10 Tips to Manage Plantar Fasciitis

 Vanessa Caceres

Got heel pain when you wake up in the morning? You may have plantar fasciitis.

“The plantar fascia is a broad, flat ligament that travels from the base of the heel bone to the ball of the foot,” says podiatrist Dr. James R. Hanna of the New York State Podiatric Medical Association in New York. “Its purpose is to help support the longitudinal arch of the foot. Overstretching of the plantar fascia can cause injury and inflammation, resulting in plantar fasciitis.”

Plantar fasciitis can have several causes, including

  • The use of shoes that lack good support for your feet.
  • Not warming up properly before sports or exercise.
  • Flat feet.
  • Excessive walking or running.
  • Major changes in running surfaces.
  • Trauma to the foot.
  • Being overweight or obese.

People with or without diabetes can be more prone to developing plantar fasciitis if they are overweight, says Dr. Yolanda Ragland, a podiatrist and foot surgeon in New York and Bowie, Maryland.

Plus, plantar fasciitis is yet one more foot problem that can occur when you have diabetes. Other common foot problems include diabetic neuropathy, dry skin, skin fissures and an impaired response to infections, says Dr. Dixie Harms, a nurse practitioner practicing in Clive, Iowa.

So how do you know if you have plantar fasciitis? The telltale sign happens when you first wake up.

“Most people report experience complications first thing in the morning when getting out of the bed, walking to the coffee maker, et cetera,” Harms says. The area with the pain or discomfort may also feel stiff. The pain may go away, but then it can come back if you’re not moving around. “Oftentimes, patients are stuck in a perpetual state of discomfort or pain,” she says.

You also may have pain after prolonged standing or after exercise, but not during the actual workout, Ragland says.

Here are some tips to help manage plantar fasciitis and guidance on when to see a health care professional.

Ice the affected area. Elevate and rest your aching foot when it gets aggravated, Harms advises. “Rolling the bottom of the foot on a foam roller or frozen bottle of water is also therapeutic,” Ragland says.

Use supportive footwear. Dr. Richard Rettig, chief of the division of podiatry at Einstein Medical Center Philadelphia, prefers patients wear tie-up shoes or sneakers.

Take over-the-counter anti-inflammatory medication such as ibuprofen or naproxen. This should only be a short-term option.

Try shoe inserts. There are shoe inserts you’ll find at a drug store or custom-made through certain health care professionals that may lessen the impact on your plantar fascia. However, it may take some trial and error to find an insert that helps you.

Rethink your exercise routine. It’s still important to work in physical activity, but Rettig advises the avoidance of foot-pounding exercises, such as running or jumping, until symptoms subside. Try some lower-impact options and avoid overdoing things. Ask a health care professional about a more suitable exercise routine while you recover.

Stretch your feet regularly. Hanna advises stretching even before you get out of bed. “This usually involves a typical calf stretch that also stretches the plantar fascia,” he says.

Another stretch recommended by Ragland: “While seated, take a towel or a flat-resistance band wrap under the ball of the foot, and pull the ends of the towel or band so that your toes are being pulled toward the body to keep the plantar fascia lengthened.”

Foot and calf stretches before and after physical activity are also helpful when you have plantar fasciitis.

Nix barefoot walking. It may feel good, but wearing supportive shoes is a better option.

See a health care professional if you're not finding relief. If you try over-the-counter pain relief and stretching for six weeks and you’re not getting better, give your health care professional a call. Sometimes plantar fasciitis will get better with self-help measures, but sometimes it won’t. “Letting the problem go on for a longer time without progress allows it to become more chronic and often more resistant to treatment,” Hanna says.

It’s especially important to see a health care professional if you have plantar fasciitis symptoms and you have diabetes. That’s because the symptoms could mimic complications of diabetes such as neuropathy and Charcot neuroarthropathy, Hanna says.

If you are diagnosed with plantar fasciitis, your health professional may recommend options such as:

  • Corticosteroid injections. However, these can raise your blood sugar, Harms says.
  • The use of an anesthetic.
  • Physical therapy.
  • Night splints.
  • Complete immobilization of the foot with a cast.

A kind of surgery called plantar fasciectomy is quick and typically offers a permanent cure, Ragland says. However, surgery is usually a last option.

Be patient. Believe it or not, it can take several months or even a year for plantar fasciitis to get better. You have to stay consistent with your self-help measures for plantar fasciitis.

Know that plantar fasciitis might recur. “Losing weight and controlling foot motion with arch supports can lower the chances of recurrence,” Rettig says.

Plantar fasciitis is more likely to recur if you’re still wearing improper shoes or walking barefoot too often, Harms says.

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