Plantar Fasciitis: Debunking the Myth of Staying Off Your Feet

Any advice suggesting staying off your feet for plantar fasciitis is misguided. This myth needs to be cleared up once and for all. Let's explore effective treatment options and debunk the common misconception that staying stationary will help alleviate your symptoms.

Understanding Plantar Fasciitis and Its Causes

Plantar fasciitis is a condition characterized by inflammation of the plantar fascia, a thick band of tissue running across the bottom of your foot and connecting your heel bone to your toes. It often causes sharp pain in the heel, especially after prolonged periods of inactivity.

Tightening of the Plantar Fascia

When you sit or stand for long periods, your plantar fascia tightens due to inflammation and micro-tears. As soon as you start walking on this tightened tissue, it leads to further micro-tears and intensified pain. If you have a plantar fascia rupture, you might experience a “pop” sensation, followed by sharp pain, bruising, and swelling in your foot.

Effective Treatment Options for Plantar Fasciitis

There are several treatment options available for managing plantar fasciitis, and staying off your feet is not one of them:

Stretching and Foot Rolling

One of the most effective first-line treatments is stretching. Spend a minute stretching your foot against the wall in the morning, holding the stretch for at least one minute, and repeat this throughout the day, especially after prolonged sitting. Rolling your foot over a frozen water bottle or a tennis ball can also relieve tension and pain. For optimal results, use a stretcher like the Straussberg sock to help manage the inflammation at night. Ensure that your bed sheets are not tucked in to avoid placing the foot in a dorsiflexed position, which can further tighten the plantar fascia.

Medications and Devices

NSAIDs like ibuprofen can be taken to reduce inflammation and pain. Orthotic devices and support socks like the Straussberg can provide additional relief. Proper footwear is crucial, and avoiding high heels or shoes with poor support can prevent further damage.

Second and Third Line Treatment Options

If pain persists, consider the following more advanced treatment options:

Second Line: Steroid Injections

Steroid injections can be a second-line treatment when combined with other therapies. However, it's important to note that steroids can lead to fat pad atrophy and should be used cautiously. Podiatrists are increasingly moving away from steroid injections if other treatments can help.

Third Line: PRP Injections and NSAID Withdrawal

Platelet-rich plasma (PRP) injections can offer a third-line treatment. This treatment involves using your own blood to stimulate healing. Additionally, it may be necessary to stop taking NSAIDs to allow for proper healing.

Fourth Line: Shockwave Therapy

Shockwave therapy is particularly effective for calcaneal pain and can be a fourth-line treatment for severe cases. This therapy uses high-energy acoustic waves to stimulate healing and reduce pain.

Conclusion

For those suffering from plantar fasciitis, the advice to stay off your feet is outdated and potentially harmful. Engaging in regular stretching exercises and using appropriate footwear and support devices can go a long way in managing symptoms. It's crucial to seek professional guidance and explore a variety of treatment options to find the one that works best for you.

First Line: Stretching, rolling frozen bottles or tennis balls, taking NSAIDs, using support devices. Second Line: Steroid injections with caution. Third Line: PRP injections and stopping NSAIDs. Fourth Line: Shockwave therapy.