Dealing with stubborn heel or foot pain? You’re not alone— plantar fasciitis is one of the most common causes of foot discomfort, especially for runners, new moms, and anyone who spends long days on their feet.
Why plantar fasciitis happens
The plantar fascia is a thick, fibrous band that runs along the bottom of the foot and supports the longitudinal arch. Plantar fasciitis develops when this area gets tight and stiff.
Much like a tendon, fascia requires load to stay healthy. But if load is increased too quickly or there is too little load, it can get aggravated. Limited hip or ankle mobility and tight calves can also increase stress on this tissue—leading to that familiar sharp and achy heel pain you feel when you first get out of bed in the morning.
Plantar fasciitis is commonly found in individuals who
Spend a prolonged amount of time on their feet
Spend a prolonged amount of time in stationary positions
Have experienced a sudden increase in physical activity level
Wear ill-fitting shoes
Have high or low arches
Are pregnant
Common Questions about Plantar Fasciitis
Plantar fasciitis can be long-lasting and stubborn, leading individuals to question whether they are doing the right things to help with their pain. Here are some of our most commonly asked questions about plantar fascia pain.
Should I stop activity?
No. As we mentioned, plantar fasciitis can occur from too much or too little activity. This means that complete rest may aggravate fascial degeneration and prolong recovery, even if there is a temporary decrease in your pain. At the same time, continuing the same training volume if you have acutely overloaded the tissue is also not the correct response and can worsen symptoms.
We suggest load management as the best strategy for recovery. This means finding the sweet spot for activity level -- low level aching without significant pain during activity or worsening of symptoms in the 24 hours after activity. The goal is to load the tissue within its tolerance to promote regeneration and healing.
Should I change my shoes?
Maybe. Proper footwear and orthotics can decrease pain while weightbearing or working long shifts. While this can be an important component of symptom management, it does not mean changing your shoes will automatically lead to recovery. Pain management is an important component of treatment, but if it stops there, we are not addressing the underlying causes of the pain -- muscle tension and fascial aggravation.
We recommend prioritizing comfort. Choose a shoe that feels good in the store with minimal rubbing or pinch points along the arch. If you are currently in minimalist or barefoot shoes, something with a little more cushion or a padded orthotic can alleviate pressure on the tissue.
Is RICE right?
Not for plantar fasciitis. The RICE protocol is an acronym commonly used for home treatment of soft tissue injuries -- it stands for rest, ice, compression and elevation. We do not recommend the RICE protocol for plantar fasciitis for several reasons. 1. RICE is an acute injury treatment recommendation and plantar fasciitis is normally chronic and requires a different approach for appropriate care. 2. RICE is outdated - it has been updated in general medical literature to reflect how the body heals.
We prefer a multi-modal approach that incorporates activity adjustments, soft tissue work and strengthening. This allows us to avoid flare-ups and decrease symptoms while addressing built-up muscle tension and improving tissue tolerance for load over time.
Should I stretch or strengthen?
Both are beneficial. Stretching provides short-term pain relief and can reduce tension in the calf muscles, which can contribute to pulling force on the plantar fascia. Strengthening improves load capacity, helping individuals move more comfortably, whether walking, running or participating in sports. If used in isolation, each of these strategies are less effective than when used together.
We combine soft tissue, strength and stretching to simultaneously assist with pain relief, muscle tension and load capacity. This is the fastest way to tackle stubborn flare-ups and progress back into pain-free movement.
You don’t have to live with heel pain. At Fixxed, our clinicians understand that plantar fascia recovery is not about doing nothing. It's about creating an individualized plan that works at the threshold you can load tissue without pain and building from there with a combination of recovery tools like cupping and dry needling to relieve pain, stretching to restore mobility and strengthening to improve function.
Schedule a consultation at FIXXED today and take your first step toward pain-free movement.
