest — Give your foot a chance to heal by resting. But don’t completely stop being active. Doing that can lead to more pain and stiffness in the long run.
Ice your foot — Putting ice on your heel for 20 minutes up to 4 times a day might relieve pain. Icing and massaging your foot before exercise might also help.
Do special foot exercises — Certain exercises can help with heel pain. Do these exercises every day.
Take pain medicines — If your pain is severe, you can try taking pain medicines that you can get without a prescription.
Wear sturdy shoes — Sneakers with a lot of cushion and good arch and heel support are best. Shoes with rigid soles can also help. Adding padded or gel heel inserts to your shoes might help, too.
Wear splints at night — Some people feel better if they wear a splint while they sleep that keeps their foot straight. These splints are sold in drugstores and medical supply stores.
Is there a test for plantar fasciitis?
No, there is no test. But your doctor should be able to tell if you have it by learning about your symptoms and doing an exam. He may suggest an X-ray, or other tests to check whether your symptoms might be caused by something else.
How is plantar fasciitis treated?
The first step is to try the things you can do on your own. But if you do not get better, or your symptoms are severe, your doctor might suggest:
• Taping up your foot in a special way that helps support the foot
• Special shoe inserts, made to fit your foot
• Shots (that go into your foot) of a medicine called a steroid, which can help bring down swelling
• Surgery (this is an option only in some cases that do not get better with other treatments)
• Some doctors also suggest a treatment called “shock wave or ultrasound therapy.”
Is there anything I can do to keep from getting heel pain again?
Yes! To reduce the chances that your pain will come back:
• Wear shoes that fit well, have a lot of cushion, and support the heel and ankle
• Avoid wearing slippers, flip-flops, slip-ons, or poorly fitted shoes
• Avoid going barefoot or wearing slippers
• Do not wear worn-out shoes
• Weight loss can help significantly reduce the chance of recurrence
• Towel stretch: Sit on a hard surface with your injured leg stretched out in front of you. Loop a towel around the ball of your foot and pull the towel toward your body keeping your knee straight. Hold this position for 15 to 30 seconds then relax. Repeat 3 times. When the towel stretch becomes to easy, you may begin doing the standing calf stretch.
• Standing calf stretch: Facing a wall, put your hands against the wall at about eye level. Keep the injured leg back, the uninjured leg forward, and the heel of your injured leg on the floor. Turn your injured foot slightly inward (as if you were pigeon-toed) as you slowly lean into the wall until you feel a stretch in the back of your calf. Hold for 15 to 30 seconds. Repeat 3 times. Do this exercise several times each day. When you can stand comfortably on your injured foot, you can begin stretching the bottom of your foot using the plantar fascia stretch.
• Plantar fascia stretch: Stand with the ball of your injured foot on a stair. Reach for the bottom step with your heel until you feel a stretch in the arch of your foot. Hold this position for 15 to 30 seconds and then relax. Repeat 3 times. After you have stretched the bottom muscles of your foot, you can begin strengthening the top muscles of your foot.
• Frozen can roll: Roll your bare injured foot back and forth from your heel to your mid-arch over a frozen juice can. Repeat for 3 to 5 minutes. This exercise is particularly helpful if done first thing in the morning.
• Toe curls: With your heel on the ground, pick up a towel with your toes. Release. Repeat 10 to 20 times. When this gets easy, add more resistance by placing a book or small weight on the towel.
Next, you can begin strengthening the muscles of your foot and lower leg by using elastic tubing, or a resistance band.
• Resisted dorsiflexion: Sit with your injured leg out straight and your foot facing a doorway. Tie a loop in one end of the tubing. Put your foot through the loop so that the tubing goes around the arch of your foot. Tie a knot in the other end of the tubing and shut the knot in the door. Move backward until there is tension in the tubing. Keeping your knee straight, pull your foot toward your body, stretching the tubing. Slowly return to the starting position. Do 3 sets of 10.
• Resisted plantar flexion: Sit with your leg outstretched and loop the middle section of the tubing around the ball of your foot. Hold the ends of the tubing in both hands. Gently press the ball of your foot down and point your toes, stretching the tubing. Return to the starting position. Do 3 sets of 10.
• Resisted inversion: Sit with your legs out straight and cross your uninjured leg over your injured ankle. Wrap the tubing around the ball of your injured foot and then loop it around your uninjured foot so that the tubing is anchored there at one end. Hold the other end of the tubing in your hand. Turn your injured foot inward and upward. This will stretch the tubing. Return to the starting position. Do 3 sets of 10.
• Resisted eversion: Sit with both legs stretched out in front of you, with your feet about a shoulder’s width apart. Tie a loop in one end of the tubing. Put your injured foot through the loop so that the tubing goes around the arch of that foot and wraps around the outside of the uninjured foot. Hold onto the other end of the tubing with your hand to provide tension. Turn your injured foot up and out. Make sure you keep your uninjured foot still so that it will allow the tubing to stretch as you move your injured foot. Return to the starting position. Do 3 sets of 10.
Demonstrations of some of these exercises:
• Towel stretch: 		http://objectivehealth.ca/r/towelstretch
• Toe curls: 		http://objectivehealth.ca/r/toecurls
•  Resisted plantar flexion: 		http://objectivehealth.ca/r/plantarflexion

Plantar Fasciitis Exercises