Let’s Talk About Plantar Fasciitis
We've got the doctor-approved details on the causes, symptoms, treatments, and a ton other facts and tips that can make handling this painful condition easier.
You wake up in the morning, get out of bed, and OWWW: A jolt of pain shoots through your heel as you take your first steps of the day—or attempt to, anyway. You’re likely experiencing plantar fasciitis, the leading cause of heel pain that affects about one in 10 of us at some point during our lifetimes. While it can be uncomfortable (to put it mildly), the good news is that it’s highly treatable. The vast majority of folks with PF symptoms improve significantly with self-care strategies, nonsurgical therapies, and time—and most are pain-free within a year of starting treatment. Whether you’re dealing with your first bout or have battled plantar fasciitis on and off for years, we’ll tell you everything we know about this condition so you can put your best foot forward.
Our Pro Panel
We went to some of the nation’s top experts in foot disorders to bring you the most scientific, up-to-date information available.
Steven Frank, D.P.M.
Podiatrist/Foot and Ankle Surgeon
St. Louis, MO
Sara Heintzman Galli, M.D.
Foot and Ankle Orthopedic Surgeon
New Orleans, LA
Bryce Paschold, D.P.M.
Foot and Ankle Surgeon
Orthopedic and Sports Enhancement Center
Very. About one in 10 of us will experience it at some point in our lifetime, and at any given moment about 2 million people in the U.S. are dealing with it. While many things can cause heel pain (and it’s important to rule out these other causes), plantar fasciitis is [by far] the most common reason for painful heels.
You’re at heightened risk if you run for exercise or if you’re overweight, spend a lot of time standing or walking on hard surfaces, or wear flimsy shoes (sorry, flip-flop lovers).
The average time to become pain-free is about nine months (though most people see at least some improvement within a couple of months of starting treatment). But keep in mind that plantar fasciitis can recur, so it’s important to keep doing what you can to address the factors that may have put you at risk for the condition in the first place. That could include keeping your calves and plantar fascia stretched out, continuing to use arch supports or other orthotics if recommended, and avoiding any rapid increases or sudden changes in your exercise routine.
Almost definitely not—it’s very unlikely. The vast majority of people diagnosed with plantar fasciitis get better with time and conservative measures like stretching, changes in footwear, OTC pain relief, and orthotics or other assistive devices. If those steps aren’t enough, there are a variety of injections and other nonsurgical treatments that can help, from physical therapy to administering shock waves to the affected foot or feet (this isn’t as weird as it sounds). Surgery is usually reserved only for extreme cases.
What Is Plantar Fasciitis?
Plantar fasciitis (fash-EE-eye-tis) is a painful condition that results from damage to your plantar fascia (FASH-uh)—the thick, fibrous band of connective tissue that runs along the bottom (plantar surface) of your foot, connecting your heel bone (calcaneus) to the base of your toes.
To locate your plantar fascia, think about where the bottom of your heel lands when you take a step. Using your fingers, trace your skin from that spot to the ball of your foot, toward the arch side. It sort of feels like a taut rubber band. That’s your plantar fascia, and this is where all the trouble starts.
This an incredibly hardworking tissue provides critical support and shock absorption to your foot when you stand or walk. When the plantar fascia becomes strained over time (more on how that happens in a moment), pain and inflammation can result, a.k.a. plantar fasciitis.
About 2 million people in the U.S. are experiencing plantar fasciitis at any given time, and it’s one of the top reasons people visit foot and ankle specialists. You can get it at any age, but it’s most likely to occur between the ages of 40 and 60, according to the American College of Foot and Ankle Surgeons (ACFAS). People who run or do a lot of other weight-bearing exercise, are overweight, or spend a lot of time standing or walking on hard surfaces have higher rates of plantar fasciitis than the general population. Both men and women experience this condition, although some evidence (not all) suggests that plantar fasciitis is more common in women. It can affect just one foot, or you can have it in both (called bilateral plantar fasciitis); up to a third of cases fall into this category, though symptoms are generally worse in one foot. Plantar fasciitis is also sometimes called “plantar fasciopathy.”
Plantar Fasciitis Symptoms
The hallmark symptom is pain and stiffness on the bottom of your foot, near where the plantar fascia attaches to the heel bone. The pain is often described as sharp, stabbing, shooting, or knife-like.
Usually the pain is centered right under the heel, but sometimes it can be closer to the arch of your foot. Plantar fasciitis pain tends to follow a specific daily pattern, which can be an important clue to diagnosing it:
It’s most severe when you first put weight on your heels in the morning and when you stand up and walk after a long period of sitting.
It usually eases up once you’ve been moving around for a bit (say, a half hour or so), then may gradually worsen over the course of the day, especially if you spend a lot of time on your feet.
Pain commonly increases after, but not during, exercise.
The pain may also be worse after climbing stairs.
If discomfort from plantar fasciitis causes you to begin walking differently than you normally would (called “abnormal gait” or “altered gait”), you may develop symptoms in other parts of your body, such as knee, hip, or back pain.
What Causes Plantar Fasciitis?
Plantar fasciitis is caused by the repeated straining of the plantar fascia beyond its normal extension, which, over time, leads to tiny tears or pulls in the tissue. These tears and pulls in turn trigger inflammation—the body’s natural response to injury—and, along with it, pain and stiffness. So, what can lead to a PF injury? Here are some leading culprits:
Big Changes in Weight-Bearing Activity
This could mean going from a job where you’re mostly sedentary to one where you’re on your feet all day, or from a job where you wear walking shoes to one where you wear high heels. Or the change could be exercise-related—for example, you abruptly increased the distance, speed, or intensity of your runs, or you suddenly decided to take up barefoot beach running while on vacation.
Whether you’re a distance runner or a city dweller who logs miles on cemented surfaces, spending a lot of time doing repetitive weight-bearing activity (walking, marching, running, dancing, or even just standing) on unyielding surfaces is a key cause of plantar fascia strain. A more recent example for many of us: Suddenly spending the majority of your time at home—say, due to a pandemic—and walking around barefoot all day on hardwood or tile floors, vs. spending most of your daily hours in shoes like you did in the “before times.”
Wearing Unsupportive Shoes
Think thin-soled flats, flimsy flip-flops, or worn-out or ill-fitting athletic shoes. When your footwear doesn’t provide the arch support, shock absorption, and stability it should, the burden shifts to your plantar fascia, which must absorb extra shock and work extra hard to keep your foot in the proper posture as you walk. Over time, that extra strain can lead to injury of the plantar fascia.
What Are the Risk Factors for Plantar Fasciitis?
You’re more likely to develop plantar fasciitis if you have certain risk factors. Here are some of the main ones.
Being Extremely Physically Active or Not Active at All
Vigorous or prolonged participation in sports or weight-bearing exercise like running has consistently been linked with higher rates of plantar fasciitis, compared to more moderate levels of physical activity. Active-duty military personnel also have higher rates of it. Conversely, living a mostly sedentary lifestyle is also associated with greater plantar fasciitis risk, compared to getting regular exercise. This may be in part because sedentary individuals are more likely to be overweight or obese (see next paragraph) and may spend more time in unsupportive (i.e., nonathletic) footwear.
Excess Weight or Obesity
Too much body weight strains your musculoskeletal system in general, and your feet bear the brunt of it, literally. In a meta-analysis of 51 studies that looked at risk factors for developing plantar fasciitis published in the British Journal of Sports Medicine, individuals with a body mass index (BMI) over 27 had nearly four times the likelihood of plantar fasciitis compared to people with a BMI under 25. Risk was especially elevated in people whose BMIs were in the obese range (over 30) and in those whose lifestyles were relatively inactive.
Limited Ankle Flexion
This refers to your ability to bend, or flex, your ankle joint so that your foot moves upward toward your shin. This motion is also known as “dorsiflexion.” The most common causes of limited ankle flexion are tight calf muscles or tightness in your Achilles tendon, which runs down the back of your ankle, connecting the calf muscles to your heel bone. Fun fact: The scientific name for limited flexion in the ankle is “equinus.” Equinus may contribute to plantar fasciitis by changing the biomechanics of your foot in a way that puts added stress on the plantar fascia.
Low Arches (Flat Feet)
This puts extra strain on your plantar fascia when you stand and walk, compared to having an average arch. To a somewhat lesser extent, having very high arches may also make you more susceptible to plantar fasciitis.
Being between 40 and 60 years old ups your odds of getting PF. As we mentioned earlier, this is the range in which plantar fasciitis incidence peaks in the general population (it tends to come on somewhat earlier in runners and athletes). But it’s been reported in people as young as 7 and as old as 85, according to the ACFAS.
This means your feet roll inward excessively when you walk or run. Feet that overpronate are also called “hyperpronatory.”
Are Heel Spurs Related to Plantar Fasciitis?
In a word: no. Imaging scans that are done in people who have plantar fascia pain often reveal heel spurs, which are bony growths on the plantar (bottom) surface of the heel. For a long time, it was thought that heel spurs were a cause of plantar fasciitis and that surgically removing them could help treat this condition. However, the preponderance of evidence over time disproves this.
The current consensus among experts is that while the two conditions often co-occur, neither causes the other; instead, heel spurs may stem from some of the same factors that cause plantar fasciitis and other kinds of foot pain, including obesity and high BMI, osteoarthritis, and type 2 diabetes. In other words, the spurs are a marker for conditions that can cause foot pain, rather than the cause of the pain. Removal of heel spurs is no longer part of the standard treatment for plantar fasciitis.
How Is Plantar Fasciitis Diagnosed?
If you think you might have plantar fasciitis, it’s a good idea to see a doctor, even though most of the treatments you’ll be advised to try first don’t require a prescription. Among other benefits, a medical pro can help confirm that what you’re experiencing is in fact PF and not another problem that can cause heel pain, like a stress fracture in the heel bone, bursitis, a pinched nerve, poor circulation, or a chronic condition such as psoriatic arthritis or rheumatoid arthritis. You should definitely get to a doctor, STAT, if you have pain that progresses or worsens to the point that it becomes disabling, or if you have swelling, redness, or bruising on the bottom of your foot (indicative of a possible fracture).
Several kinds of doctors specialize in treating foot and ankle problems, including plantar fasciitis. Among them are podiatrists (D.P.M. degree), orthopedists (M.D. degree), physical medicine and rehab physicians (also M.D.s, sometimes called physiatrists or P.M.R. doctors), and osteopaths (D.O. degree). If you’re more comfortable starting with your primary care doctor, or if going straight to a specialist is unrealistic because of where you live or the type of insurance you have, then begin there and your GP can provide a referral if one is needed. Physical therapists also sometimes diagnose and treat plantar fasciitis.
At your appointment, you can expect:
Your doc will begin by asking when the pain started, what it feels like, and if there are times of the day it gets worse and better (in order to establish whether or not it follows the typical plantar fasciitis pattern we detailed above). You’ll also be asked about your occupation (stand on your feet all day?), activities (go for a run on cement every morning?), and footwear (favor flimsy flip-flops?).
The doctor will conduct a physical exam of your foot, assessing your arch (it is high? low? average?) and pressing along the length of the plantar fascia. If you feel pain or tenderness when he or she pushes on the tissue, that’s an important diagnostic clue. The doctor will also check your range of motion in the ankle on the affected side.
Most cases of PF can be diagnosed based on symptom history and physical exam findings alone, according to guidelines published in 2017 by the ACFAS. In fact, doing imaging tests right off the bat can turn up incidental findings that can potentially lead to overtreatment.
However, sometimes additional tests are required to confirm a PF diagnosis. These tests include:
Your doctor may order an X-ray or more advanced imaging scan, such as magnetic resonance imaging (MRI, which uses strong magnetic fields and radio waves to produce a detailed picture of what’s going on inside the body). This can happen if your pain is unusually severe, or if your doctor suspects your symptoms could stem from another problem, like a fracture or from trauma.
You can expect to have imaging done if you’ve already tried conservative treatments for a couple of months and your pain hasn’t improved. Increasingly, doctors are ordering an ultrasound (which uses sound waves to create an internal image) to help diagnose plantar fasciitis. This technology can be used in the office (as opposed to sending you out for an MRI, which requires large, specialty machinery); allows the doctor to see the full degree of swelling and inflammation in the plantar fascia; and enables your doctor to compare the thickness of the tissue (an indicator of severity) between your affected foot and your non-affected or less-affected foot. A review of 10 studies in the International Journal of Sports and Physical Therapy found that ultrasound was accurate and reliable compared to other imaging techniques (mainly MRI) in the diagnosis of PF, offering several advantages, including lower cost and an easier experience for the patient.
Plantar Fasciitis Treatment
However diagnosis is determined, once your doctor is sure you’re dealing with plantar fasciitis it’s time for the next step: Getting your foot feeling good again.
As foot conditions go, plantar fasciitis has plenty of treatment options, which can be both awesome and kind of overwhelming. No one conservative treatment has been shown to be more effective than any others, and different strategies may work for different people…so your treatment process may involve some trial and error, and even some detective work with your doctor. This can be vexing if you’re looking for a super-quick fix, but keep this in mind: About 90% of people with PF improve significantly after two months of initial treatment, according to the American Orthopaedic Foot and Ankle Society (AOFAS). Your chances of stepping past such painful symptoms are excellent.
Conservative Treatments for Plantar Fasciitis
Sometimes, doing less is more. Your doctor might recommend trying any or all of the following noninvasive measures for up to two or three months; most are inexpensive and can be done in your own home. In addition to these steps, you’ll probably be advised to rest your foot when possible and to avoid doing activities that make the pain worse, such as excessive running, dancing, or jumping. Your doctor will likely recommend switching to lower-impact activities for exercise while your foot heals, like cycling and swimming.
The very first thing you need to do? Stretch your PF and related muscles to help prevent your PF from recurring. A series of specific stretches for plantar fasciitis target your calf muscles (mainly the bigger of the two muscles, called the gastrocnemius) and your Achilles tendon (sometimes called the heel cord), in addition to the plantar fascia itself. If you also have tight hamstrings (the muscle on the back of each thigh), your doctor might recommend hamstring stretches, too.
Ice and/or Cold Compress
A typical treatment approach is applying ice or a cold compress for 15 to 20 minutes to the affected foot, three to four times a day, particularly after you’ve been on your feet. You can use ice packs or (perhaps even better) freeze a bottle of water and roll your affected heel back and forth over it, which combines the benefits of icing with massage.
Over-the-Counter (OTC) Pain Relievers
Nonprescription nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil/Motrin (ibuprofen) or Aleve (naproxen) can help quell pain as needed while you deal with the acute phase of recovery. But keep in mind that these medications have side effects and aren’t meant for long-term use; they generally shouldn’t be taken for more than two weeks or so continuously. If you can’t take oral NSAIDs (for example, they’re too hard on your stomach), you can try a topical (meaning, you apply it directly to your foot) NSAID such as Voltaren (diclofenac) gel. However, unlike many of the other measures listed here, NSAIDs don’t actually help your plantar fascia heal—but they can help patch you through the discomfort.
This OTC device is worn overnight to keep your plantar fascia stretched out while you sleep. Your feet normally point somewhat downward during rest, which leads the plantar fascia to tighten up overnight; this is one reason PF pain is sometimes most severe in the morning. Night splints can be awkward to wear and may interfere with sleep for some people. If you get up during the night to go to the bathroom, you’ll probably have to remove the splint (or risk breaking it; they’re not designed to be walked on). Doctors usually recommend them mainly to people who have really bad morning pain and who can tolerate sleeping with the splint on. Once the pain abates, you can stop using the splint. If you try this method and find it too disruptive, don’t sweat it—you have other options to try.
Goodbye, stilettos and rubber flip-flops; hello, shoes with thick, shock-absorbing soles, firm heel cups, and plenty of cushioning and arch support. If you aren’t positive what size or width shoe you are, go to an athletic footwear store and get your feet measured. (If ever there’s been a moment to wear properly fitting shoes, this is it.) If you love sandals, choose those with firm soles and supportive arches that stay on your feet when you walk. The American Podiatric Medical Association (APMA) has an extensive list of shoes that have received its Seal of Acceptance; you can search by type of shoe or even brand.
Orthotics (Shoe Inserts)
These come in both OTC and Rx (custom) versions. It usually makes sense to start with an OTC insert, since they’re less expensive and require no waiting time; they’re sold under many brand names including Dr. Comfort and Spenco. (As with shoes, the APMA has a full list of recommended orthotic products.) If off-the-shelf inserts don’t help enough, your doc might recommend getting fitted for a custom orthotic. You can also try an inexpensive soft silicone heel pad (heel cup), which may help reduce pain by cushioning your heel.
Physical therapy is often a part of plantar fasciitis treatment—so much so that the American Physical Therapy Association has its own clinical guidelines for diagnosing and treating it. In one large study that looked at visits to doctors’ offices and hospital outpatient departments for PF diagnosis and treatment over a 15-year period, this treatment was either ordered or provided at 19% of visits.
A physical therapist (PT) can help you with stretching exercises for the plantar fascia and calf muscles, plus perform hands-on therapies like soft tissue mobilization and ice treatments. PTs can also do kinesiology taping (see the very next entry, below) and prescribe devices like orthoses or night splints. They may perform other treatments, including iontophoresis or phonophoresis, in which a topical steroid is delivered to the plantar fascia area transdermally (through the skin) using an electrical current (iontophoresis) or sound waves (phonophoresis).
This involves placing kinesiology tape (usually involving four separate strips) in a strategic pattern across your foot and ankle to stabilize the arch and take pressure off of the plantar fascia. A foot doctor or physical therapist can do it, or the doc or therapist can show you how to do it yourself at home. Taping can be especially useful for short-term relief—you are waiting for custom arch supports to be made, for example, or you have an event to go to where you have to wear shoes that your usual shoe inserts won’t fit in. The tape lasts a few days to a week, depending on how sweaty your feet get and how often you bathe or shower.
Additional Nonsurgical Treatments for Plantar Fasciitis
If conservative treatment hasn’t eased your pain after two to three months, talk with your doctor about these next-line options. They’re more involved or more expensive than the conservative measures, but still less invasive than surgery.
The most commonly used injection for plantar fasciitis (and generally the only one covered by insurance) is a corticosteroid, usually cortisone. The doctor will inject it either directly into or near the plantar fascia. The cortisone is usually combined with a local anesthetic such as Lidocaine CV or Lipoden (lidocaine), which can provide some immediate pain relief while you wait for the steroid’s anti-inflammatory effect to kick in, usually in 12 to 24 hours. Steroid shots don’t aid in healing this condition; they block the inflammation that is part of the body’s natural healing process, so they should be used only sparingly as needed for pain relief, and only after other measures haven’t helped. Many experts won’t inject cortisone more than two or three times per year, and always at least a month apart. The pain-relieving effect of the steroid can last from several weeks to three to six months, according to the AOFAS.
Extracorporeal Shockwave Therapy (ESWT)
In this procedure, shockwave impulses are applied through the skin to stimulate the healing process in damaged plantar fascia tissue. The waves create a slight injury that triggers an acute (“good”) inflammation response to in the affected area, which helps the tissue heal itself. There are two versions of ESWT:
High-intensity ESWT. This is done under anesthesia (because it is extremely painful). It requires one treatment of about 15 minutes in an operating room.
Low-intensity ESWT. This version can be done in the doctor’s office in a series of three to five weekly sessions which don’t require anesthesia.
Compared to surgery, ESWT offers a lot of advantages: There’s no cutting, no scarring, no risk of infection, and the recovery time is minimal. You can bear weight on your foot right after having it done (though you’ll probably be advised to hold off on exercise for about a month). One disadvantage of ESWT? It isn’t always covered by insurance.
For people who can’t take or don’t want to take steroids, two other injection options are available, though the evidence on both is mixed.
Platelet-rich plasma (PRP). This treatment involves drawing a small amount of your blood and spinning it at high speed to extract the platelets (small cells in your blood that help with clotting). The resulting material is then injected into your heel. Platelets contain numerous growth factors—naturally occurring substances that are believed to aid in wound healing and new cell growth. The idea is that by injecting your own platelets into an injured area, you can help boost your body’s own healing process. PRP might be administered in a single shot or in a series of several shots, depending on the provider.
Injection of amniotic tissue. The idea is the same as with PRP—amniotic tissue (which can come from donated placentas, among other sources) is rich in growth factors that in theory can help stimulate healing.
A major downside of trying either of these injections is that insurance doesn’t cover them, since they’re considered experimental, and they can cost up to $1,000 per shot. So try them only if you’re OK with paying out of pocket.
Plantar Fasciitis Surgery
Professional guidelines for treating PF advise that surgery be considered only after trying six to 12 months of aggressive nonsurgical treatment. In other words: Exhaust every other option. Our experts say they follow the 12-month rule with their patients and emphasize that surgery for this condition is pretty rare, since more than 90% of people recover completely from plantar fasciitis with noninvasive measures, and among those who don’t, many dismiss the idea of surgery. But rare isn’t never, and if you’ve tried everything else and are desperate for relief, it may be time for you and your doctor to consider surgery.
There are several surgical options, none of which has proven superior to the others; different doctors favor different approaches. They generally involve either:
Cutting (in surgical speak, “releasing”) a portion of the plantar fascia from the bone. There are two versions of this: fasciotomy, in which one-third or more of the fascia is cut, focusing on the tightest part (which allows the remaining tissue to stretch; think of cutting partway into a rubber band); and fasciectomy, in which a portion of the plantar fascia that is scarred or inflamed is permanently removed.
Surgically lengthening the calf muscle.
Some doctors perform the procedure through an open incision about an inch long on the foot (for plantar fascia release) or the calf (for calf lengthening). Others do the procedures endoscopically—that is, through smaller incisions through which a small, flexible tube with a tiny video camera is inserted. This is considered to be a minimally invasive surgery.
Plantar Fasciitis Surgery Recovery
Surgery is generally pretty effective at relieving plantar fasciitis pain, but there’s no guarantee it will relieve your pain completely or permanently, and you’ll need to be prepared for several months of recovery. For open surgery, that will include about six weeks in a boot and up to five months before you’re back to your normal activities. (Endoscopic procedures may have a shorter recovery time.) Like any surgery, PF surgery carries risks, including infection and nerve damage. In an older (2002) study in Foot & Ankle International often cited in the medical literature, 88% of people who underwent plantar fasciitis surgery had a good to excellent result, as assessed by the doctor, and 40% had a complete resolution of their pain. In the same study, 91% of patients who returned a survey about their experience reported being at least somewhat satisfied with their outcome. However, 25% said if they had it to do over again, they would not have had the surgery.
As an alternative to full-on surgery, you might ask your doctor about having something called an ultrasound-guided percutaneous procedure. These are done under the skin, but they are less invasive than surgery. In such procedures, the doctor uses ultrasound to view the fascia while using a special instrument to either shrink or remove some of the inflamed tissue (depending on procedure). The instrument is inserted through a small incision on the foot. Insurance may or may not cover these procedures; check with your plan.
What Lifestyle Changes Can I Make to Prevent Another Bout of Plantar Fasciitis?
Once you start treating your plantar fasciitis, chances are excellent that your heel(s) will feel better within a few months. But here’s the thing: You have to maintain the measures that helped restore your feet to good health, or your heel pain can and very likely will recur. Follow these steps, which can also help prevent a first bout of plantar fasciitis if you’ve never had it:
Shed Excess Weight if Needed
For years, doctors have relied upon BMI (body mass index) as an indicator for whether or not you needed to lose weight, with anything over a score of 25 being considered (by most physicians, anyway) as overweight, while a BMI of 30 or above was labeled obese. While BMI is no longer the only measurement tool to determine a healthy weight—muscle mass and how/where you carry your weight are both also considered—consult your doctor about the ideal weight for you, and, if you need help, ask for guidance about how to get there. Why? Putting less pressure on your plantar fascia will help you prevent future bouts of PF.
Work Out—but Smartly
Increase the speed, duration, or intensity of running or other weight-bearing exercise a little bit at a time—never suddenly. If you start a new activity, do so gradually. If you take time off from an activity, restart it at a decreased intensity compared to what you did previously, then work back up slowly. Prepare properly for exercise by warming up.
Lose Your Bad Shoes
The importance of wearing properly fitting shoes with a firm sole, adequate cushioning, and good arch support can’t be stressed enough, say our experts. Replace running or other athletic shoes regularly as they get worn out and lose their cushioning. Limit time spent in high heels. Wear shoes designed for the activity you are doing (jogging, walking, work boots). If you enjoy walking around barefoot at home (we know we do), we’ve got bad news: This is apparently one of the worst things you can do for your heels, especially if you have hardwood or tile floors. If you prefer not to wear your street shoes around the house, designate an extra pair as house shoes and put them on when you come home. When possible, try to stand on cushioned surfaces if you’ll be on your feet for an extended time (think standing on a mat for washing dishes).
Regularly stretch your calves, Achilles tendons, and plantar fascia of each foot. The best time to stretch your plantar fascia is first thing in the morning, before you get out of bed; make this a daily ritual.
Strengthen Your Arches
To do this, practice picking things up with your toes—for example, pencils or marbles. Having stronger muscles on the bottom of the foot may help lighten the load on the plantar fascia.
The pain of plantar fasciitis can be searing, no doubt, and if it goes on for a long time it can become disabling. So, don’t delay getting diagnosed and starting treatment: Once you do, you have an outstanding chance of recovering without ever needing surgery. With so many therapies to try, your odds of getting through this are outstanding—if not completely pain-free, then significantly more comfortable, and armed with a toolkit of strategies that can help you keep your heels healthier for years to come.
Review of Research on Plantar Fasciitis: UpToDate. (2021.) “Plantar fasciitis.” https://www.uptodate.com/contents/plantar-fasciitis
Professional Guidelines for Diagnosing and Treating Plantar Fasciitis (1.): The Journal of Foot & Ankle Surgery. (2017.) “American College of Foot and Ankle Surgeons Clinical Consensus Statement: Diagnosis and Treatment of Adult Acquired Infracalcaneal Heel Pain.” https://www.acfas.org/Research-and-Publications/Clinical-Consensus-Documents/Clinical-Consensus-Documents/
Professional Guidelines for Diagnosing and Treating Plantar Fasciitis (2.): American Family Physician. (2019.) “Plantar Fasciitis.” https://www.aafp.org/afp/2019/0615/p744.html
Diagnostic Ultrasound: International Journal of Sports Physical Therapy. (2016.) “Ultrasonography, an Effective Tool in Diagnosing Plantar Fasciitis: A Systematic Review of Diagnostic Trials.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5048334/
Heel Spurs:* Foot & Ankle Specialist*. (2013.) “The Conundrum of Calcaneal Spurs: Do They Matter?” https://journals.sagepub.com/doi/10.1177/1938640013516792
Stretching Exercises: Washington University Orthopedics. (n.d.) “Plantar Fasciitis Exercises.” https://www.ortho.wustl.edu/content/Education/3691/Patient-Education/Educational-Materials/Plantar-Fasciitis-Exercises.aspx
Physical Therapy for Plantar Fasciitis: Journal of Orthopaedic & Sports Physical Therapy. (2014.) “Heel Pain—Plantar Fasciitis: Revision 2014. Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health From the Orthopaedic Section of the American Physical Therapy Association.” https://www.jospt.org/doi/pdf/10.2519/jospt.2014.0303
Taping for Plantar Fasciitis (1.): Journal of Back and Musculoskeletal Rehabilitation. (2015.) “Taping for plantar fasciitis.” https://pubmed.ncbi.nlm.nih.gov/24867905/
Taping for Plantar Fasciitis (2.): Journal of Sport Rehabilitation. (2018.) “The Effectiveness of Low-Dye Taping in Reducing Pain Associated With Plantar Fasciitis.” https://pubmed.ncbi.nlm.nih.gov/27705070/
Extracorporeal Shockwave Therapy (ESWT): American Orthopaedic Foot & Ankle Society, FootCareMD. (2018.) “Extracorporeal Shock Wave Therapy.” https://www.footcaremd.org/conditions-treatments/injections-and-other-treatments/extracorporeal-shock-wave-therapy
Plantar Fascia Injection: American Orthopaedic Foot & Ankle Society, FootCareMD. (2018.) “Plantar Fascia Injection.” https://www.footcaremd.org/conditions-treatments/injections-and-other-treatments/plantar-fascia-injection
Platelet-Rich Plasma Injection (1.): American Orthopaedic Foot & Ankle Society, FootCareMD (n.d.) “Platelet-Rich Plasma Injection.” https://www.footcaremd.org/conditions-treatments/injections-and-other-treatments/platelet-rich-plasma-injection
Plantar Fasciitis Injection (2.): British Journal of Sports Medicine. (2016.) “Injection therapies for plantar fasciopathy ('plantar fasciitis'): a systematic review and network meta-analysis of 22 randomised controlled trials.” https://pubmed.ncbi.nlm.nih.gov/27143138/
Plantar Fasciitis Injection (Platelet-Rich Plasma vs. Corticosteroid): American Journal of Physical Medicine & Rehabilitation. (2019.) “Autologous Blood-Derived Products Compared With Corticosteroids for Treatment of Plantar Fasciopathy: A Systematic Review and Meta-Analysis.” https://pubmed.ncbi.nlm.nih.gov/30362977/
Time to Surgery: American Orthopaedic Foot & Ankle Society. (2015.) “Treating Plantar Fasciitis: Before considering surgery, try other options first.” https://www.choosingwisely.org/patient-resources/treating-plantar-fasciitis/
Surgery Outcomes: Foot and Ankle International. (2002.) “Distal Tarsal Tunnel Release With Partial Plantar Fasciotomy for Chronic Heel Pain: An Outcome Analysis.” https://journals.sagepub.com/doi/abs/10.1177/107110070202300610
Ultrasound-Guided Percutaneous Procedures: Foot and Ankle Surgery. (2016). “Radiofrequency microtenotomy is as effective as plantar fasciotomy in the treatment of recalcitrant plantar fasciitis.” https://pubmed.ncbi.nlm.nih.gov/27810027/
General Plantar Fasciitis Information (1.): American Academy of Orthopaedic Surgeons, OrthoInfo. (2010). “Plantar Fasciitis and Bone Spurs.” https://orthoinfo.aaos.org/en/diseases--conditions/plantar-fasciitis-and-bone-spurs
General Plantar Fasciitis Information (2.): American Orthopaedic Foot & Ankle Society, FootCareMD. (2020). “What Is Plantar Fasciitis?” https://www.footcaremd.org/conditions-treatments/heel/plantar-fasciitis
General Plantar Fasciitis Information (3.): American Podiatric Medical Association. (n.d.) “Heel Pain.” https://www.apma.org/heelpain
General Plantar Fasciitis Information (4.): National Institutes of Health, MedlinePlus. (2020). “Plantar fasciitis.” https://medlineplus.gov/ency/article/007021.htm
General Plantar Fasciitis Information (5.): UpToDate. (2020). “Patient education: Heel and foot pain (caused by plantar fasciitis) (Beyond the Basics).” https://www.uptodate.com/contents/heel-and-foot-pain-caused-by-plantar-fasciitis-beyond-the-basics