Plantar Fasciitis Treatments

Patient education and self-management are very important in recovering from plantar fasciitis.

Conservative treatments tend to be the best way to treat plantar fasciitis. However, it can take months to years to heal depending on your situation and commitment to treatment (6 weeks to 6 months or longer); 90% - 98% of people experience a lot of improvement within 12 months.

Avoidance of aggravating activities (any activity that involves repeated, impact of your heel on a hard surface such as jumping) and activity modification (pursuing less strenuous, weight bearing routines such as water exercises or biking) are recommended. It is suggested that you start at 50% of what you would normally do, and increase gradually as you see improvement in your condition.

Taping your feet will also add support and relieve stress during vigorous activities. Plantar fasciitis accounts for 10% of runner-related injuries and US doctors see 200,000 cases of this condition per year. Therefore, wearing appropriate athletic and/or regular shoes with significant arch support and motion control will help protect your feet. It is recommended that you avoid flat shoes and/or walking barefoot whenever possible.

URICE: This philosophy is used to decrease inflammation and relieve pain for chronic or diagnosed plantar fasciitis within the first 48 hours of a flare-up:

Ultrasound around your injured heel and foot for 5 - 10 minutes, 3 times per day. This is best accomplished with a personal, therapeutic ultrasound device.

Rest your foot and limit your activity; you may want to use a walking aid to prevent immediate weight bearing on the joint if severely damaged or painful.

Ice your foot and heel area 2-3 times/day for approximately 15 - 20 minutes at a time to help reduce blood flow and fluid build up in your foot. Gel packs are a better option than frozen peas if possible, as they mold to your knee shape and are reusable (do not apply ice/gel packs directly on your skin, instead wrap cold compress in a wrap or cloth.

Compress your foot if possible by adding light pressure to minimize swelling (make sure the compress is snug, but not too tight as it could cause numbness, tingling or more pain).

Re-freezable cold therapy compresses are excellent because they provide ice therapy, compression and a protective covering to prevent skin burn from the cold. This combination drives the cold deeper into the injured tissue than regular ice packs, and speeds the healing process. These compresses are fitted to your foot, easy to use, mess-free and re-usable.

Elevate your foot above chest level to relieve the pressure and allow any fluid to drain from your injured area.

If you do not have access to ultrasound therapy or you have experienced an acute foot injury and/or have not been diagnosed, adhere to the RICE philosophy within the first 48 - 72 hours. Gentle massage around the foot area or small flexing or extending movements will also help increase blood flow, oxygen, nutrients, and will prevent stiffness.

Therapies:

Ultrasound therapy is a great option to decrease inflammation, pain, tension and soft tissue (muscle, tendon, ligament, nerve and connective tissue) damage experienced with plantar fasciitis. This can be received using a portable, home ultrasound device (self-administered) or by seeing a physiotherapist. The treatment is easy, painless, safe, and generally requires between 5 - 10 minutes. It is based on a form of deep tissue therapy, which is generated through high frequency sound waves (that we can not hear). These waves send vibrations deep into your body and raise the temperature of your soft tissue. The waves are delivered through a hand held transducer and medicinal conductive gel that are used together in a slow, circular motion on your skin over the injured area. You may experience a slight tingling or warm sensation during the process as a result of the gel; this enhances the therapeutic effects of ultrasound (Phonophoresis).

Ultrasound therapy increases collagen and tissue elasticity, which in turn promotes blood flow (circulation) and brings oxygen and nutrients to your tight foot muscles and tendons. This cleans your tissue by getting rid of cell waste products and helps your injury to heal. If not treated properly injured tissue can heal with a weakened state, which can lead to scar tissue or calcification. If used on an ongoing basis, ultrasound will help to improve your range of motion and will break down any scar tissue or calcifications that may form in your foot area. Ultrasound waves penetrate deep into your tissues, relax your muscles and tendons, decrease chronic inflammation and accelerate your recovery rate, so you can return to your daily activities as soon as possible.

Blood Flow Stimulation Therapy can help your body repair your plantar fasciitis, heel spur, arch pain or tendon injury by boosting the natural healing process using an Inferno Wrap™. The Inferno Wrap's patented design delivers the most effective Blood Flow Stimulation Therapy you can find. By stimulating the flow of blood to your foot you are increasing the amount of healing oxygen and nutrients to the area. Unfortunately, we need to rest in order to heal and this decreases the blood flow throughout our bodies. Since you can't work your foot without danger of further injury, you need to stimulate the blood flow another way. Our innovative Inferno Wrap™ gives you the best Blood Flow Stimulation Therapy available. The Inferno Wrap™ creates energy waves that stimulate blood flow while you rest by penetrating through the outer layers of your foot. The energy waves reach deep into your foot reducing your pain as they heal the inner tissue.

The Inferno Wrap™ provides effective, non-invasive, non-addictive pain relief with no side effects. By treating your heel spur or plantar fascia in the morning before stepping out of bed, you will warm the area and prepare it for use during the day with less risk on re-injury. When your injury has healed somewhat and it comes time for more aggressive rehabilitation, stretching and activity, Blood Flow Stimultation Therapy warms the tissues in the injured area which increases range of motion and allows for a safer stretch with less risk of reinjury.

How Stretching Will Relieve Your Plantar Fasciitis Pain

Stretching will help to alleviate muscle tightness in your plantar fascia as well as your foot, lower leg and hamstring muscles. This simple effective treatment makes sense, remember the high heeled shoes, walking around with the toes pointed and the plantar fascia and hamstring muscles become shorted after time, causing pain and inflammation.

A simple solution - it is best accomplished by doing regular stretching. Avoid flat shoes or walking barefoot, switching to soon if you haven't gently stretched the shortened tissue will increase pain of your plantar fasciitis.

The calf muscles are made up of several muscles which serve to plantar flex the foot. These include the gastrocnemius, the soleus, and the plantaris muscles. When these muscles are tight they can contribute to the development of plantar fasciitis. Stretching of these muscles can reduce the symptoms. Consult your doctor to discuss which stretches work best for your.

There are several techniques which include:

• A lunge with one foot while leaving the heel of the other foot planted on the ground. Leaning into the lunge will stretch the calf muscle of the back leg. Do not bounce as you stretch as this may cause tendon damage. A nice, steady stretch held for 30-60 seconds will give you the desired results. You should stretch both legs even if only one side is bothering you. This should be repeated several times per day.
• A very simple stretch to get started can be done by standing with the feet at shoulder width. Go into a full squat with your knees bent all of the way. While in this full squatting position your can lean forward and you should feel the stretch in your calf muscles and your feet. You may support yourself with your hands if you feel like you are having trouble keeping your balance. Throughout the stretch you should push your heels toward the ground as you lean forward. This is a good stretch of your soleus muscle.
• Another stretch that will help starts with you putting your toes on a step and your heel on the floor below. Lean into this foot and you will feel a stretch in your calf muscles and foot. This stretch primarily focuses on the gastrocnemius muscle when you keep the knee straight.
• You may also consider stretching the gluteal muscles and hamstrings. This is because they, along with the calf muscles share the same fascial plane and kinetic chain. Releasing tension in these muscles and the fascia that surrounds them, through stretching will take tension off of the plantar fascia as well.
• One of the most important times to stretch is in the morning. People with plantar fasciitis know that this is the most painful time. The reason is that the feet naturally plantar flex when we lay down to sleep. Over eight hours of plantarflexion the plantar fascia becomes taut again. This makes the first steps of morning particularly painful. Stretching before these first steps has been shown to alleviate this problem in 72% of people.⁽¹⁾

Consistent stretching of the posterior leg muscles including the calf muscles, gluteal muscles and hamstrings can be very beneficial. That is why it is one of the treatments of choice for therapists, doctors and athletic trainers.

Physical therapy will help to improve pain in tissues and restore your weakened muscles through use of ultrasound, muscle stimulation or extracorporeal shockwave therapy and will provide you with a customized exercise program.

Chiropractic care, deep massage, reflexology and acupressure have also shown to be effective in relieving tension, strengthening your foot and helping with alignment.