How to Treat Plantar Fasciitis [what your doctor won't tell you] - Ariana Rabinovitch Yoga and Movement Education Google+



How to Treat Plantar Fasciitis [what your doctor won’t tell you]

Matters of the FEET are close to my HEART.

Ariana and papa

That’s me with my Papa
circa a long time ago

My grandfather (I called him Papa) was a Podiatrist. I lived with my grandparents for many years when I was growing up and my Papa often gave me advice. About my feet. Two pieces of advice stand out to me:  1. Make sure your socks don’t squeeze your toes together, and  2. Buy good shoes that are flexible at the ball of the foot AND that don’t squish your toes together.

Because of my grandfather I take good care of my feet. It makes good sense to me. Afterall, about 25% of our bones and muscles are located in the feet! Issues in the feet have direct impact throughout the rest of your body. You should take care of your feet too because Foot Health=Total Body Health (tweetable?).

I meet many people who have Plantar Fasciitis, but most of them don’t know WHAT it is or HOW to treat it. I wish that doctors had the time to explain or define conditions to their patients. I also wish that patients would ASK for that information to empower themselves about their health.

What is Plantar Fascia?

If you want to help your body and take care of it, it helps if you try to understand what is inside. Plantar Fascia is the name of the connective tissue (fascia) on the bottom of the foot. It connects from the heel of the foot (calcaneus) all the way to the flexor tendons of the toes (bottom of the toes). It is a dense fibrous tissue that supports and stabilizes the arches of the feet.

This is a view of the bottom (plantar side) of the foot with the plantar fascia. There are a lot of other muscles there that are not shown. This image is from Dr. Joe Muscolino's The Muscular System Manual companion CD, 3rd edition.

This is a view of the bottom (plantar side) of the foot with the plantar fascia.
There are a lot of other muscles there that are not shown.
This image is from Dr. Joe Muscolino’s The Muscular System Manual companion CD, 3rd edition.


What is Plantar Fasciitis?

Plantar Fasciitis occurs when this band of fascia gets inflamed and starts to degenerate where it attaches at the calcaneus (the heel bone). It is a syndrome of overuse – either from being overstretched or from being overly contracted. The degeneration at the heel is what is most painful because the fascia is being pulled away from the bone. Ouch. If it is not relieved, a bone spur can grow there. Even bigger Ouch. 

What Can You Do to Treat Plantar Fasciitis?

1. Answer these questions: What kind of shoes do you wear most of the time? Does the toe box squeeze your toes together? Do you wear flip-flops? Do you wear high heels or sneakers with a lot of height in the heel? If you answered yes to any of these then STOP DOING THAT! Why? That could be a whole other post. Find shoes that allow your toes to spread and allow you to have a natural gait cycle with the foot (listen to my Papa!).

2. Notice if you walk with your feet or one foot turned out. If you do. STOP DOING THAT! If you catch yourself doing it, correct it. Remember to walk with your feet pointing straight forward in the direction you want to go. As if you were steering your car.

3. Self-treatment with therapy balls. I like Jill Miller’s Yoga Tune Up® balls and Sue Hitzmann’s soft Melt Method balls. Fascia (that’s your connective tissue) is more responsive to soft pressure so please don’t use anything hard like a golf ball. Also do not apply pressure directly on the heel. You can do this standing near a wall or sitting on a chair. Start with sustained pressure in the center of the foot. Then apply gentle pressure at the base of each toe. Roll from side to side across the ball of the foot and across the base of the toes. Next, gently roll from the base of the big toe TOWARD the heel. Pick up the foot when get close to the heel and then start again at the next toe and so on until you get to the pinky toe. Finally, roll around any which way you like just stay clear of the attachment at the heel. I am doing this right now as I write this. heaven.

You might aMojiFootPRO_rightsidelso want to try a foot massager like this one called Moji Foot Pro which can be placed in the freezer so you can get some cold rolling therapy for your feet too. You use this one sitting down. The balls are hard but the pressure is distributed through all of the 6 balls so it’s not nowhere near as intense as using something hard like a golf ball.

4. Now for some stretches. Contrary to what you might think – stretching the actual tissue near the heel will most likely aggravate it more. Which is why I offer stretches AROUND THE AREA AND NOWHERE NEAR IT! Tension in the Plantar Fascia is often connected to tension up and down the back of the leg – so it makes sense to stretch the calf muscles (gastrocnemius and soleus) as well as the Hamstrings. It also makes sense to stretch the top of the foot to bring the attachments closer to each other, creating some slack for the Plantar Fascia.

Stretch A: Cut your Plantar Fascia some slack! Instead of stretching the sole of the foot, stretch the top side of the foot. That’s right! The other side of the foot. This allows the fascia to go slack and get a little relief from the tugging. When I wake up in the morning, my left heel is tender. This is the first stretch I do and I get immediate relief.

Stretch for the top (dorsal) of the foot.

Super easy stretch for the top (dorsal side) of the foot!
You can do this anywhere.

Stretch B: Calf muscle stretch. Place your heel on a soft but stable surface like a rug or yoga mat. Roll up a towel and place the ball of your foot on it. Step forward a little with the other foot. Do this with the knee straight and then try it with the knee bent. If you feel pain on your heel from doing this then limit the amount of stretch or skip this one for now until you can do it without pain in your heel.

Here I am using a half dome I got from Katy Bowman, but you can use a rolled up towel. The more you step the other foot forward the more you stretch the calf. In photo 4 I am bending my knee to target the Soleus - another calf muscle underneath the Gastrocnemius.

Here I am using a half dome I got from Katy Bowman, but you can use a rolled up towel.
The more you step the other foot forward the more you stretch the calf.
In photo 4 I am bending my knee to target the Soleus – another calf muscle underneath the Gastrocnemius.

Stretch C: Hamstrings stretch: Place the back of your heel on a chair or something lower like a step. Straighten both knees and make sure you have not allowed the standing foot to turn out. Keep your spine neutral (don’t let it round) and fold your pelvis over your thigh. If you keep your spine neutral then you do not have to go far to get the stretch in the hamstrings. If you forgot why you are stretching your hamstrings for Plantar Fasciitis then go back to point #4.

In the first picture my spine is neutral and I am flexing (folding over at my hip joint). In the second photo I am flexing my spine (folding over along my spine).

In the first picture my spine is neutral and I am flexing (folding over) at my hip joint. In the second photo I am flexing my spine (folding over along my spine).

So there you have it – a bunch of things you can do to treat and alleviate discomfort from Plantar Fasciitis. Good luck, and remember FOOT HEALTH=TOTAL BODY HEALTH! I think my Papa would have been very proud of this post:)

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18 Responses to How to Treat Plantar Fasciitis [what your doctor won’t tell you]

  1. Dawn October 18, 2013 at 7:40 PM #

    HI Ariana!

    Great post. It’s similar advice I give to my patients who have PFS….I also look at the spine, pelvis and hips from a mechanical point of view. An L5/S1 nerve root irritation can also mimic plantar fasciitis! I recently had a patient come to me with bilateral PFS that was misdiagnosed. I treated his lumbar spine and heel pain was gone. The body is amazing!


    • admin October 20, 2013 at 2:46 AM #

      Thanks Dawn! I had never heard that before about the L5/S1 nerve root irritation mimicking PFS. Fascinating. Thanks for sharing.

    • Natalie April 29, 2014 at 4:34 PM #

      I have struggled with PF for 2 years now, how would you find out if you had the nerve root irritation or something else going on? I know for I have back issues, it balls up and goes out every couple of years and it is usually related to my hips being out of place and my right foot will usually be shorter than the other. After a few adjustments at the chiropractor I am back to normal.

      I have tried everything, wear very expensive, custom fit Brooks every single day, ice, stretch, wear a night splint and even had accupuncture and shock wave therapy. It went away for awhile and is now back again. I am very overweight and I am sure it is the cause and I used to walk barefoot all the time, I know losing weight will help.

      • admin April 29, 2014 at 5:07 PM #

        Hi Natalie, sounds very frustrating if it keeps coming back! But you seem determined to figure it out. Losing weight could help, but if your PF is due to leg length discrepancy then this blog post from my colleague – Brooke Thomas might be helpful for you:
        Also having your walking pattern assessed by a Movement Professional who specializes in gait patterns might prove to be very useful too. It is often in how we move and use the body over long periods of time (in inefficient ways) that leads to injuries. Good luck! and please keep me posted on your progress.

  2. Jean October 20, 2013 at 3:34 PM #

    Thank you – I will try these stretches. Can you show examples of good shoes for people with PF?

    • admin October 22, 2013 at 2:14 PM #

      Jean – Let me know if my suggestions help you. I like your question about examples of good shoes for people with PF! That is a hard one because any pressure on the heel will probably aggravate it more. It might be about getting an insert to provide more cushion for the heel? I will look into it. Maybe people reading this will have suggestions too.

  3. Charles October 21, 2013 at 4:45 PM #

    In terms of avoiding turning your feet out, I do better with that if I make sure to reach my foot forward and strike on the heel. A physical therapist working on an issue with my achilles tendon noticed that I was never straightening my legs and was planting my feet flat on the ground as I landed. She told me to reach my leg forward as I walked and I noticed it forced me to keep my feet pointing forward.

    BTW, the feet actually want to point where the knees are pointed, according to my PT. My knees are angled slightly out, which she tells me is unusual, so I don’t want my feet perfectly forward but slightly out; just not as out as they’d been.

    • admin October 22, 2013 at 2:18 PM #

      Charles- thank you for your input. I agree that it is optimal for the feet and knees to point in the same direction. See Amit’s comment below about your hips – which are probably the culprit for the turnout in your knees. It could be due to the shape of your bones/how your femur sits in your hip socket. But it could also be a muscular imbalance around the hip. As Amit suggests – your external rotators might be stronger than your internal rotators.

  4. Amit Younger October 22, 2013 at 8:28 AM #

    Thanks Ariana for a great post. I could not agree more with the need to keep the feet healthy, mobile and strong!!
    Charles- I have seen many people with slightly turned out legs and knees angled slightly outwards- it is not unusual. You should however look at the muscular balance in your hip joint and make sure the muscles that turn the thigh bone outwards are not too strong/tight in the expense of weak internal rotator muscles.Ask your PT about it…

    • admin October 22, 2013 at 2:19 PM #

      Thank you Amit! and I appreciate your suggestion to Charles too about his hips.

  5. Jackie November 25, 2013 at 10:07 PM #

    Thank you for this post. I was told by my doctor that yoga is great for plantar fasciitis. Are all poses good for this condition? I would love your input. I’ve been dealing
    with this condition for over 18 months.
    Thank you!

    • admin November 26, 2013 at 2:53 AM #

      Jackie – there are so many kinds of yoga classes out there that it is hard to say that “yoga” is great for specific conditions. It really depends on the style, the poses that are done and the teacher’s instruction. There are poses you should stay away from – like any poses that tug directly on the attachment at the calcaneous are going to make matters worse, not better. If you decide to try a class I would recommend going to a beginners class and mention to the teacher that you have PF. And back off if you start to feel pain in your heel.

  6. Kas February 23, 2016 at 5:32 PM #

    Do you have any info on achilles tendonitis?

    • cath June 1, 2016 at 4:34 PM #

      I have had back surgery for slipped disc, I also have a trapped nerve and have siatica…my planter fascitus has returned is this due to my back?

      • admin June 3, 2016 at 2:51 PM #

        Hello, sorry to hear that. Hope you recover fully and quickly. There’s no way for me to know if your foot pain is because of your back. It’s possible I suppose but the best thing to do is see a professional to treat the foot pain if it doesn’t resolve on its own. good luck.

  7. Liz T. September 9, 2016 at 12:42 PM #

    I was diagnosed with PF a week ago after going in for pain. He used ultrasound to view the tissue and could detect a few small “hernias” that had formed. I do not notice “heel pain” though. For me it is dead center for my high arch. Bought very expensive German shoes and have been trying to walk barefooted for 30 mins a day as I saw a video that suggested building up the natural foot muscles would be a great benefit. I have been trying to do stretching from some Yoga moves. Have noticed that in the AM my feet are not stiff as they were before however after walking barefooted on concrete a burning pain emerges.Pain comes in the evening as the day wears.

  8. Joyce Jenkins October 17, 2016 at 1:55 PM #

    I had foot pain for over 20 years. I tried many podiatrist and spent tons of money on orthodics. Then I finally started seeing a chiropractor. The last podiatrist wanted to do surgery on my right foot after 2 sessions with a PT did me no good. The chirpractor looked at my ankle and saw it was out of place. With it aligned the pain stopped! Now, 2 years later it came back though not as severe. This time she said my ankle was fine but lower back was out of alignment. I was happy that fixed it. But I like to read ways to keep my body aligned. Thanks!


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