Plantar Fasciitis Treatment: Part 1 Conventional
Foot pain is a fairly common problem that utilizes both conventional and current concepts of healing the foot while battling plantar fasciitis. In discussing conventional treatment, I’m basically talking about self-care. Current concepts in foot treatments include both self-care and physician care.
The conventional school of thought regarding treatments for plantar fasciitis is to follow the acronym RICE—rest, ice, compression, and elevation. In the sports world, RICE is applicable to all sports injuries—not just running. I would also like to add to our list of conventional treatments for plantar fasciitis, the wearing of proper running shoes, exercise including stretching, and over-the-counter medication.
R is for Rest: Rest can mean laying down, but it can also mean doing less than you are used to doing at the time you notice that something is wrong–walk instead of run, sit instead of stand, etc.
I is for Ice: Apply ice to the affected site immediately. Precautions should be taken to prevent the ice from burning the skin. Cover the ice pack in a towel for protection.
C is for Compression: Apply pressure to the foot by use of an Ace bandage or TED hose and a good pair of support shoes. Don’t apply enough pressure to cut off the circulation—only enough pressure to render support.
E is for Elevation: Elevate the foot to prevent or reduce any swelling.
“Conveniently, many runners have developed their own interpretation of RICE. They believe that “R” is for running through every injury. “I” is for ibuprofen, in 500-count bottles. “C” is for cortisone injections. To their horror, “E” becomes an emergency room trip, when a stress fracture turns into a compound fracture at mile 22 of a marathon.” 2
Proper shoes are extremely important. Don’t just go to the mall or discount shoe store to purchase your running shoes. It’s important to purchase a shoe that is right for your foot and your stride. If you aren’t wearing the shoe that is right for you, it can cause poor posture, poor hip alignment, and can cause all kinds of foot, leg, and back problems. It’s best to seek the advice of a professional if you are looking for a good pair of running shoes.
Stretching the foot, ankle, and calf are the most prescribed exercises for anyone with plantar fasciitis problems. I’ve got seven exercises that I recommend. The first exercise is trying to pick up marbles with your toes to help strengthen the muscles of the foot. The second is called the “towel drag.” Put a can on a towel and try to drag the towel across the kitchen floor with your toes. Then there are toe raises, the Achilles stretch, and the tennis ball roll.
There are several ways to do the calf stretch. You can either place your foot against the wall and lean into it as shown in the photo or you can sit on the floor with your legs extended in front of you. Place a small towel around the foot and hyper-flex your foot with your toes pointing toward your shins. Give it a little extra pull with the towel.
Another stretch is placing your ankle over the knee while you are in a sitting position. Stretch your foot and toes toward your knee with your hand.
According to Matt Furey, “Hindu squats actually rehabilitate the knees while strengthening the muscles of the legs. Hindu squats when done properly and combined with deep breathing, not only strengthen the entire body, but they rehabilitate the knees and ankles and build phenomenal lung power.” Actually, since I started Hindu squats, I have found great improvement in the plantar fasciitis. I am experiencing almost no pain as a result of doing these specialized squats.
The difference between a regular squat and a Hindu squat is that you use your arms, you come up on your toes, and you concentrate on your breathing.
So here are the recommended plantar fasciitis exercises.
1. Marble pick up
2. Towel drag
3. Toe raises
4. Achilles stretch
5. Tennis ball roll
6. Calf stretch
7. Hindu squats
The final conventional treatment for plantar fasciitis is the use of over-the-counter anti-inflammatories and analgesics. Anti-inflammatory medications reduce swelling whereas analgesics are used for pain. Tylenol is an analgesic, but does not have anti-inflammatory properties. The most widely used anti-inflammatory otc madications include ibuprofen and naproxen. The anti-inflammatory meds should only be used at the time of the initial injury until swelling is reduced. Long term use of these NSAIDs can lead to stomach problems.
In part 2 I’ll be discussing current concepts regarding the treatment of plantar fasciitis and in part 3 I’ll talk about clinical trails.
1. Furey, Matt. Combat Conditioning February 2000. Matt Furey Int. Fl, Tampa
2. Glazer, James. Physician and Sportsmedicine Magazine; “Plantar Fasciitis” Nov 2004 Vol 32, Issue 11
3. Jabbour, Dr. Kamal. The Post Standard “Dealing With Injuries” May 27, 1997
4. Stovitz, Steven D. Physician & Sportsmedicine; “Foot Pain” Aug2004, Vol. 32 Issue 8, p19-26,