Feet > Plantar Fasciitis >Treatments

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To properly cure plantar fasciitis, physicians generally prescribe a combination of the following treatments:

   Rest and activity modification ­- relative rest is generally prescribed to treat plantar fasciitis. You do not necessarily have to stay off your feet, but you should decrease the duration and intensity of your walking and running. Switching from a running sport to swimming or cycling can reduce stress to the plantar fascia. Changing to a softer exercise surface, like grass instead of concrete, can also help.

   Ice – applying ice to your heel for 15 minutes after walking or activities can help reduce the inflammation. An easy and effective method for icing your foot is to roll a can of frozen juice under your arch and heel.

   Stretching – successful treatment often requires routine foot stretching to be done two or three times a day. Before you get out of bed in the morning, physicians generally recommend that you warm up the plantar fascia tissue by stretching your foot up and down and side to side. Before walking, it is often helpful to stretch the bottom of your foot, by pulling your toes back with your knee straight and your ankle flexed towards you.

   Non-steroidal anti-inflammatory medications, like aspirin or ibuprofen, are sometimes prescribed to reduce pain and swelling.

   Massage – many patients receive pain relief from local, deep massage in the painful area of the heel. Massage is usually prescribed for the morning, after a hot shower or bath. Rolling a tennis ball under your arch also can help relieve some of the tension in your plantar fascia.

   Proper footwear – shoes should have a stable heel and a well-cushioned sole. Many dress shoes do not have adequate arch support and strain the plantar fascia. Your physician can recommend the type of shoe that provides the best support for the shape of your foot. Most major athletic shoe manufacturers design shoes to fit specific types of feet. Physicians often suggest that patients wear padded sandals around the house instead of going barefoot.

   Orthotics/shoe inserts – at your physician¹s discretion, you may need to wear orthotic inserts in your shoes to properly support your foot. The inserts usually have an arch support, a suctioned heel lift, and often a cutout around the tender area. Depending on the shape of your foot, you may be able to buy an over-the-counter heel cup or shoe insert. Your physician may prescribe custom molded orthotic inserts. Most people are instructed to wear the inserts all day in all their shoes.

   Night splints – physicians commonly prescribe splints for patients who do not respond to other treatments. The splints are worn at night and hold your foot in a flexed, stretched position while you sleep so the plantar fascia and foot muscles do not tighten.

If a combination of the above treatments does not relieve your heel pain within about three months, your physician may prescribe a corticosteroid injection. Corticosteroids have strong anti-inflammatory properties when injected directly into your heel. Some physicians may give you an injection earlier so you can start rehabilitation free of pain. However, it is important to be aware of the potentially dangerous side effects of corticosteroid injections. As with any type of injection into a joint, there is the risk of infection. In addition, in high or repetitive doses, corticosteroids may actually cause the plantar fascia to rupture.

Rehabilitation [top]

Rehabilitation exercises, stretching, and non-operative therapies are synonymous for plantar fasciitis treatment. Curing plantar fasciitis often requires between six and 12 months of physical therapy. Your physician and physical therapist can design a custom rehabilitation program with specific stretching and strengthening exercises for your calf muscles and feet. Most physicians recommend a comprehensive leg-strengthening program to improve your overall endurance and flexibility. Rehab usually begins with stretching exercises for a period of weeks until your foot is flexible. Strength training usually begins within a month after treatment begins. Initially, you will probably perform light exercises, including picking objects off the floor with your toes. The weight of the objects gradually increases as your foot heals. The final stages of rehab usually include coordination exercises that are more activity oriented. The more intense and dedicated you are to following your physical therapists instructions, the quicker you can heal your foot and return to sports and activities.


   Plantar fasciitis rehabilitation exercises

Prevention [top]

Overuse and overtraining put you at high risk for recurring plantar fasciitis. Physicians generally recommend that you avoid repetitive activities that put constant strain on your foot. Try to incorporate cross-training into your workout schedule. For example, instead of running every day, alternate between running, cycling, and swimming workouts. Plantar fasciitis is one of the most difficult sports injuries to completely cure. If you feel pain recur, decrease your activity level and give your foot a chance to rest. Stretching and massage can help decrease tension in the plantar fascia and prevent injury. Finding a shoe with the proper shape and support for your foot can help prevent abnormal foot strain. Your athletic shoes should have good shock absorption in the heel, good flexibility, and sturdy materials to prevent side-to-side motion. Try to minimize the time you spend walking in unpadded dress shoes or boots. You should avoid wearing everyday shoes with heels higher than one-and-a-half inches. If your physician has prescribed orthotic inserts, you should usually continue to wear them in all your shoes. Based on your activity level, shoe inserts usually wear out within six months and need to be replaced.

Non-Surgical Treatment
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