Ask the Expert

Hi Mike,

This sounds like a classic case of plantar fasciitis, a common foot condition causing pain and discomfort to the bottom of your foot. The plantar fascia is a thick band of tissue that runs along the bottom of your foot, connecting your heel bone to your toes. It acts as a shock absorber and supports the arch of your foot. There are two reasons why this condition can be stubborn to resolve.

Firstly, at night, your foot will flex, allowing the fascia to contract (shorten) and it begins to repair itself in that shortened state. Upon rising in the morning and putting weight on your foot, you are reinjuring it all over again. As you bear weight, the tissue stretches too fast and damages the repaired area.

Secondly, your foot has the tough job of bearing your weight each day. This makes it difficult to rest in the injured area as you might would with a non-weight bearing body part.

While seeking proper diagnosis and treatment is essential there are things you can try at home. All stretching should start gently, not be painful and held for shorter periods of time in the beginning. You can gradually increase the time and intensity as you establish your tolerance.

1. Rest and Ice:

To begin your healing process, prioritize rest as best you can and avoid activities that worsen the pain. To maintain fitness without straining your foot, engage in low-impact exercises like swimming or cycling.

Ice bottle massage (pictures A1-A3): One of the best things you can do is apply a frozen water bottle to the bottom of your foot for 15-20 minutes up to three times per day with one being before bed. This can reduce inflammation and provide pain relief. Do not apply ice longer than 15 to 20 minutes at one time.

2. Stretching Exercises:

Stretching exercises play a vital role in alleviating tension and tightness in the bottom of your foot, facilitating healing and reducing pain. Incorporate the following stretches into your routine:

Tennis ball massage (pictures B1-B2): Keep a tennis ball beside your bed so you can do this stretch prior to putting weight on your foot in the morning. Put the ball under the sole of your foot. Gently move your foot back and forth. As you feel your foot loosening up you can gradually add more of your body weight to the ball, thereby increasing the stretch.

Calf Stretch (picture C): Stand facing a wall, with feet shoulder width apart and one foot in front of the other. Lean forward, keeping your back leg straight and your heel on the ground. You should feel a stretch in the middle of your calf. Perform 5-10 repetitions, holding for 30 seconds to 2 minutes each.

Calf Stretch (picture D): Stand facing a wall, with feet shoulder width apart and one foot in front of the other. Lean forward, slightly bending your back leg and keeping your heel on the ground. Bend until you feel a stretch in your lower calf. Perform 5-10 repetitions, holding for 30 seconds to 2 minutes each.

Four-way hip stretch: Your foot may benefit from loosening up your knee and hip joints:

Back of thigh (picture E1-E2): Lie on the floor on your back with your knee bent. Holding a belt with your right hand, loop it around the ball of your right foot and gently pull it toward you, feeling a stretch in the back of your right leg. Hold for 15 seconds to 2 minutes and repeat three times on each leg.

Inner thigh (picture F): Lie on the floor on your back with your legs bent. Holding a belt with your right hand, loop it around the ball of your right foot and gently pull it toward you and then straighten your left leg to the floor. Let your right leg gently fall out to the side until you feel a stretch in your inner thigh area. Hold for 15 seconds to 2 minutes and repeat three times on each leg.

Outer thigh (picture G): Lie on the floor on your back with your legs bent. Holding a belt with your right hand, loop it around the ball of your right foot and gently pull it toward you and then straighten your left leg to the floor. Let your right leg gently fall across your body until you feel a stretch in your right outer hip area. Your hip can come off the floor a little but do not twist your back and allow the hip to fully rotate. Hold for 15 seconds to 2 minutes and repeat
three times on each leg.

Front thigh (picture H): Lie on the floor on your stomach with your right leg bent. Holding a belt with your right hand, loop it around the top of your right foot and gently pull it over your shoulder until you feel a stretch in your right front thigh area. Hold for 15 seconds to 2 minutes and repeat three times on each leg.

3. Footwear and Orthotics:

Choosing supportive footwear is crucial for managing plantar fasciitis. Select shoes with good arch support, cushioning, and a firm heel counter. Avoid high heels and flat shoes lacking proper support. Additionally, consider using orthotic inserts or shoe inserts to provide additional support and distribute pressure evenly across your foot.

4. Night Splints:

If you are still not getting relief, you may want to try night splints. Night splints maintain the foot and ankle in a stretched position while you sleep, promoting proper alignment of the foot and calf muscles. This reduces morning pain and stiffness associated with plantar fasciitis. Consult with a healthcare professional like the ones at Northern Rehab to determine if night splints are suitable for you.

5. Massage (picture I):

Performing a cross friction massage to the affected area can stimulate healing, relieve pain, and improve blood circulation. You may want to do this after icing to decrease tenderness during massage. If you imagine a line from your heel to your toes, perform the massage from side to side across that line.

6. Gratitude:

As always, a proper mental focus on healing is an invaluable and often-overlooked tool. With Thanksgiving approaching, it would be great to incorporate gratitude into your healing strategy. Think of what a blessing it is to walk, run, work, and play. You would not have this problem if you could not walk. Focusing this way, releases powerful chemicals which can enhance and speed the overall healing process.

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Hope this helps Mike. We will be rooting for you. If you need any assistance do not hesitate to give us a call at 336-719-7129.