How To Prevent — & Treat — This Common Foot Problem

Photographed by Mike Garten.
If you've managed to avoid the intense heel pain of plantar fasciitis, we're impressed. In addition to being one of the most common causes of foot pain, plantar fasciitis is actually twice as likely to happen to women (though among young people, men and women suffer equally). Part of the reason it eventually strikes more women is that the condition is frequently linked to our choice of footwear.

Plantar fasciitis hurts like crazy, but the good news is that it's a) preventable and b) very treatable. We talked to Jackie Sutera, DPM, a Vionic Innovation Lab member, to find out exactly why this frustrating foot problem happens and what you need to do to feel better.
What is plantar fasciitis?
It's the result of an inflamed fascia in your foot. Fascia aren't muscles or ligaments; rather, fascia is stretchy, strong connective tissue that helps stabilize you. This particular one (the plantar fascia) starts at your heel bone, runs along the bottom of your foot, and connects to your toes.

The plantar fascia is super important because it supports the arch of your foot, making it possible for you to balance, no matter what you're doing." It elongates and contracts depending on the shoes you wear, the activities you do, the impact on your foot, and your body weight," says Dr. Sutera. Without it, your arch wouldn't be able to move the way it needs to in order to support you.

But when the fascia becomes inflamed or irritated due to wearing shoes without the right arch support for the activity you're doing (whether that means standing for long periods in heels or running in worn-out sneaks with no arch support), your heel lights up in pain, especially in the morning or when you first stand up. That's because while you're resting, the fascia relaxes and the irritation relaxes a bit, too. But as soon as you stand up, the fascia contracts again, re-starting the inflammation. If left untreated, the pain can spread up your Achilles tendon and begin to affect your knees.

How to fix it
If you're already feeling the pain, Dr. Sutera says there are a number of things you can try at home to soothe it. Bonus: Some of these tricks may also help prevent the problem from happening in the first place. Here's Dr. Sutera's advice.

Change up your footwear
Plantar fasciitis tends to hurt really bad in the morning when you first wake up. Although the pain may disappear after your first few steps, it often then gets progressively worse throughout the day. Staying completely off your feet is probably not an option, but wearing shoes with good arch support can help take some of the pressure off your fascia so it can heal.

It's also worth noting that bad shoes are among the main causes of this issue to begin with. You don't have to swear off flip flops forever, but it's worth checking in with the shoes you're wearing most often. Are you wearing the same kind of shoes every day? If so, try switching it up. Are the insoles worn out? Do they even have supportive insoles of any kind? If not, there are many orthopedic inserts that can make your favorite shoes work better with your feet.
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Stretches
Stretching your calf muscles helps lessen the strain on the plantar fascia. If you're already feeling the pain, Dr. Sutera recommends doing a calf-stretching routine four times per day, starting first thing in the morning and doing your last session before you get in bed. In the morning, before you even get out of bed, start with a calf stretch: With your legs together in front of you, wrap a yoga band (or towel) around one foot to pull your toes back and your foot up while keeping your leg straight. Hold for 10 to 20 seconds; then, switch sides.

Then, move on to a downward dog, holding for 30 seconds. Next, try a runner's stretch against the wall: Stand facing a wall with your feet staggered. Your front knee should be bent slightly, and your back leg extended behind you. Place both hands in front of you and lean forward against the wall until you feel a stretch in the calf of your back leg. Hold for 10 to 20 seconds and switch sides.

If you're just trying to prevent plantar fasciitis, repeating the routine four times a day is probably not necessary. Instead, focus on that morning stretch and, as we mentioned above, pay extra attention to your shoes.
Photographed by Mike Garten.
Massage
Dr. Sutera recommends massaging your feet every night, concentrating on the heel and arch. Then, move diagonally up to your toes and across the width of the foot. "It might not feel great, so it is important to adjust pressure, because you don’t want to hurt yourself," says Dr. Sutera. "But a little discomfort is expected."

Ice
Finally, every night after stretching and massaging, ice your feet for 30 minutes. Feel free to get creative with this one, says Dr. Sutera. Use a bag of frozen peas, a frozen water bottle — whatever works.

Dr. Sutera says these more conservative treatments (along with OTC pain relievers) improve the pain in most cases. If you're not seeing any improvement after about two weeks of this routine, it's time to get professional help. The problem may take up to a few months to fully heal, so she recommends patients still check in with a doctor periodically during this time. Some people need more intense treatments (such as steroid shots) to help things along, while others might be suffering from a more serious problem, such as a tear in the fascia, which usually requires surgery to repair. Thankfully, Dr. Sutera says that 80 to 90% of patients are just dealing with inflammation that will go away with time — and plenty of stretching.
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