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Heel Hell! How to Treat and Beat Plantar Fasciitis

Exercises for plantar fasciitis
Image © Wachiwit/Shutterstock

Plantar fasciitis is a chronic pain in the heel, most common in people over 40. The good news is that it's easy to diagnose and respond wells to treatment.

I

t's the same story every morning. I swing my legs enthusiastically from bed to floor, ready to leap into a new day only to discover the floor is lava. Well, not technically lava, but the intense burning, stabbing pain that greets my heels as soon as they contact the floor would suggest otherwise.

While the pain would ebb and flow somewhat erratically during the day, sometimes disappearing altogether for a few days, periods of prolonged sitting such as driving or sitting at my desk would see it flare up furiously. I was confused. Why the sudden heel hate? What had I ever done to make them turn on me so viciously?  

Strain from over extreme exercising was immediately discounted as that would require actual exercise in the first place. In keeping with that, I’d gained a little weight and they may be protesting about the larger load. And sure, there were the years of killer stilettos, but they’d been mostly retired since the advent of offspring.  

So, I simply expected them to get better. They did not. Within a few months the pain had become a constant. And walking, exercise impossible and normal daily activities were becoming unbearably painful.  My heels, or anything even resembling fashionable footwear, were relegated to the back of the cupboard to silently go out of style. A little research and foolishly delayed visit to my GP resulted in a diagnosis of plantar fasciitis. 

What is plantar fasciitis?

Plantar fasciitis is the name of a frustrating and debilitating inflammation disorder of the plantar fascia, the strong, fibrous tissue that runs along the bottom of the foot, connecting the heel bone to the toes.

Plantar Fascia © Pure Health Hub

Plantar fasciitis causes a sharp pain under the ball of the heel which occasionally extends to arch pain, though this is less common.  Plantar fasciitis pain is generally at its worst with the first steps of the day, although it is often acute after, but not during, exercise, following prolonged periods of sitting or standing or when climbing stairs.  

Plantar fasciitis tends to start gradually and becomes more painful over time due to the hard-working nature of feet. While plantar fasciitis generally resolves itself without the need for treatment, it can last for months and even years if left untreated, and lead to chronic hip, back, and knee pain. 

Risk factors of plantar fasciitis

Most common in people between the ages of 40 and 60 due to collagen degenerationthere are several other risk factors that increase the likelihood of plantar fasciitis. It’s also more common in menopausal women as the reduction in estrogen levels affects the elasticity of the tissue connecting the heel bone to the toes. These include obesity, diabetes, certain types of arthritis, flat feet, high-arched feet and tight calf muscles. There’s an increased risk for factory and hospitality workers, or those who are required to stand and walk on hard surfaces for extended periods. Aerobics, ballet and running can also place stress on the heel bone and Most common in people between the ages of 40 and 60 due to collagen degeneration, there are several other risk factors that increase the likelihood of plantar fasciitis. It’s also more common in menopausal women as the reduction in estrogen levels affects the elasticity of the tissue connecting the heel bone to the toes. These include obesity, diabetes, certain types of arthritis, flat feet, high-arched feet and tight calf muscles. There’s an increased risk for factory and hospitality workers, or those who are required to stand and walk on hard surfaces for extended periods. Aerobics, ballet and running can also place stress on the heel bone and surrounding tissue leading to a higher incidence of plantar fasciitis.  

How is it diagnosed?

Your general practitioner, physiotherapist or sports doctor can diagnose plantar fasciitis based on symptoms, clinical examination, and lifetsyle. X-ray can reveal any calcification within the plantar fascia, often referred to as a heel spur, while ultrasound and MRI scans can also identify tears, inflammation and rule out others causes, like stress fractures of the heel. 

How to treat plantar fasciitis

Most people with plantar fasciitis find symptoms improve significantly with treatment, though it can take time and patience. Non-surgical treatment methods include relative rest, applying ice to the heel area, reducing weight if obesity is a factor, avoiding walking bare footwearing orthotic insoles or shoes that have padding or shock absorbing material in the heel, physical therapy including daily exercises and stretches, anti-inflammatory medication and corticosteroid injections into the heel bone 

Three easy stretches for plantar fasciitis pain relief

These easy but effective treatments can provide instant relief for plantar fasciitis pain and can be practised just about anywhere. 

1. Toe Pull The most effective stretch I’ve found to start the day without plantar fasciitis pain is the toe pull. Before placing your feet on solid ground of a morning, sit on the side of your bed and cross your affected foot over the opposite knee. Grab the base of your toes and pull them back towards your body until you can feel the plantar fascia tighten along the bottom of your foot (It will feel like a tight solid string). Hold it for 15 seconds then release. Repeat three times. Voila, no pain on first steps! You can repeat this exercise in a chair several times a day.

2. Roll stretch – Sit in a chair and place a tennis ball, metal water bottle or can under your affected foot, then roll it back and forth under the arch for three minutes to stretch the plantar fascia.

3. Towel CurlsPlace a towel at the base of a chair with your feet over. Scrunch the toes of your affected foot into the towel and try to lift it towards you. Drop, then repeat 10 times.

Five alternative treatments for Plantar Fasciitis

1. Give acupuncture a go – Randomised controlled trials of acupuncture as a treatment for plantar fasciitis demonstrated significant pain reduction between four and eight weeks of treatment, reducing plantar fasciitis pain in the short term.  

2. Sleep in a splint  –  A night splint keeps your foot in a better position throughout the night, sustaining stretch to the Achilles tendon and calf muscles, which play a role in plantar fasciitis, and helping to reduce that intense early morning foot pain. 

3. Dry cupping – technique used in for thousands of years to treat pain, dry cupping involves positioning a cup on the skin and creating a vacuum to apply negative pressure, resulting in increased blood flow, reduced pain and inflammation and a softening of stiff connective tissue. Randomised controlled trials suggest it may be an effective low-cost alternative for the treatment of plantar fasciitis. 

4. Try TENs therapy – Transcutaneous electrical nerve stimulation (TENs) therapy is a non-invasive treatment that stimulates  blood flow via muscular contraction in soft tissues through low-voltage electric stimulation. TENs can be administered by a professional or with an at home TENs muscle stimulator. Randomised clinical trials show that TENs combined with stretching exercises can be effective in controlling pain related to plantar fasciitis. 

5. Lather it in lavender – While there’s a lack of significant data, several studies have demonstrated the potential anti-inflammatory properties of lavender essential oilAdding a few drops to a foot bath or massaging it into the heel could be a potential treatment for plantar fasciitis. If not, at least you’ll be left with feet that smell fabulous!  

Disclaimer: This article provides general information only, and does not constitute health or medical advice. If you have any concerns regarding your health, seek immediate medical attention.

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