After a year suffering through the dreaded Plantar Fasciitis I can say that there is only two certain ways to get rid of it.

1) Never walk on it, i.e. don’t leave your bed.

2) Cut off the ailing foot.

I looked through my running log and it was a year ago today that I first mentioned foot pain and took a day off. I have tried a lot of things in the past year, all to no avail.  I’ve done physical therapy and spent a lot of time at the doctor’s office listening in as the doctor and therapists share with the residents about Plantar Fasciitis.

I’ve broken this post into three segments – immediate actions, intermediate actions, and last ditch/extreme measures.

IMMEDIATE ACTION REQUIRED

1) Stop running.  Take a few days (weeks) off immediately to give your foot a chance to heal. I recommend swimming to keep the cardio strong.  Everyone says it is ok to bike, but I’d be really cautious.

2) Stop walking around barefoot.  Nothing is nicer than kicking off your shoes and letting the old dogs relax.  However, walking around barefoot can exacerbate Plantar Fasciitis.  I’d recommend some nice Crocs or slippers with about an inch of padding to protect your heel.

3) Take ibuprofen.  I’m not a doctor.  My doctor recommended taking 800mg (4 tablets) 3x’s a day with food for 2 weeks.  This will help take down the inflammation.  The consistency builds up the amount of medicine in the body which helps it work faster.

4) Check & Change Shoes.  All of them.  Even if they are brand new I would recommend buying new running shoes, maybe switching brands or styles.  Go to a running specialty store and have them analyze your running (after resting for a few days).  Then check all of your other shoes for wear.  If they show a little excessive wear – get rid of them.  I know its expensive but it is better to be healed or buy new shoes?

5) Roll out the foot.  I used a can of soup for a long time before buying a more advanced roller. In a fluid motion roll the jar under your foot from heel to the ball back and forth for a minute or so. Really dig into the heel. Do this two times a day.  One of the times you should soak the foot in warm water first.

6) Stretch the arch.  Place your foot on the opposite knee.  Taking the 5 toes bend them towards the same knee.  This will stretch the fascia. Hold for 30 seconds.

7) Ice. At the minimum put ice on the heel. The best option is to take a frozen dixie cup of ice and massage the affected area.  I just rub an ice cube into it until it melts.  Another option which combines step 5 and 7 is to roll out your foot with a frozen water bottle.

8) Night Splint. I’ve used both the Strassburg Sock (my review or Amazon) and the Dorsi-Wedge.  Obviously, neither worked.  I felt the Strassburg Sock was easier to wear.  My sports doc (who works at the University of MN) felt like the sock allowed too much room for “cheating”, etting the foot move around or not wearing it properly. Other night splints on Amazon.

9) Stretch. Obviously stretching the entire body is always an important part of the routine.  It is important to stretch out the calves, achilles, and hamstrings.  I’ve used both the foam roller and the stick to do this.

Optional:

10) Massage.  Especially the calves and foot. This actually feels really good, I should go get one again.

11) Hot Tub.  Sitting in the hot tub really can feel great and helps relax the muscles.  I need to do this again too!

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INTERMEDIATE ACTIONS

1) Physical Therapy. This encompasses a wide variety of tactics and exercises.  Most of mine focused on hip, core, and ankle strength.  It is important to have a strong core to help hold your body together and in proper alignment.  This Running Times article covers a lot of the hip work that I was doing.

2) Iontophoresis (wikipedia). Actually a part of physical therapy, but this takes a steroid like dexamethasone and electrically injects into the skin.  This works well for a lot of people, but loses effectiveness after 8 treatments.

3) Taping.  I had mixed success with taping my foot while running and walking around.   I used this method. The idea is that this helps reduce the load that your fascia is forced to carry.

4) Inserts/Orthodics. I’m not really sure where to put this. I’ve heard of people having success with it, but I haven’t with inserts.  Also, with orthodics you’ll become dependent on them.  It might “fix” the problem but not change the body issues creating the problem. Treating the symptoms, not the problem.

5) Active Release Technique. ART, as it is called, releases the fasciia and other “tight” areas the cause Plantar Fasciitis.  I’ve heard that it works well and the Ironman offers ART Certifications, but my sports doc wasn’t aware of this non-traditional treatment.  It is often offered by chiropractors.  More information can be found here. Locally, some of my friends recommend Dr. Folske.

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LAST RESORT/EXTREME MEASURES

I’m sure there are more than these 2 but I don’t know of them.

1) Cortisone shot. Or other steroid injection. This injects a steroid into the fascia which speeds healing.  This is not a long term fix and masks the pain – quite well I’ve heard.  It has at least 2 major drawbacks:  tearing the fascia and atrophying the fat pad in the heel.  My sports doc really doesn’t like to use this option.  She thinks the long-term risks often outweigh the short-term gains.

2) Surgery. Yuck, who wants to go under the knife.  Basically they cut the fascia and it heals itself and is stronger.  This is the ultimate last resort. My thought is that if I just put my foot in a cast for 6 weeks I’d probably get the same results.

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Have you had success with any other treatments?