Plantar fasciitis is a debilitating condition that's most often characterized by heel & foot pain, especially after long rest periods.
Plantar fasciitis affects around 2 million people in the US, resulting in more than one million visits to primary care physicians and foot specialists (Schwartz 2014).
This condition comes from repetitive overload of the plantar fascia - a thick and fibrous connective tissue at the bottom of our feet, running from our heel to the midfoot.
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Table of Contents
*Disclaimer*
What we discuss in the entirety of this post isn’t a substitute for medical advice – and is for educational purposes only! Please consult a physician if you have any concerns about your health that you feel like need to be addressed immediately!
What is Plantar Fasciitis?
Plantar Fasciitis is a condition that occurs when there is chronic overload and degeneration of the connective tissue in our foot – namely the plantar fascia.
This annoyingly debilitating condition is one of the most common causes of heel & foot pain in the United States, and likely many people all around the world.
The term fasciitis is used to describe inflammation of the fascia – however, there’s evidence that there might just be degeneration happening instead of inflammation.
So how do you know if your heel or foot pain is plantar fasciitis? Let’s look at some Signs & Symptoms.
Symptoms of Plantar Fasciitis
Here are some tell-tale signs & symptoms you may be dealing with something beyond just ‘regular’ foot pain. Some of these symptomologies may be similar to Shin Splints, so take a look at that post as well!
- Pain at the bottom of the foot, anywhere from the heel to the mid foot
- Severe pain in the morning or after a rest period
- Gets worse by long periods of weight bearing (e.g., standing, walking, running)
- Pain occurs when you pull your big toe towards you
- Tenderness over the inner portion of the heel (medial calcaneal tubercle)
Image Source: Complete Anatomy App
What aggravates Plantar Fasciitis?
Just like how there are things that can make plantar fasciitis better, there are things that can make it worse.
Remember that this condition is mainly caused by repetitive overloading.
Anything that you do in your day-to-day life that can overload your feet and heels will aggravate your PF.
We’ll discuss in greater detail what this includes when we talk about Risk Factors.
Can shoes cause plantar fasciitis?
There are many contributing factors that can lead to the development of plantar fasciitis.
Essentially – anything that mechanically puts stress on your plantar fascia is a risk factor, including poor fitting or worn-out shoes. Which, strangely enough, can affect your low back pain as well.
However, to be more specific we’ll break it down for you!
There are mainly two types of risk factors that can lead one down a path of precarious foot pain.
There are intrinsic and extrinsic risk factors.
The intrinsic factors relate to anatomical or biomechanical elements that have to do with specifically with your own body.
For example – weak intrinsic muscles of the foot are something that anatomically relates to you and your body that relates to how you could be experiencing plantar fasciitis.
Intrinsic Risk Factors
| Intrinsic Risk Factors |
|---|
|
Obesity |
|
Pes Planus (Flat Feet) |
|
Pes Cavus (high-arched feet) |
|
Shortened Achilles Tendon |
|
Overpronation (inward roll of your ankles) |
|
Limited ankle dorsiflexion (low range of motion bringing your ankle & feet toward your shin) |
|
Weak intrinsic muscles of the foot |
|
Weak plantar flexor muscles (e.g., the calf muscles) |
Table 1: Intrinsic Risk Factors for Plantar Fasciitis – adapted from (Schwartz 2014)
Here are some extrinsic factors – which are things that you do to yourself or are exposed to that affect your risks of experiencing PF (plantar fasciitis) – these are just some examples of what can aggravate your plantar fasciitis.
Extrinsic Risk Factors
| Extrinsic Risk Factors |
|---|
|
Poor biomechanics (e.g., heel-striking during running) |
|
Constantly on hard surfaces (concrete, asphalt, etc.,) |
|
Walking Barefoot (and not being accustomed to it) |
|
Prolonged weight bearing (eg., pregnant women standing for long periods of time) |
|
Poor footwear |
|
Extreme progressive overload (eg., increasing the amount of intensity you do in exercise in a short period of time) |
|
Inadequate mobility (i.e., the calf muscles) |
Table 2: Extrinsic Risk Factors for Plantar Fasciitis – adapted from (Schwartz 2014)
How to get rid of Plantar Fasciitis permanently
Plantar fasciitis is an overuse condition – relative to the person. Overuse for an athlete and your regular joe is quite different.
A combination of stretches & massage for quick pain relief, mixed with strengthening exercises for long term treatment & prevention are what helps most of the time.
Eliminating root causes will of course be the main method of getting rid of plantar fasciitis permanently. If you run on hard surfaces, consider switching to grass or tails
The habits of the plantar-fasciitis-free.
Just like with every condition – there always seems to be someone out there who can’t empathize with your situation; mostly meaning they’ll never be able to put their feet in your shoes (pun fully intended!)
- Stop any repetitive impact exercises (like running, skipping, etc.,) until you’re completely asymptomatic for 4-6 weeks (that means no pain in the area, even when you touch it!)
- Avoid running on hard surfaces, try grass, sand or even tracks to ease the pressure off your foot muscles and connective tissue
- If you’re advancing in your exercise regime, slow down your progression – meaning smaller increments of increasing intensity and/or volume
- Don’t walk or stand for extremely long periods of time! Take a break, have a chocolate bar or something
But what should I do for my heel and foot pain?
Everyone’s specific situation is unique – one treatment plan for someone else with Plantar Fasciitis may be wildly different compared to yours.
Generally speaking, a combination of alleviating pain through massage, mobilizing through stretches and strengthening weakened muscles is your best bet for conservative treatment.
Pick and choose what works for you and what’s comfortable for your body. Discard and don’t do things that are painful.
Let’s go through some of those now!
Here's how to massage plantar fasciitis
Here’s how to take control of your foot pain once and for all!
Let’s run through exactly what you can do at home to treat your PF.
Here’s how to massage your Plantar Fasciitis!
1. Recovery Ball - Plantar Fascia Release
Massaging right on top of where you feel the pain can decrease it and aid with a bit of blood flow! You’ll need a lacrosse ball or recovery ball to do this movement. All you need to do is slowly roll the ball under your feet while you’re sitting down or standing – to your level of comfort! Not too hard and not too soft – moderation is the key!
2. Calf Foam Roll
These muscles and the soleus muscle underneath it can definitely tire out – roll them out and send some blood flow their way! An inch per second is awesome for trying to help with recovery & soreness, any faster and it might not be as effective!
3. Tibialis Anterior Release
This underrated and undertrained muscle helps control our ankles and knees and ways we aren’t grateful for – release this muscle and the muscle knots your probably have in it as well! Similar to the plantar fascia release – you’ll need a lacrosse or recovery ball, except this time you’ll keep the ball on the sore spots instead of rolling.
4. Cross Fibre Friction Massage
This is mostly done right on top of tendons to de-sensitize the ‘angry’ receptors and nerve endings. Roll your fingers or a tool if you will, back and forth rapidly for 30 seconds to a minute and watch the pain disappear (if it doesn’t, then stop!).
5. Peroneal Muscles Release
These muscles are responsible for moving your ankle off to the outside of your body – and connect into parts of your foot as well! Similar to the Tibialis Anterior Release, you’ll keep the ball under any sore spots in these muscles.
More than just massage.
Why just stop at massage? Let’s focus on other things that you can do to help!
Strength training and stretching are proven methods that have helped, for the most part, permanently solve cases of PF.
Here are some exercises & stretches that can not only alleviate your foot pain, but ensure it never happens again!
Stretches for Plantar Fasciitis
1. Plantar Fascia Stretch
This is probably the most famous of all stretches to help with pain in the plantar fascia.
The effectiveness of the stretch is generally rated as being quite good, however there are cases of people who’ve reported pain with doing this stretch – or just not helping at all.
Try it for yourself and see if it stave away the pain until you’re able to move onto exercises!
2. Calf & Soleus Stretch
A classical stretch for the calf muscles and the powerhouse of a muscle that’s hidden underneath the calf muscles: the soleus.
Both the calf and soleus attach to the same tendon – the Achilles tendon, which goes into your heel bone.
Stretching these sets of muscles can give you more mobility that you might be missing, temporarily decrease pain and having you feel a bit freer than before.
Exercises for Plantar Fasciitis
Here are 6 exercises that you might want to try to help with heel & foot pain, especially from plantar fasciitis.
1. Towel Curls
This movement will help strengthen the intrinsic foot muscles – especially important for sufferers of plantar fasciitis – as your plantar fascia probably needs some controlled exercise stimulation to be able to move properly again!
2. Heel Raises
Similar to calf raises – but by choosing to lift just a bit off the ground instead of all the way – you emphasize the plantar fascia over the Achilles tendon! Which is what we want in this case, most of the time.
3. Soleus Bridges
These muscles are often overlooked since they’re hidden behind the big & flashy calf muscles, or gastrocnemii
4. Ankle Eversions
Most people’s everters – namely the peroneal or fibular muscles are weakened – but they’re important since they attach to the bottom of the feet as well! You can actually see me shaking as I move back into the neutral position since mine are actually a bit weak.
5. Calf Raises
The classic calf raises – quite important for foot and heel pain since the tendon connects right into them! (Indirectly and directly).
6. Band Resisted Glute Bridges
Can’t ignore the larger hip muscles! They’re quite important for mechanics of all the joints below and above – so work them too!
How to prevent it from returning.
Just massage or just exercise may not be enough to combat the potential return of PF – it takes more than just that. Often, you’ll need to keep a close eye on habits that may contribute to your plantar fasciitis pain.
Why won't my Plantar Fasciitis go away?
Are you having recurring signs and symptoms over and over again? Some further investigation may be required.
If you’re doing all you can to help stave away the pain of PF, at this point it may be a good idea to consider reaching out to a health care professional.
Physiotherapists, chiropractors, medical doctors and even massage therapists can help assess, treat and prevent many orthopedic conditions, including plantar fasciitis.
Frequently asked questions about Plantar Fasciitis
Yes it’s perfectly fine to massage your plantar fasciitis. It used to be thought that this was an inflammatory condition, so massaging it would theoretically make it worse – yet recent evidence shows that it’s more likely due to tendon degeneration.
So go ahead and massage away as long as it doesn’t worsen your condition!
There’s no “cure” per se. However, conservative treatments like massage, stretches and exercise have proven to be quite effective in cases of plantar fasciitis.
Deep Tissue Massage can somewhat help with the buildup of muscle knots in areas that affect your plantar fasciitis. Places like your gastrocnemius, soleus, tibialis anterior and your hip abductors can contribute to the discomfort of plantar fasciitis.
However, deep tissue massage, or any type of massage isn’t a reliable permanent solution – stick to the program of massage, stretches & exercise to increase the likelihood you’ll never have to meet plantar fasciitis again.
It’s not a good idea to just stay bedridden until the pain goes away – if anything it could make it worse.
However, excessive walking or running can worsen your plantar fasciitis.
It’s best to progressively increase the amount of walking and running you do after taking a solid break so your body has a chance to adapt and recover.
The evidence that plantar fasciitis isn’t an inflammatory condition is stacking up, and ice is usually a treatment for inflammation & swelling.
So unless you feel like your feet are swollen – ice isn’t going to be the best answer for your plantar fasciitis.
Heat can stave off the pain, increase blood flow and help with the healing process – however, it’s only a piece of the many solutions you should consider in combatting plantar fasciitis!
Relaxing plantar fasciitis during the acute or early stages is important to help avoid pain and compensation patterns in the rest of your body! A combination of a healthy amount of rest between physical activities, stretches and self-massage can help reduce that pain until you’re comfortable with strengthening exercises!
Need a little help?
Let’s say that doing it yourself doesn’t really work – that’s fine! Sometimes a little help will come along the way. You can always see a health care professional, wherever you are, and whether or not that’s a Registered Massage Therapist is up to you!
However, if you’re looking to have treatment with a health care professional about a pain problem or functional issue you have, and happen to live in the Greater Toronto Area, specifically Mississauga. You’re always welcome to come see me in person! You can book online with a click of a button!
Richard Lam
Richard is the owner of Vital Wellness centre and practices as a registered massage therapist with a specialty in therapeutic massage, utilizing techniques including manual therapy, contemporary medical acupuncture and PDTR.
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