Does Your Heel Ache? 7 Ways to Treat Plantar Fasciitis
Plantar fasciitis is one of the most common causes of foot pain (specifically in the heel). After I started showing symptoms of it (and consequently started complaining about it) I was surprised to find out that this rather fancy sounding condition affects many more people than I ever suspected.
Brock Armstrong
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Does Your Heel Ache? 7 Ways to Treat Plantar Fasciitis
I spent the last year (or so) dealing with a type of foot pain that is referred to as Plantar Fasciitis (plan-tar fash-ee-eye-tus), or PF for short. During that time, I tried pretty much anything and everything. Here are a few things I learned that you can try if your plantar’s fascia becomes inflamed.
What Is PF?
The ligament called the plantar fascia is a flat band of tissue that runs along the bottom of your foot and connects your heel bone to your toes. One of its most important duties is to support the arch of your foot. If you upset your plantar fascia, it can get swollen, irritated, and inflamed, which will make your heel hurt when you stand or walk. Most often the pain is stabbing and intense during your first few steps in the morning, and again after any time you spend sitting idly for a while. Other than that, it is mostly confined to an annoying ache.
Plantar fasciitis is defined as “an overuse syndrome characterized by localized inflammation or degeneration of the plantar fascia at its anatomical insertion on the calcaneus.” Simplified, that means that it is not the whole plantar fascia that is likely inflamed, it is just a particular point (the anatomical insertion) where the tissue attaches to the bone (the calcaneus) that experiences inflammation or degeneration.
Plantar fasciitis is common in middle-aged people and it can occur in one foot or both feet. Luckily, I only have it in one. #blessed
How to Treat It
Common treatments for Plantar Fasciitis include using a heel insert (which I tried—meh), night splints that keep your foot in a dorsal flexed position (I have enough trouble sleeping, thanks—meh), non-steroidal anti-inflammatories (masking the pain—meh), injection of a corticosteroid (maybe, if I get desperate enough, but until then—meh), and staying off your feet (be more sedentary—double meh). Let’s look at some other treatments that feel a little more get-fit and quick and dirty.
1. Stretching
Stretching is very helpful for treating Plantar Fasciitis because it can help reduce inflammation and provide greater elasticity in and around the affected area. If you have PF you should stretch your calves and your hamstrings. You should also stop wearing shoes with heels (any size of heel) which is known to cause shortening of your Achilles tendons, hamstrings, and so much more.
While you are at it, it is a good idea to make sure your pelvis aligns where it belongs as well. Biomechanist Katy Bowman has a great page about pelvic alignment called Mind Your Pelvis. I have actually noticed that during my morning “wake-up & get-moving” routine, my heel really loosens up when I get to the hip circle portion of the routine.
2. Massage
Massage therapy is one of the most popular forms of dealing with plantar fasciitis. Our body’s soft tissue areas are composed of muscles, connective tissues, and tendons, and massage therapy can loosen those tight muscles and encourage upset tissue to relax. Massage also increases blood circulation to the injured areas which increase nutrient and oxygen uptake in the tissue.
Very often the tension in the plantar fascia is caused by, or results from, tension higher up the leg. In my case, getting some deep tissue massage on my calves provided significant short term pain relief.
3. Roll Out Your Feet
Gently rolling out your affected foot for a few minutes can really help loosen up your plantar fascia, which can make it less irritated. I have a tiny device similar to a rolling pin that I use for my feet, which I keep by the yoga mat and couch for those times when I just want to space out on a Netflix show but still do something good for my body. You can use a tennis ball, a golf ball, a fancy Kinesio ball, or anything else that fits under your foot and can be rolled around. Physical therapist Kelly Starrett has a video explaining how to do this on his Mobility WOD YouTube Channel.
Pro Tip: If your heel is acutely sore, roll it out with a frozen water bottle. You get the massage benefits and the icing pain relief all in one.
4. Alfredson Protocol
The Alfredson protocol is actually most often prescribed for Achilles’ tendinopathy but I had a brave (and clever) physiotherapist who thought outside the box. The Very Well Health website explains how to do this protocol…very well, but in a nutshell it is: a basic calf raise, performed with your heels hanging off of a step or platform, focusing on the eccentric (or lengthening) part of the movement.
After you have done that for a while, you can start doing a more ballistic version of this movement called a Heel Drop. Yes, it is exactly what it sounds like. Just like the Alfredson Protocol, you stand on the edge of a stair and do a simple calf raise. Then you basically let go, drop your heels and allow all of your body weight to kick off a “repair me” response in the affected tissue. It’s not as painful or scary as it sounds once you get used to it.
5. Extracorporeal Shockwave Therapy (ESWT)
This treatment can be compared to having a tiny jackhammer applied to your body, which is kind of fun but also kind of freaky. In ESWT, sound waves bombard your heel to stimulate healing within the ligament. This is thought to work by creating microtrauma in the tissue, which initiates a healing response. Blood vessels then form and increase the delivery of nutrients to the affected area. The microtrauma is thought to stimulate a repair process but also helps to relieve pain. The Very Well Health website has a great article about Shockwave for PF.
6. Graston Technique or Scraping
In the Graston technique, a trained professional (don’t try this at home, kids) uses a small stainless steel instrument (like a dull butter knife) to apply progressive, targeted pressure to the plantar fascia. This targeted pressure breaks up adhesions and scar tissue in the inflamed, damaged ligament, which can improve blood flow and encourage healthy tissue to regenerate. The Heal that Pain website explains more about Graston and PF.
7. Toe Alignment Socks
Foot or toe alignment socks are designed to help align the toes back to their more natural (non-shoed) position. The socks work by allowing you to passively stretch your toes apart, so you can return to walking the correct way. The socks feature spacers between the toes, much like the ones you may use while you are painting your toenails. If you have a baby or toddler available, take a look at their toes and then look at yours. See how their’s have some air between them and yours are all bunched together? That is a result of wearing shoes for umpteen years and is exactly what the socks are aiming to counteract. And did I mention how good it feels?
For a demonstration of how good this feels, just slide your fingers between your toes and leave them there for a couple of minutes. Right? After years of wearing shoes that mash our toes together, returning them to their natural state will take longer than you can likely sit and hold your toes apart, which is why I ordered the socks.
One Size Doesn’t Fit All
Keep in mind, this is a list of a few things that worked for me, but it doesn’t mean that it is the “one cure to end all heel pain.” The best way to help your Plantar Fasciitis is to be proactive about preventing it from happening to you in the first place (or preventing it from returning to you in the second place).
Do some regular stretching routines, allow your feet to return to a more natural position by letting them be free (and naked) as often as possible, roll your feet out if you have been on them all day or have been wearing tight shoes, jam your fingers between your toes now and then, and basically never forget about your feet. Those little piggies need some love and attention too!
For more heel info, foot tips, and to join the painful conversation, head over to Facebook.com/GetFitGuy or twitter.com/getfitguy. Also don’t forget to subscribe to the Get-Fit Guy podcast on Apple Podcasts, Stitcher, Spotify, Google Play or via RSSopens XML file .
About the Author
Brock Armstrong was the host of the Get-Fit Guy podcast between 2017 and 2021. He is a certified AFLCA Group Fitness Leader with a designation in Portable Equipment, NCCP and CAC Triathlon Coach, and a TnT certified run coach. He is also on the board of advisors for the Primal Health Coach Institute and a guest faculty member of the Human Potential Institute.