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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.
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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!
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.
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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.
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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.
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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.
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.
Have you had success with any other treatments?
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Nick;
Sounds like a painful experience. Good info and advice contained on this page.
I get a pain in my feet once in a while, but only when I first start biking in the spring, then it goes away.
Take care and maybe we will see each other running/biking soon.
Bill
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Thanks for your article. Sounds like good suggestions. I've basically had this for 6 months and have tried P.T, custom made orthotics, home exercises, ice, heat, anti inflammatory medication, vicodine, etc. etc. etc. I have about 6 hours a day that I can function and at about 3:00 the pain becomes so bad I'm basically done for the day. Very depressing and upsetting. Will keep trying with the hope it will stop some day. I will not consider surgery as my research has shown it is not a good option. Thanks for your advice.
Hi Linda. I am in the same boat you are currently in. By the end of the day my foot is starting to hurt. I've noted that both of my feet often feel tired so that doesn't make me as nervous. One thing I've done is started to walk barefoot more often (strengthening) the foot. I feel this last hurdle is hard to get over. Good luck.
I've been suffering with PF for 10 months now and am starting to feel really depressed! I've tried everything that everyone has mentioned, except for surgery. I was booked to try extracorporeal shock wave treatments, but they are not covered by insurance. The company said it would not bill me directly, but it would bill my insurance company $15,000, even though they knew it wouldn't pay, and that I would be responsible for an co-payments and out of network expenses. These were not detailed. Then there was the $750 podiatrist fee. I could well imagine that the final bill would be several thousands of dollars.
Has anyone tried shock waves to break up the scar tissue?
Hi again Linda. I've not tried ESWT though I did recently read an article that it has mixed reviews. There haven't been a lot of standardized studies to prove its effectiveness. I couldn't find the exact article I read, but this one from Podiatry Today seems to have drawn a similar conclusion. It says that both EWST and surgery have similar success rates, around 82%. Here is their concluding paragraph:
Do you have a cost estimate of surgery? One of the reasons insurance doesn't cover this treatment is because it is still seen as experimental. I assume you've done the ultrasound treatment? Have you tried a chiropractor? I've had some success with that route – aligning my body properly and all.
Linda,
I have tried everything as well mentioned above and no success. I have had plantar fasciitis for almost 2 years and work in an orthopaedic office. It sucks so bad and no one knows how you feel unless you have it as well. I have no idea what the next step is, I really do not want surgery. One of the doctors where I work has had this and he did a bone stimulator(something normally for fractures and go thru a cast), but he said that it helped him. I sometimes have to take pain medicine just to relieve the pain. They ache and hurt sooooo bad, especially at the end of the day and at night. Any other suggestions??? I am so miserable.
Wow, Corrie sounds like you are in a lot of pain. You say you've done everything above. Have you switched work shoes? Sometimes my feet hurt at the end of the day, do both of your feet hurt/tired or just the affected one? If my good foot felt tired then I knew that the pain was just exacerbated by a long day and not necessarily getting worse.
I would check with a chiropractor or an acupuncturist to see if they could give you any relief.
I was an avid runner for over a decade. I miss it so much. I started having what I believed were plantar fasciitis problems about 2 years ago. I have tried everything under the sun. I have done cortisone shots, Sole inserts, night braces, stretching, massage, fin swimming, and calf raises. I have been regimented about my recovery, and it has all been to no avail. Last week, I started having chest cramps. I went and saw my doctor, and he informed me that my blood pressure was extremely high. My diet, exercise, and lifestyle are top notch. I am in my 30s. According to my doctor, it is hereditary, and there is little I can do except medicate it. I got put on Novarsc and Hydrochlorothiazide. Hydrochlorothiazide is a diuretic, and it has pulled a lot of the water out of my system. Basically, my foot problems went away over night after a 2 year battle. My body is fit, but I was retaining too much water in my blood vessels causing unnecessary pressure within in my feet muscles. IF YOU ARE HAVING PROBLEMS WITH YOUR FEET, DO YOURSELF A FAVOR AND HAVE YOUR BLOOD PRESSURE CHECKED. I am so happy that I will be able to put on the old running shoes and head down the road for a jog in the near future.
@AA
That is an interesting perspective. I am glad you found a solution that worked out for you. This just goes to show there is no one definitive response to heel pain!
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I had electro shock acupuncture done. The needles were inserted in my calves then hooked up to cables which in turn were attached to a small machine runs electricity thru the cables. The machine is turned up gradually until you tell them you feel something. The level was upped until it felt kind of like you are getting a 'charlie horse' in you calf. You stay there for about 10 minutes. It's not painfull, but not exactly pleasant either. I've had pain before this for 5 months and wearing nothing but running shoes everyday and limping most days. After 3 sessions of this, and stretching, and taking a magnesium powder, my foot is significantly improved. I can go down the stairs without hanging on to the handrail. I am trying to find this sock to wear at night or some kind of brace. Hard to find in Canada. The treatment is really working great! I highly recommend it. My doctor, podiatrist, and an orthopedic surgeon who was consulted did not help at all. I got my acupuncture treatment from a naturopath intern.
Shawna – thanks for sharing about your acupuncture treatment. I'm really glad that it is working for you! I would definitely try to get some type of night splint as it will help keep your tendons stretched overnight. And keep stretching!! Please let us know how the treatment continues to progress!
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Hi I'm 12 and have had plantar fasciitis for 2 years on and off. I've tried everything exept the steroids and surgery, I've been to the hospital a number of times for it and at one point they said I also have severs disease as well! At the moment really the only thing I have left is the jabs or surgery!
I hope your foot has/does got better and any other treatment would be greatly appreciated! Thankss
Hi Lucie, thanks for stopping by. I hope your foot gets better!
Hi Lucie (and anyone else who reads), I'm Wendy. I have had PF for 7 years. Its a wicked thing and painful. Lucie I am sorry to read about your severs disease. I can tell you what helped me for a bit, and hopefully it will help you even in a small way. For a period of time what helped me were as follows; orthotic sport inserts, stretching, ice in the evening before you go to bed and the splints that aid your stretch and everyone who reads – soak your feet – or have a warm bath in epsom salts. Epsom salts is high in magnesium and your skin will absorb the magnesium. My physio said it's the best way to absorb it. Also check your shoes, I run in neutral asics but they changed the foot bed for the shoe and I tried brooks – great shoe but my pain increased so now I have switch back and trying to locate the old series of asics. Lucie it will hurt but it will also ease up if you are vigilant. Please do not wear any old shoes, no old navy flip flops or shoes with no support. It is possible to get better, i'm not cured but I ran a half marathon in December 2012. I also swim. that will take the pressure off your feet and tendons and ligaments and allow you to exercise – also help build the muscles around the joints that need help and stretch them. Take care.
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Hello
I have had it for 2 years and like a lot of others have tried everything including acupuncture but not cortisone or surgery. I did change shoes to fairly expensive Rockports which was a fairer result but no solution for night pains. The crocks thongs I found extremely helpful for the first hour or so of the day but then PF would be felt not badly but enough to not have your mind at peace. I do lots of conservation work travelling to remote places but PF put a stop to all that. I do the calf and heel excercise plus the hamstring. They all help in some way but the PF has not healed. A friend mentioned MBT shoes so as a last resort I bought a pair even though expensive (8 years of Swiss research). Instantly the PF was not noticeable as I walked around in heaven. So much so that I went off fast walking 30 mins first day, 50 mins second day and because i was so excited to be walking without PF I overdid the third day (all day walking fast everywhere) and suffered for it. So it was back to rockports, more rest, more massage etc for a week until I had it in a managed state again. It has been a week now since back into MBT more responsibly in building up gradually. This is extremely key on my experience. Honestly it is a solution as I think gradually the PF will heal totally.
Wow, thanks for sharing Graham. Great to hear that the MBT shoes worked out for you. I hadn't thought about them, but their expense makes it quite a risk. Thanks for identifying them as a good option to try!
I've had PF in both feet. 3 yrs ago I got the cortisone shot in the left and it worked great and at the same time I purchased orthotics and was wearing them every day at work and things were fine. About a 1yr and a half ago my right foot started hurting real bad. The orthotics were now making it worse and I was switching up all different foot wear and only got some minor relief. I'm on my cement floors usually 10 hrs a day, 5days a week which is a real killer. Last May 2011 I was going to a holistic Dr. and was being treated for various things but not the foot.I had great success with his treatments and not until 2 months ago I started telling him about my foot problem, he said he has cured others with the same problem.He tested me and said I had TIN in my foot,yes TIN,so I said OK, sounds weird to me. I took the supplement for detoxing metals and within 1 mo. the pain is completely gone.I really can't believe it myself.I feel like I've never had a problem at all.
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I posted an No.22 in May 2011 and I would like to give an update.
I can honestly say that I am much more at peace as now I just manage pf simply…. and truly most of the time it is not on my mind. Sometimes I have thought it was cured so much so that I have put on other (older) shoes/joggers for longer walks but it has not worked….some pain came back but fairly mild. For me there is only one shoe to wear and that is MBT. It is a strange shoe as it feels a bit like being on skates but it certainly protects the feet when into long walks and jogging and gradually the feet settle. In social settings, shorter walks etc I still wear good and definitely newer rockports. I agree you have to get rid of old shoes and this I have done too so I only wear MBT and newer Rockports. Daily I do calves and achiles excercises…..just 4 of each on both legs for 30 second holds. Right now I am in my crocks thongs which are fabulous to leisure around in for a few hours a day but not to be jogged in. The MBT shoes are expensive in the shops but you can buy them online as I have and I paid around $120 US$. The main thing is do not overdo it as I have a few times …..just manage your pf sensibly and I do believe strongly that healing is taking place. I still remember the horrible nights when the pain was all over the feet….massaging and ice seemed to help but pain would return easily. For me MBT shoes have been a winner along with sensible management. I wish you all well.
I have suffered with plantar fasciitis for over two years and have tried almost everything; ice, stretching exercises, acupuncture, taping the foot, cortisone injections, ultrasound and nsaid's. My doctor had suggested surgery if a course of strong nsaid's didn't work which actually didn't. Then I read about low level light therapy, I spoke to a physio and decided I had nothing to lose. I had five 40 minute sessions combined with ultrasound. I could not believe it, initially after the first session the pain had diminished greatly and continued with every treatment. I know how debilitating this can be so if this post helps anyone reduce the pain of the dreaded P.F. then great. I am actually walking now and hope to be back to normal (taking things slowly to ensure i don't have a relapse).
Hi Suzanne, Do you have a link or any other info on this light therapy idea?
Hi Graham thanks for coming back and updating. I'm glad the MBT's worked for you!
Hi: I've had plantar fasciitis for over 3 years. I am a nurse and I have tried everything (Physical therapy, stretching, ice/heat application, special shoes, inserts, ultrasound, deep tissue massage, shock wave therapy and accupuncture.) The doctor recommends surgery as the only treatment at this point. I am concerned about the possible complications from this surgery, i.e. nerve damage and chronic pain. Has anyone had the surgey and with what results? Please let me know your story, I am very worried about the long-term effects. Thanks, Cynthia
To Cynthia
I have posted at 22 and 26….please read
I am NOT SUFFERING PF anymore. I bought MBT sports shoes and boots and wore them every day starting back in May 11. I also bought crock thongs for those first steps out of bed. Up until about a month ago I just wore these plus I did the excercises. Except I wore Rockport shoes for social activities but limited the time in them. MBT are strange to wear like wearing skates but I can tell you they work. Now I am running again, skipping again, basketballing again and best of all that constant having PF on your mind for me is gone, I cannot say it is completely cured but it is definitely in the latter stage of being healed. I might feel it sometimes but it is not that horrible pain….sometimes, and it is getting less all the time, I might just wiggle my toes and stretch the foot a bit.
You have to do what you have to do …..but I know for me what I have said works…..it takes patience, daily excercise and good management. On the MBT shoes I do not wear the sports anymore I'm back to normal joggers but I do wear the boots when gardening as they are comfortable and continuing to help the healing.
I wish you and all the very best as I understand your stress.
I was at the stage where walking was very painful until I discovered a possible sollution from a fellow sufferer. It seemed to easy but proved to be a godsend. Purchase some magnoplasm from your chemist, smear on heal and arch and bandage. leave on for 72 hrs changing every 12 hrs. I didnt believe it would work but the pain has been reduced by about 80%. 3 months now without serious pain. Please try it. It works. Repeat it the pain returns.
L
I've read this article and the posts with great interest. I'm 47, retired Army, an avid runner and triathlete. I started having PF (a heel spur) in my left foot just a few months ago, first time I've ever had problems with my feet. I've had steroid injections twice, I do stretches three times per day, ice every night, wear a night splint from the podiatrist, and recently went through "ossatron" shock wave therapy. I had shock wave done for the retropatellar tendon in my left knee four years ago, it worked great – but that was a big machine, I had to be put under for it. The machine they used on my foot was smaller, so I had three treatments, each a week apart, 2000 pulses each, no anesthesia needed. The last one was almost three weeks ago. So far, all is unchanged. I have SOLE inserts in my trail running shoes and work shoes, they help some but not enough to let me run again. I take 800mg/day ibuprofen, which I've done for years anyway because of arthritis. I'm not sure what else to do, probably surgery is the next thing. I haven't been able to run since the end of October. Getting to my wit's end!
My heart is with all of you. I USE to be a very active individual who use to run. It will almost be a year in a month since i've been suffering from plantar fasciitis and heel spurs according to some specialists. I have tried EVERYTHING, physio therapy, shock wave therapy ( it was so painful, like someone taking a hammer and hitting what is already sore), massage therapy, ATR, ice, stretch, ball, muscle stimulator, 3 different orthotics, accupuncture, everything. Im at my wits end!!!! I dont have any more money left, had to leave my job, because it was on my feet and after taking pain killers every two hours for 4 months, the pain killers no longer worked. I dont believe in masking the pain with meds, but something has got to give.
I have read about traumeel, ginger, turmeric, high doses of calcium and Apple cider vineger, but I just dont know anymore. Im out of money for trying and dont really know what to do. Everything I do now, is based on the pain in my feet, which I cant be on for more than an hour.
And thats in running shoes with orthotics.
Im in desperate need of help. I refuse to take cortozone injections because ive read it damages your fat pad. And refuse surgery.
It seems something different has worked for everyone. But surely….there has to be a cure!
"Surely there has to be a cure."
Nope. It's like death – no cure. Sorry.
Did you ever get your p.f. under control? Relatively pain free or do you just suck up the pain? I can't believe you are running with p.f. It can't be very serious if you are RUNNING!
OK, I had back pain for 10 years (age 39-49) and then 10 months free enough of pain that I started running again slowly. Then – wham! – I jumped out of a swing and my heel hit stones. The heel hurt BADLY and then spread to the p.f. (bottom foot). Can't stand more than 5 minutes or walk around a block without the foot burning.
So I never got the "cure" in the blog post. I've tried night splints, rest, stretching, blah, blah. Everything but cortisone, surgery, super-expensive (and questionable) shockwave therapy.
I read your later posts and you STILL had p.f. so how is it "cured"? Or even managed? I have taken the rest thing super seriously (no running or walking more than 1/2 mile). I use the disabled exercise machine (arms/legs stationary bike). That's my life. Sucks.
I would advise young people to NOT take up running – or jump off swings with stones below. Acts of (a cruel ) God are hard to avoid.
I continue to feel the best when I run. The pain isn't severe enough that I can't run through it and actually when I don't run is when the pain is the worst. Actually after standing all day my leg and foot feel like crap. So if I could just work with my feet elevated and only run then I think I might be ok. It sounds like your issue might be more severe than just PF – heel spurs maybe or maybe you broke the heel bone?
I use the Strassburg Sock. It's the only thing that has ever worked. I had PF for 20 years. I wore the sock for about 6 months and the pain is gone.
I've been suffering with plantar fasciitis pain for 3 months now and am starting to feel really depressed! I've tried everything that everyone has mentioned but Night splints helped me a lot.
Do you have a link or any other info on this taping idea? Thanks for the post.
Tightness of the Achilles tendons and calf muscles can contribute to plantar fasciitis pain by keeping the plantar fascia in a constantly tense state. Regular stretching can help loosen things up.