If you wake up in the morning with pain in the bottom of your heel or the arch of your foot that goes away after walking, you might be tempted to think that warming up your foot is fixing the root problem. Not only is this assumption incorrect, but it can needlessly prolong your pain.
The plantar fascia is inelastic connective tissue that runs the length of the foot and supports your arch. If you stand or walk on hard floors all day, wear the wrong shoes, or simply have a body mass index over 30, the fascia can develop tiny tears that lead to inflammation and pain.
As you rest your foot in your sleep, or by sitting for a while, the fascia shortens. When you stand, it lengthens, which makes it prone to developing more tears. So while it feels like you can just push through that morning pain, you’re actually reinjuring the fascia.
To get rid of plantar fasciitis pain for good, the first step begins before you even get out of bed.
Step 1. Reduce morning pain
To reduce both pain and the risk of reinjury, set your alarm a few minutes earlier so you can complete this series of simple exercises before your feet hit the floor:
- Write the alphabet with your foot. Sit at the edge of the bed with your knee extended. Pretend that you’re holding a pen with your toes and trace each of the letters of the alphabet in the air. This will stretch the foot and ankle.
- Next, cross your foot over the opposite knee and use your hand to gently pull your toes back toward your shins to relieve muscle tightness. You can also wrap a towel under your foot and pull on that. Hold the stretch for 10 seconds and repeat three times.
- Sit on the edge of the bed and place a tennis ball, foam roller, or a similar object under the arch of your foot. Roll it back and forth for about two minutes. Any time that you’re sitting for more than 30 minutes, repeat these stretches.
Once your foot is stretched and before you get out of bed, put on your most comfortable, supportive shoes (not slippers). This will distribute your weight over the arch of the foot and help prevent additional tearing.
Step 2. Evaluate your activity
Plantar fasciitis can be deceiving. You may feel perfectly fine while you’re being active, only to be struck with pain after you’ve finished exercising and are resting. The trick is to reduce your activity just enough to prevent the pain from kicking in. If you know that your plantar fasciitis acts up after the 18th hole on the golf course, try ending your game a few holes earlier and see how you feel. A good rule of thumb is to reduce activity by 20 percent to see if it makes a difference. If you can’t find a comfortable level of activity for even short periods of time, try other types of exercise, such as bicycling and swimming. But don’t stop moving. Inactivity can cause the plantar fascia to stiffen and then become painful again when you start to move around. You may have to experiment to find the right activity level.
Step 3. Choose your shoes
There is no single shoe that is the best choice for people with plantar fasciitis, but there is one type of shoe everyone should avoid: One that is worn out. I’ve met many patients who have been running in the same shoes for three years or who work on their feet all day in shoes that are no longer supportive.
If you see uneven wear on the soles of your shoes, it’s a sure sign that it’s time to get new ones. But you can’t always see the whole story. Generally, shoes lose their support after a year. Athletic shoes can wear out much faster. If you’re a long-distance runner, for example, you should replace your sneakers as often as every three months. Likewise, if you stand at work all day and wear the same shoes when you get home, you should probably replace your shoes more often than you have been.
When choosing new shoes, the first criterion is comfort. A good quality shoe feels different on different types of feet, so you need to find the one that feels best to you. It’s a great idea to go to a running store or a traditional shoe store with professional employees who can assess your foot mechanics and suggest options that are made to work with your type of foot. When it’s time to buy, you usually get what you pay for. A $35 pair of sneakers isn’t the bargain it looks like: You’ll end up paying in other ways down the road.
Step 4. Try OTC solutions
If you can’t find just the right shoe, there are many over-the-counter products that may help. For example, if you’re working all day in steel-toed boots and you can’t find a comfortable fit, something like a gel heel cup or insole can reduce pressure, provide support, and make you more comfortable. The objective is to be as comfortable as possible so you don’t compensate by walking differently. Turning your foot to the side to reduce plantar fasciitis pain can quickly turn into knee pain. Whatever cushioning device you use, be sure to put it in every pair of shoes you wear.
If orthotic therapy is not effective, you might want to try night splints to prevent shortening of the fascia while you sleep.
A nonsteroidal anti-inflammatory drug, such as aspirin, ibuprofen, or naproxen, can also help relieve pain and inflammation. These simple strategies can resolve pain in most patients, though it may take some time. If you still have pain after six months of following this plan, you may be a candidate for additional treatments, such as physiotherapy or custom orthotics.