What is the best treatment for plantar fasciitis?

The best treatments for plantar fasciitis are Achilles and plantar fascia stretching, getting a good pair of shoes with arch support, and anti-inflammatories. If the pain is real bad then you may need to wear a splint at night; surgery is rare. I used to run a lot in highschool. Between cross country, indoor track, and outdoor track I basically ran year round averaging around 45 – 50 miles per week. My friends who played other sports would say that running was the worst part of their practice, but for me that was the only part of my practice. One season I had the unlucky experience of having plantar fasciitis. It would hurt in the morning when I got up, and it was painful after my runs. I can still remember that pain and how annoying having plantar fasciitis really was. As an orthopedic surgeon in Colorado Springs, I treat a fair amount of plantar fasciitis. Fortunately, there are many things you can do to help get rid of your plantar fasciitis and you almost never need surgery for it.

What is plantar fasciitis?

If you were to cut open the bottom of your foot, after a few layers you would eventually come to a thick white band of tissue that goes from your heel to the base of all of your toes. This layer is called the plantar fascia, and is important in maintaining the arch of your foot, especially when you lift your big toe upwards. Most of the time we don’t really think about the plantar fascia, it is kind of just there. It only becomes noticeable once it gets inflamed at which point you have plantar fasciitis and pain. The pain is generally worse with the first steps you take in the morning because the plantar fasciitis is getting stretched out after it contracts while you sleep. You also may have tenderness over the inside of your heel, which is where the plantar fascia attaches.

What can I do about my plantar fasciitis?

The goal with plantar fasciitis is to decrease the inflammation. But to decrease it, you need to know what is causing it, or really what is putting extra stress on it. Often times in the body when one area is tight, it affects another area. This is true with the plantar fascia in that your Achilles tendon is probably tight. Loosening up your Achilles tendon will lessen the stress on your plantar fascia. There are also plantar fascia specific stretches which you should incorporate as well. Apart from stretching, getting insoles with good arch support will take some of the stress off the plantar fascia, especially if you have flat feet. You don’t need anything fancy, something over the counter will do. Like almost any condition with inflammation, anti-inflammatories such as Advil will be your friend if you can tolerate taking them. If it is really painful, your doctor can prescribe you a splint to wear on your foot at night which keeps your ankle from pointing down, which decreases the stress on the plantar fascia. You can also get a night splint over the counter. As a rule of thumb, you generally want to avoid steroid injections to your plantar fascia as it can cause your plantar fascia to rupture or cause fat atrophy of your heel (you want fat in your heel for cushioning). If all else fails, some get relief with shockwave therapy or in very rare instances surgery. Fortunately, most people with plantar fasciitis get better with the above mentioned non-invasive treatments and time. With time and patience, my experience is that most of my patients here in Colorado Springs get improvement with their plantar fasciitis.

I hope I was able to answer your questions about the best treatment for plantar fasciitis. If you still have any questions or want to schedule an in person or virtual consult, please feel free to contact me.

-Written by Dr. Daniel Paull

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