Plantar fasciitis… I keep hearing these commercials on the radio making it seem like some special (and very expen$ive, like $1000 and up) insoles are some sort of miracle fix and that there’s this great store in Lee’s Summit that can sell them to you.
As a Doctor of Physical Therapy, I would like to let you know what plantar fasciitis is, what can cause it, and what might help.
Why should you trust me?
One, because physical therapists are the experts on treating plantar fasciitis.
Yes. In fact, here is a link to the most recent update on our practice guidelines, if you are nerdy like me and want to read it. And, my own academic advisor (Tom McPoil, considered a world-class expert in foot and ankle problems) in my Doctoral program was even the lead author for the original study and involved heavily in the update.
Second, I treat plantar fasciitis successfully all the time. I can honestly say it is one of my favorite things to treat and I get people back to doing what they want to do almost every time.
What is Plantar Fasciitis?
The plantar fascia is the thick, tough connective tissue that supports the arch of the foot. Plantar fasciitis is felt as pain in the arch, or most often in the heel. Some people say it feels like there is a pebble that they are stepping on. It usually is worst when taking your first steps in the morning or after long periods of rest, but can also increase with fatigue from standing or walking/running long periods of time.
There are other things that arch and heel pain could be, such as stress fractures, nerve pain, and other such things, so it’s important to get to an expert for evaluation if it doesn’t go away within a few days or so.
What Causes Plantar Fasciitis?
Generally, overuse leads to plantar fasciitis. This can come from many different things and usually it’s not just one thing causing it. Excess body weight, weakness in arch supporting muscles, tightness in ankle/calf muscles, improper training/running load or progressing too quickly… these are just a few of the most common causes.
‘Heel spurs’ may be involved, but usually aren’t. They are actually more common than you would think and often don’t cause any problems anyway.
Interestingly, both ‘high arches’ and ‘flat feet’ can cause plantar fasciitis, but for different reasons.
Heck, even a big toe that isn’t flexible enough can be a factor.
Because there are so many potential causes of plantar fasciitis and it’s extremely rare that there is just one cause, I always suggest seeing an expert to sort it all out.
What Can Help Plantar Fasciitis?
This all really depends on which causes are involved, so there are no blanket recommendations.
It is true that arch supporting insoles can help certain people, but they very rarely need to be custom-made. If insoles are indicated for my patients, I usually just tell them to get over the counter Superfeet insoles, which are $40-50.
Calf stretching can help in people where ankle flexibility is limited. Night splints can help in the same group of people, but many people can’t sleep comfortably with them on.
Strengthening the muscles that support the arch is usually helpful.
Hands-on manual therapy can help in people with feet that are not mobile enough.
A good physical therapist would also look at how you walk and what is happening even up in the hip, as problems there can also result in plantar fasciitis.
What About Dry Needling for Plantar Fasciitis?
A very new research article that was just published last week looked at adding electrical dry needling to a standard approach at treating plantar fasciitis. I know the thought of allowing someone with needles near your foot doesn’t sound too appealing, but adding electrical dry needling actually resulted in significantly better results. People who had needling done reported more pain relief, better improvements in function, and more of them were able to stop taking medication than those who didn’t get needled.
So, try some of these ideas if you have plantar fasciitis. Hopefully, you will get some relief and get back to doing the things you love to do.
If you don’t get the relief you want, (and for reading through all of my ramblings) I would like to offer you a free phone consultation or you could apply for one of my limited free ‘Discovery Visits’. Just click on the link and enter your information.
Here’s to your recovery:)