Plantar Fasciitis: Q & A

Question:

“Tom, how do I treat plantar fasciitis? Ice or heat? Exercise it or rest it? Special shoes? It’s extremely painful and I can’t sift through the conflicting information!”

Answer:

Plantar fasciitis (inflammation of the aponeurosis of the foot) generates a lot of conflicting info because it really is several different conditions that get balled up into one name. So some people will respond better to heat, though more will respond positively to ice in terms of pain reduction. But there are a few things we can say about it:

1) If it is brand new, just starting, in its acute phase: Use ice, buy a new pair of shoes, and / or see someone about your foot mechanics.

2) Get directly toward an anti-inflammatory diet, do not pass Go, do not collect $200. Stop the coffee especially.

3) A hydrocortisone injection, though it’s not my favorite medicine, can be very helpful if it is placed properly. Too many docs land the injection in the general area, but it has to be very precisely – like within a couple of millimeters – placed on the site of inflammation. Not too many of these good ‘needle men’ left. No more than 3 tries at this game, please – corticosteroids ain’t so good for your stomach lining.

4) Look elsewhere on the Superficial Back Line. Especially in chronic cases, the result is plantar fasciitis but the cause is in the Achilles complex, the hamstrings, a pelvic torque, or even up at the sub-occipitals. Strange but true, I have solved a lot of plantar fasciitis from the neck.

plantar fascia strain image - plantar fasciitis

A heel spur presents similarly to plantar fasciitis, so I need to know from the client if the pain is nervy or burny and where it is in the foot to distinguish between the two.

I ran my way through my own plantar fasciitis, combining the exercise with bodywork on the rest of me (but not directly on the plantar fascia, which often responds angrily to deep work – this is one of those conditions for which: “Where you think it is, it ain’t”). But for some the strategy of keeping exercising leads to almost crippling pain. Continued below…

And here’s the final problem: however you decide to treat it – with whatever exercises, lifts, bodywork, acupuncture, fire or ice – it will take some days (3-10) to know whether the chosen treatment is working, as plantar fasciitis is stubborn and will take a while to recede. Persevere!

Rolling gently / slowly on a ball before sleep and on waking can reduce the pain for some, but sorting it out (especially if it came on slowly, not from a single incident) is a matter of getting the foot and leg biomechanics right.

— Tom Myers, May 12 2015