Video Transcript

In this video, we will be discussing plantar fasciitis. Plantar fasciitis is one the common overuse injuries of the foot, typically presenting with heel or arch pain. The plantar fascia consists of three bands of connected tissue that start in the heel, run along the bottom of the foot through the arch, and insert into the toes. When we walk, our arch naturally collapses, and the plantar fascia stretches along with each step. Overuse of this tissue due to activity, occupation, or simple biomechanics, can lead to plantar fasciitis.

Foot orthoses are an effective treatment for plantar fasciitis. Orthoses work by supporting the arch and providing extra cushioning as the heel works to absorb shock and reduce excessive movement. Combined with a comprehensive treatment plan including stretching, activity modification, and appropriate footwear, the symptoms of plantar fasciitis can be effectively treated.

Heel Pain & Plantar Fasciitis

What Is Plantar Fasciitis?

At its core, plantar fasciitis (heel pain) is an inflammation of the fascia at your heel—that’s what the -itis part means. There’s lots of academic discussion around the true nature of plantar fasciitis. Some say it’s truly inflammation, while others argue that the tissues are degrading. For most people, plantar fasciitis means pain on the inside bottom part of your heel, especially when you wake up in the morning.

The hallmark of plantar fasciitis is pain on the bottom, inside part of your heel after periods of rest. You might be reading this and think, “But most of my pain is at night. What gives?” Don’t worry. While the majority of typical cases present with morning pain, some atypical cases hurt only later in the day.

What Are The Symptoms of Plantar Fasciitis?

The hallmark symptom of plantar fasciitis is pain on the bottom, inside part of your heel after periods of rest. People describe the pain in a variety of different ways. It could be sharp, it could be dull, it could be achy, it could be burning. It could be all of those things. The quality of pain differs in how people describe it, but the location is usually the same.

Plantar fasciitis is often most painful right after you wake up in the morning and take your first 10 to 20 steps. If you have PF, that’s usually the worst part of your day. You’ve been resting for the longest period of the day while you slept. At night while you sleep, your foot relaxes. All the damaged soft tissue starts to half heal in this relaxed and shortened position. Then, when you get up and put weight on your foot, your arch lowers and you increase the stretch on your plantar fascia. That increases the tensile pulling on the attachment point at the heel. With every step, you’re re-tearing the half healing from the night before. That’s where a lot of the pain comes from, so that’s the most important part to pay attention to.

Risk factors for Plantar Fasciitis

Longer time spent standing or walking on hard surfaces
Being overweight
During pregnancy
Over- training, or doing too much too soon too fast
Reduction in ankle range of motion
Compensation from another injury

How To Relieve Symptoms of Plantar Fasciitis

Try range of motion exercises before you get out of bed in the morning
Replace your old worn down running shoes with proper ones for you
Consider off-the-shelf orthotics to move more pressure into your arch, and remove it from your heel

What are my options for Plantar Fasciitis treatment? Who else can help?

Treatment for plantar fasciitis (heel pain) is often stepped in nature. First line therapy often consists of physiotherapy, ice, rest, off the shelf orthotics or gel heel cups, and sometimes medication prescribed by your family doctor. If your symptoms do not settle within 6-8 weeks, consider custom orthotics to help your on-going heel pain.

Seeing a physiotherapist and massage therapist may also be of benefit.

Prevention of Plantar Fasciitis

Plantar fasciitis is easier to prevent than heal. You can’t fix things like high arches, but you can minimize your risk factors by trying to keep your weight down, keep your flexibility and your range of motion up, and mitigating other risk factors such as hard surfaces for long periods of time and training errors. The other important thing you can do to prevent plantar fasciitis is keep your feet as strong as possible. If the supporting musculature of your foot and ankle is strong, PF is less likely. Once you’ve had PF, you’re more susceptible to getting it again, so it’s important to stay aware and keep your feet strong.

Staying active with heel pain

We have two rules for staying active during injury. Number 1: Don’t do anything that makes it worse during or after. Number 2: See rule Number 1.

Don’t make it worse. That’s not always as simple as it sounds. The problem with plantar fasciitis is that often people will be able to stay active and not have any big pain once they get past their first morning steps. If you’re functioning with a low baseline level of pain, you can go running, you can play soccer, you can play tennis. It’s only after you sit down from them and then go to get back up again, or when you get up the next morning, that you feel the damage. That’s when you’re in more pain, not when you were being active the day before. If your plantar fasciitis is bad enough that it’s painful while you’re doing your activity, you simply have to cut that activity out completely until you recover.

Typically, I tell people that pain shouldn’t be increased during or after activity. If you have more pain during, stop. If you have more pain after, then you want to reduce what you did by 15 to 20 percent at first. Try the activity again to see if the pain after is better. If it isn’t, keep cutting it back, possibly to the point where you just don’t do it for now. You might find that you can still play a round of golf, but maybe it means walking for nine holes and carting for the back nine instead of walking the full 18, or carting for the full course.

Do you suffer from heel pain with your first 10 steps in the morning?

To feel better, read on!

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Listen To Our Podcast Episode with Dr. Ian Alexander, MD and Foot Surgeon in Ohio State Box

How can SoleScience help you feel better?

Your SoleScience Pedorthist will create an individualized treatment plan that suits your specific needs, goals, and symptoms. We will work with you to determine not only what we need to do to address your current concerns, but also to prevent future problems.

Your pedorthist will complete a thorough and comprehensive foot examination at your initial appointment. A comprehensive follow-up exam will ensure that you are meeting your goals and allow your pedorthist to reassess your treatment plan (as necessary). During these appointments we will:

Assess joint and muscle function, including range of motion and gait assessment
Assess your footwear for both fit and function
Identify any risk factors that can be modified and make recommendations for change
Identify areas of risk with specialized tools such as pressure mapping (F-Scan or Pedograph)
Discuss a treatment plan, which may include a change in footwear, activity modification, or custom foot orthoses and/or a complementary treatment referral (such as physiotherapy)

In addition to your individual treatment plan, your SoleScience Pedorthist will provide you with educational resources to help you best maintain your foot health.

Our take on the need for custom orthotics for Plantar Fasciitis

Custom orthotics may be an integral part of helping you heal. Custom orthotics Plantar Fasciitis will help reduce gait compensations, reduce strain on your heel, and generally make your day to day more comfortable. In our option, though, custom made ones are not always needed as a first line treatment (within the first 1-4 weeks) of plantar fasciitis.

Custom vs OTS orthotics for Plantar Fasciitis

Off-the-shelf orthotics often help with plantar fasciitis. They’re a generic solution that often works for the average person. If you’re not average, though, an off-the-shelf orthotic just won’t fit your foot properly, or you might need greater correction than an off-the-shelf product can provide. That’s where custom-made orthotics come in. These devices are made specifically for your foot using a 3D cast.

A custom-made orthotic can give you all the individual support, stability, and cushioning you need. In some ways, the sky’s the limit. We have all kinds of options for materials, shapes, and styles. Because they’re fully custom, they can be made to fit any kind of foot. Custom- made orthotics for Plantar Fasciitis are also fully adjustable if things don’t feel quite right.

Plantar Fasciitis Footwear recommendations

Choosing appropriate footwear is crucial when recovering from plantar fasciitis. See our footwear section here for more info on picking the right athletic shoe. Wearing shoes that too worn down, may be placing more strain on your plantar fascia. Try wearing your Plantar Fasciitis shoes first thing in the morning to reduce your symptoms.

Make a confident choice in SoleScience, and we’ll do everything in our power to make you a raving fan!

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