Healing the pain of plantar fasciitis Health Consultant

Healing the pain of plantar fasciitis

Are sore heels keeping you from your dancing shoes? The pain may be plantar fasciitis, an inflammation of the fibrous band that runs from heel to toe, along the bottom of your foot.

“Oh, there’s no mistaking plantar fasciitis,” runner Lindsay McLaren, 37, says.

“It’s a fairly sharp pain under the arch of the foot. In my case, it was close to the heel where the plantar fascia inserts at the back of the foot. And, of course, it was worse in the morning, or when I ran on it or stood for long periods of time.”

McLaren developed plantar fasciitis during the cold and icy winter of 2007. She began to run instead of bike to the University of Calgary, where she is a professor in the community health services department. The former national running team member figures she added too much mileage, bringing on the common, and painful, injury.

“As a typical runner, I thought it would get better on its own,” McLaren says.

The stab of morning pain is the body’s overnight repairs ripping, simply from the body’s weight on bare feet, says Gord Hobbins, owner of Gord’s Running Store. The ultramarathoner and coach sees customers every week with plantar fasciitis, referred by health care providers to buy supportive footwear.

Causes of plantar fasciitis include wearing bad shoes, gaining weight or adding extra mileage. And there are various standard treatments, which can be combined for better results.

McLaren saw a podiatrist, chiropractor, physiotherapist and sports medicine physician. Each therapy – a night splint, physiotherapy, orthotics and taking months off from running, walking and hiking – helped incrementally, but she fears the injury has become chronic.

Chiropractor Dr. Dale Macdonald, of Elite Sport Performance in Calgary, often uses active release massage on the plantar fascia – the physical manipulation breaks down scar tissue that has built up between layers of fascia.

He says research shows eccentric strengthening, or elongating the muscle, can help resolve repetitive strains such as plantar fasciitis. Exercises such as standing with toes on a stair and dropping the heel can also help.

Macdonald notes he no longer tapes feet, as studies based on soccer showed the tape’s integrity lasted only minutes. He also advocates avoiding or modifying the activity causing the problem until it is resolved.

A meta-analysis of research on plantar fasciitis conducted by University of Virginia researchers shows that using night splints or orthotics greatly reduces reported pain. The orthoticwearers also reported improved function.

And don’t ignore the cure that’s free, says Hobbins: time, or 12 weeks of eliminating barefoot activity. That means wearing runners or walking shoes at work, Birkenstocks or other supportive slippers around the house, and Crocs or other water-tolerant shoes in the shower.

“Think of it like a game of Snakes and Ladders,” Hobbins suggests. “The runners, the Birkenstocks, the Crocs – they’re like small ladders. The minute you step partial weight or full weight onto a bare foot, that is like stepping on a snake . . . (it) takes you back to Square 1.”

Look at your calendar for a little incentive.

“It’s 12 weeks to Christmas this weekend, so your reward for getting over the plantar fasciitis is to wear your fancy shoes at your New Year’s Eve party,” he suggests.

Non-surgical treatments

Night splint

Holds the foot in a neutral position. Provides a little more stability than the Strassburg sock. $60 to $135 at medical supply stores

The Strassburg sock

A support sock that holds the foot at a 90-degree angle and the toe up slightly to stretch the plantar fascia when worn, usually while sleeping. About $55 at running stores, medical supply stores, online at thesock.com

Custom orthotics

Custom-fit shoe inserts that provide heel and arch support, and correct foot function. Based on a plaster mould of the foot. $350 to $400 at podiatrists

Store-bought inserts

Can provide some arch support and cushioning, but don’t control foot function.

Approximately $40 at sports stores

Physiotherapy, Acupuncture

Various modes of physiotherapy break down scar tissue and reduce inflammation. Acupuncture stimulates circulation and can provide pain relief. $60 to $70 per treatment at physiotherapy clinics

Virtual Health Center