I recently had a cousin ask me what shoes her brother should be wearing for his plantar fasciitis. He had just been to his doctor and was told that he needs to have “good shoes”. My followers probably already know how I feel about the phrase of “good shoes” so I won’t discuss that in this post. At least in detail!! You can read this post for a quick understanding of my thoughts on shoe gear.
What is plantar fasciitis?
Plantar fasciitis is inflammation. It is described as inflammation if the plantar fascia which is a dense connective tissue that spans the arch. It originates on the heel bone and fans out to each long bone (metatarsals) of the foot.
Previously in medicine it had been thought to be known as heel spurs, although evidence based studies have disproven the involvement of the spur and the symptoms of pain. We now think the symptoms are not only coming from the fascia itself, but also the three muscles which originate on the heel bone with the plantar fascia that are major stabilizers of the foot. These three muscles become irritated from over use.
What causes plantar fasciitis?
The overuse described above can be brought on by a number of different reasons, but basically its an over use of the foot muscles without a gradual adaptation. For example, someone who previously had a desk job and now they are required to be on their feet for hours a day. The same goes for a runner who had been averaging 10-15 miles a week and then rapidly jumps to 20-25 without a gradual increase. The reason flip flops get a bad rap with foot pain, is that most people wear supportive shoes all winter long which weakens the foot muscles. Then once the weather breaks, they put on a pair of flip flops and wear them too long without adapting.
How to treat plantar fasciitis.
As with any inflammatory condition, rest, ice, and anti-inflammatories (such as ibuprofen and naproxen) will help. Shoe can play a role early on in the condition when the muscles need a rest. Any supportive running shoe that is immediately comfortable upon placing on will work. The idea is the shoe acts as a cast for the foot and rests the muscles. If this is an acute situation (several weeks to a month) shoes will help more with the condition. If it has been chronic (several months to a year) then gradually introducing barefoot activities will help strengthen the feet as opposed to relaying in supportive shoes.
Calf stretches are the hallmark for treating the condition especially in the mornings when it typically hurts the most, or after getting up from a period of rest such as driving. Perform the stretches 3-4 times a day. Click here for a handout.
Sometimes the condition is so severe that the inflammation needs to be treated with prescription anti-inflammatories or cortisone injections which will require an office visit. Many times plantar fasciitis resolves faster when treated early on as opposed to waiting many months before seeking treatment.
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