By: Daniel Joy, PT, DPT, OCS
It seems like we’ve all experienced or know someone who has dealt with chronic heel pain.
Usually we don’t remember how it began or what seemed to trigger the pain, all we know is that it hurts! One trip to the doctor later and a common diagnosis is plantar fasciitis, a diagnosis effecting the heel or arch of the foot.
A quick search of the Internet and we can be inundated with advice about different shoes to buy or stretches to perform in order to get rid of the pain. It can be a bit of information overload. So where to begin?
First, let’s review what is plantar fasciitis. Despite the “itis” at the end (generally referring to inflammation), plantar fasciitis is more of a degeneration of the tough tissue on the bottom of the foot. It usually will come on gradually but tends to affect those who have to stand for prolonged periods of time on a surface that is less forgiving (for example, hard concrete floors) or taking on an activity that ramps up our movement far greater than what we were previously used to (for example, starting a new running program with little previous experience).
Treatment does not have to be complicated, but if you need some guidance seek the help of a local physical therapist. Below you’ll find a few evidenced based helpful tips to be effective for the treatment of plantar fasciitis.
- Massage: whether it is using your hands, a rolling pin or a foam roller, working on the soft tissue in your legs (most notably in your calves due to their shared attachment at the heel) can be beneficial for alleviating discomfort.
- Stretching: we all know that stretching is important but making sure to target the plantar fascia directly as well as some of the calf muscles can help improve flexibility. Often this is best to do after long bouts of rest before getting up to walk (think first thing in the morning before getting out of bed or before getting up from your desk).
- Orthotics: If you’re working with a physical therapist, they may try a supportive taping technique on your foot to see how it affects symptoms. If there is a positive result, you may benefit from orthotics. The good news is that it does not need to be an expansive custom pair. Good data supports that pre-fabricated, over-the-counter inserts can be equally as helpful.
- Night Splints: one of the tell tale signs of plantar fasciitis is a pain upon the first step when waking up in the morning. Those who have had heel pain for over 6 months may benefit from use of a night splint for a 1-3 month period.
- Footwear: patients may benefit from a shoe with a rocker bottom as well as rotating between different shoes during the week. This can be helpful although the research is not as strong compared to other items on this list.
At the end of the day, patience may be the most important thing to exercise. Especially when treating something that takes time and effort to be fully remedied. Our bodies are a product of the stresses and force we place on them on a daily basis. With a little bit of patience, and if need be, the help of a physical therapist, we can expect good results and the condition to resolve.
References:
Heel Pain—Plantar Fasciitis: Revision 2014 | Journal of Orthopaedic & Sports Physical Therapy.
Daniel Joy, PT, DPT, OCS
Doctor of Physical Therapy
Orthopedic Clinical Specialist
Phone: 609-896-9054
Dan is a physical therapist who works in the RWJ Rehabilitation at Delaware Valley (link) office in Lawrenceville, NJ. He graduated from Ithaca College and recently became an Orthopedic Clinical Specialist. Dan’s special interests include the orthopedic rehabilitation of the shoulder and knee with emphasis on the overhead athlete and post-operative ACL care. Dan’s goal is to create an atmosphere that facilitates independence and allows the patient to be as active as possible in their everyday life.
The RWJ Rehabilitation at Delaware Valley office looks forward to assisting you. Please call our office at (609) 896-9054 to schedule an appointment.