In this video I talk about common reasons for plantar fasciitis, how conventional medicine treats the problem, and how I address the foot pain with less invasive therapies, often leading to a faster recovery with significantly less chance of the pain returning.
Natural Injury Treatment & Prevention for the Athlete Within
Thanks for the VOD – this is great and easy to follow!!!
Hey Doc!
Thanks for your comment on toesalad.com. Wow, this video is such an eye opener. I’ve experienced all those problems, including “walking into” new problems with orthotics (which cost way too much.)
I tried poking around my calf muscles and they really hurt! I’ll be sure to massage those from now instead of doing crazy foot stretches (which again, havn’t helped at all) and see what happens. Thanks again!
Great, hope it helps. Let us know.
What’s your opinion on barefoot science insoles? fyi, I have flat feet on top of the PF.
I don’t think you should need any insole, or especially any foot orthotic. If you have flat feet when you are weight bearing and also non-weight bearing then most likely that is the way you have always been. But most people have a normal or at least somewhat of an arch non-weight bearing and then it collapses when they stand. This is because of the muscle weaknesses in the lower leg and foot, primarily the tibialis posterior muscle, which supports the main arch of the foot. So your flat feet and PF – 2 symptoms stemming from the same problem.
I think I know already, but what is your feeling about rolling the bottom of your foot on a tennis ball? Of all the things I’ve tried for my PF (orthotics, anti-inflamatories, stretches), it is the one thing that actually feels good. Feels like a massage. Would you argue it aggravates the PF? Also, when talking about minimal shoes, would any flat shoe without arch support be okay? I’m thinking Converse, dress flats, etc … shoes I can wear out in the world without looking like a crazy person. (Yes, I think the Vibram toe shoes are too ugly to wear in public, though I understand the reasoning.)
Yes, that is very good – the old style soda bottles shaped like an hour glass work well too as does a golf ball.
Yes, any flat shoe is fine. Before all the minimalist shoes came out in the past year or so, the Walmart-type and Converse were some of the few choices; now there are lots. Yeah, the Vibrams might not be right for an office meeting. Vibram makes a lot of nice dress shoes though too, not just Five Fingers.
I had what I believed to be PF a couple weeks back that started shortly after a long marathon training run. I had taken a few weeks off to alleviate some knee pain then jumped in for the 22 mile run without much build up to fill the gap. I didn’t have this professionally diagnosed but my mistreatment suggest PF.
One thing that I found worked for me was cold soda cans. My office keeps the fridge stocked, and so I started using them to roll my feet on. This made a big difference in the minimizing the pain. Do you have any more detail on using varied temperatures to aid in this manner?
While I did find that the soda cans help cut down the pain, they didn’t completely eliminate it. It wasn’t until the day before my marathon that anything did clear it away. I tried on a pair of compression socks at the expo. The vendor let me walk around the expo in one for ten minutes, and it made a world of difference. By the end of the day walking around in a pair I didn’t have any PF pain. What is your take on using compression socks and they affect the body?
Yeah, the cold cans do work and even better are the cold classic-style Coke bottles. I think you’re probably getting more benefit from the rolling than the cold.
I still think compression socks are more hype than benefit. The studies still are inclusive and those who tout how great they work are the pro athletes getting paid to wear them. Now in regards to the injury, they may have been supporting the muscle injury you were experiencing causing your PF type pain. If they help with recovery from an injury, then go for it. But right now I think their performance benefit is all placebo, especially for first-time users.
For someone who doesn’t believe in pills, there sure are a lot of pills behind you in your video.
Where do I say “I don’t believe in pills”? You perhaps mean medications? (Which I clearly state are necessary at certain times.) Those are many different types of vitamins, minerals, amino acids, herbs, and other products.
I started with left ankle and knee pain just over a year ago which has eased off but now I have plantar faciitis in my left foot and I am noticing pain in my right hip . Your advice re plantar faciitis makes so much sense and its the first time in all my research that I have resonated with the cause and treatment. Stretching has just not worked. I’m up for strenghtening with picking things up with my toes. And also, my job has been far more stressful than I can handle for far too long and I as am aiming to take a month off after next week – I feel that I am now on the right track.
Thankyou for your advice – it makes so much sense – at last.
Jeannette
Awesome Jeannette. Thanks!
Good information. I had felt like stretching my calves just didn’t seem quite right. Although, if I do a little flexing and stretching before I get out of bed, it makes it not so bad to stand.
I have been in a spinning class for over 2 years. When I spin I give it my all, so I am hitting my max heart rate often and 3 times a week. From what you’ve suggested, it sounds like that might be the source. When I poke at my calves, even lightly, I could scream bloody murder, so I’ll try your suggestions.
I am 5’8″ 122 lbs., which is as low as I feel I can go without getting too light headed. I don’t have any reason to have cellulite on my legs, but I’ve got quite a bit. My legs feel very fibery (when I “roll” my skin I could also scream bloody murder). I’m wondering what else might be going on and what I should do about it.
I use two cans of frozen black beans for my feet, about three times a day. The metal cans seems to transfer the cold well and it doesn’t get messy. It’s helping quite a bit. Also taking advil, but I sure would like to stay away from that. I feel like Im getting better, but how would I know if I’m taking a pain reliever.
Correct, all that anaerobic work will cause some major foot and lower leg imbalances resulting in the tight calves. Cold cans won’t fix that; just temporary pain reduction. If you take any pain relievers and feel better, then the fats in your body are out of balance – read here: http://sock-doc.com/2011/03/dietary-danger-partially-hydrogenated-trans-fats/
What you say makes sense. I have plantar fasciitis with heel spurs and orthotics. I think the cause is the muscle imbalances and stress from sitting at a desk all week for 24 years without regular exercise. The orthotics relieve the pain but it returns when they start to wear out, which seems to happen each time that I begin to get into a routine of walking every day. I think my feet are weak from sitting and wearing orthotics and I understand the need to strengthen them (and the rest of me) gradually. My question is regarding gait. There seems to be a lot on the internet about running barefoot with the forefoot or midfoot striking the ground first and you need to make a conscious effort at first. Do you need to consciously change how you walk when you begin to walk barefoot to avoid aggravating the plantar fasciitis or will a correct gait come naturally with time?
No, your body will naturally land midfoot or forefoot if the muscles are balanced and you’re wearing proper footwear. With an injury and weak muscles – which you will have from the orthotics – this may take some time. But you shouldn’t have to force a gait pattern. If you try to land your foot a certain way you will most likely create a new injury.
Hi, I watched your video with interest. I developed plantar fasciiitis for the first time a week or two ago and have been doing a fair amount of stretching as advised in so many other videos and articles. I can see your logic as to why this may be a problem and I’ll refrain from doing this from now on. The other advice that is regularly given is to ice the affected area – is this a good idea and will it help?
Also, regarding rolling on a tennis ball / golf ball / cola bottle or similar, is it best to avoid the actual area of pain itself (where the plantar fascia attaches to the heal bone)?
Many thanks
Alan
I don’t think ice helps as much as people think with any injury – other than numbing the area. Especially in a case of plantar fasciitis, there is very little inflammation, which is why some say it should be called plantar fasciosis. Either way, as you now know from watching the video it doesn’t matter what you call it, but how you got it.
Yes, it is best to stay off the area of pain. The trigger points – treatment area – is almost never where you’re experiencing the pain, but either in the bottom of the foot or more commonly in the tibialis posterior as I discuss in the video.
I’ve been dealing with persistent foot pain (heel, arch, both feet) for seven months. I had been running barefoot happily for 1.5 years, good form, and the pain began gradually and became quite severe until I got completely off my feet for several months. I’ve been working with a PT/Feldenkrais whose approach is pretty much like yours – exercising the foot and calf, massage of trigger points in the calf, overall leg strengthening. I’ve been thinking of this as PF but it doesn’t hurt more in the morning, my feet are not at all stiff or inflexible, I hardly ever sit – so it doesn’t behave like everything I read about PF. I’ve been working the program for five months now, tried a tiny bit of running – 200 yards – and the pain came roaring back. I’m frustrated and confused and would love to hear some input. Thanks.
Hi Mia – hard to say since you’ve tried the general advice I show in the videos. In the office I’m able to see exactly what muscles are not working correctly in the lower leg and foot, and address them each individually as they relate to your entire body. For example, your tib posterior may be inhibited but shows a need for a specific nutrient related to adrenal gland function, such as a B vitamin, while another lower leg muscle, say your gastroc, may improve by treating an old injury somewhere else in your body. I don’t prescribe “overall leg strengthening” because you actually can’t facilitate (turn on) inhibited muscles by exercising them. So in my practice I treat the patient, have them run, and see what muscles didn’t hold and why, and make appropriate corrections to typically someone is running pain free or at least with dramatically less pain in a day or two.
Your reply is very interesting, thank you. The “overall leg strengthening” was me, staying active on the bike, by the way, not a recommendation from the PT, who I think is on your wavelength. Since reading your article, I’ve stopped massaging my feet and have been really working the trigger points on the outer lower leg and the results are pretty dramatic. Interesting you mention B vitamins, I do take monthly B12 injections. The body is such a puzzle. Any thoughts of how I might proceed, or any practitioners in Portland, Oregon who you would recommend? Thanks very much.
Good to hear there Mia. If your results are dramatic you might not need any more help! I don’t know anyone in that area, sorry. For B vitamins the most common for lower leg and adrenal gland issues are actually B5 and B1. B1 – thiamine deficiency often results in burning feet during the day and/or having to get up at night to go to the bathroom.
Mia, I’m from Portland too. Have you seen Ray McClanahan: https://nwfootankle.com/? He is very much in line with Soc Docs philosophy. In fact he is the founder and creator of Correct Toes that Soc Doc has advertised. Look him up. He is great!
I am very interested in the minimalist approach and/or barefoot and have been for some time. However, after being diagnosed with PF in May 2011, I’m a little hesitant. Per the MRI, there is a small tear (more than just the microscopic tears that a majority of the population have). Despite all of the conventional methods that I’ve tried, the pain is still there, and I would assume that the tear is as well.
Will a PF tear heal on its own over time via the body’s own natural healing process i.e. scar tissue or is the only way to fix the tear with PF Release Surgery?
You make very interesting and logical points in your video. I have stopped stretching my PF before I get out of bed. I got rid of the orthotics within weeks of getting them because they really upset things.
What are your thoughts on stopping with the calf stretches and wearing the night splint?
I also assessed along my tibialis posterior muscle, and it’s was very,very tender all along the muscle. I plan to work on those trigger points and focus on strengthening my calves and foot muscles instead of stretching. I also need to take a look at my diet. As a mother of 2 small children, my stress level is usually high and I’m certain there’s a deficiency in my intake.
If you have any other thoughts or recommendations, please pass them along. Thank you for information and your time.
Hi Michelle. I have never seen a patient who I needed to send out to have release surgery. Once you have that done you’ll never be the same – it’s a lifelong sentence of weak plantar fascia, and if it does help with the pain it will either come back or you’ll end up with a new injury somewhere else.
I think calf stretches are terrible for any injury, especially PF. And I think the night splints are a even worse – why one would ever want to keep their already injured fascia lengthened and stretched during the night is beyond me.
Yes, stress and diet has a lot to do with it. If you get stuck and not getting any better we can talk or schedule something – under the Contact Tab.
Thank you for your quick response.
I’m not completely on board with having the release surgery for the reasons you mentioned but I am so determined to get back to running. It’s been 10 months of rest and conservative treatments (air cast, night splint, PT, cortisone injection, orthotics ) and I’ve made no progress! Will a PF tear heal on its own over time via the body’s own natural healing process? I don’t feel I have any other option but the surgery.
As far as diet, do you have any specific diet recommendations to help facilitate the healing process?
Also, if there’s anyone in the Pittsburgh area that you would recommend I see for my PF, please let me know.
Thanks, again.
Come see me or we can start by a phone consult on the phone if you’d like (look under the Contact form). No guarantees, but I’ve never not been able to resolve PF and get a person running again, often very quickly. Sorry I don’t know anyone in the Pittsburgh area. I rarely refer anymore unless I know a doc well. Most don’t figure out the source of the problem and actually do hands-on treatments anymore.
Diet – look at the Paleo Diet on this site.
Thank you so much for all of your comments and suggestions regarding my PF injury. I may be in contact with you in the near future for a phone consult. In the mean time, I will continue to follow the recommendations you have provided. I also wanted to mention that your website is fantastic. It’s a great resource and I’m so glad I stumbled upon it!
Hi! How often a day do you think I should work on the trigger point? Thank you
Two at the most. If the TGPT isn’t going away after a few days then there is something else provoking it.
Thank you for having a different method than what is actually common place on most PF sites. Your approach makes sense.
You suggest walking barefoot which I do most of the time.
However, I live in a house with concrete floors and have noticed that when I walk barefoot it actually hurts more than if I wear flip flops or similar shoes around the house. Any thoughts on why this would be? Does barefoot apply to any type of floor?
Thanks Sea, once your PF is healed and your foot is truly strong you will be able to stand on any surface all day long w/o pain or discomfort. Concrete – tile – stone – the harder the better when it comes to barefoot.
Hi Doc,
I was listening to your podcast on trail nation, and I really enjoy your philosophy on minimalist.
To make a long story short,
I run 3 to 5 ultra per year I eat well and I love running.
In September 2011 I was running a 100 miles, and after 50miles I started to feel a pain under the heel eventually I did stop. I went to the doctor got a scan and it was a partial tear of the fascia, also 13mm of thickness at one point on the fascia I think.
So I did it all started with Physiotherapy, then went on chock wave treatment very painful no results, then went to a podiatrice said that need a movable cast for 6 weeks plus 2 cortisone shots again very painful, now today still in pain same place plus atrophy on my Wright side.
I was in the wave on minimalist shoes last spring but I guess I was to aggressive with It, but I really enjoy running with the five fingers and have a couple of pair of minimalist shoes the inov-8 150 I think.
I need your opinion on what should I do, I started to do what is the video on your website, but what next should I just go barefoot and forget about all of the other treatment.
And what about the fascia can it totally tear.
And the pain that I have is it scar tissues can it tear again.
Please help doc.
Thank you
Thanks Christian. For some reason I remember answering this question before but if it wasn’t you then it was someone with almost the exact same problem and therapy history. Anyway, in any event, yes the fascia can definitely heal. It may take time and if everything is functioning correctly then it can happen rather quickly and you can still run (perhaps). Wear whatever shoes are comfortable for you right now whether that is minimalist, barefoot, or even something with a little support if you need it (transitional type shoe). Also address the other issues I discuss – PF is from too much stress in life – footwear, training, diet, work, etc…
Always welcome to come to NC and I will treat you.
I went for a 45 min easy pace this morning, after being off for 5 months
It feel really good, and I went with a brook st racer
I think it have a bit to much of a high heel but it is pretty flexible
In the midfoot.
Tomorrow I will try something with less heel pad.
I have to say I am in a bit of a pain, so it could be that
Something maybe in my running gait or even walking because
It feels the same pain have before.
Could it be nerve intrapment does it existe.
Sorry can’t give you a “diagnosis” on-line. That just wouldn’t be cool, or accurate. But remember that it doesn’t matter as much what you have, but why you have it. So sure a nerve could be entrapped but you still have to address the biomechanics.
I’m recovering from Breast cancer…. shortly after completing chemo & starting on a medication called arimidex, I developed plantar fasciitis, I’ve lost count of how many shots I’ve had in my feet, i’ve had ultra sounds (therapeutic) & taping etc… I’ve been being treated by a podiatrist for almost a year and my feet keep getting worse…. My dr. is now talking about surgery… I can’t go barefooted at all, because my feet hurt worse when I don’t have shoes on…. prior to this i was usually barefoot unless it was too cold or not appropriate for the situation…. I was off work for 9 months while being treated, I’ve been back to work since August. I would appreciate any advice you can give me!
Hi Tina, did you read the new post I just put up “Barefoot People = Healthy People”? It will really pertain to people such as yourself as you developed an injury in your foot due to poor health – immune system and hormonal problems. So everybody, such as your podiatrist, is treating just your symptoms, the plantar fasciitis. If you were my patient I’d be going through all the muscles of your feet to see which gets them working again; though some may be local points to treat a lot of it will have to do with getting your immune system and hormonal system (namely your adrenals) back on track. Make sure you’re getting plenty of sleep, aerobic exercise, and a very healthy diet, sorry I can’t give you any specific advice.
Hi Doc, well after a couple of weeks on working out my foot, it seems that the PF is just gone like the wind.
After a long series off ineffective treatments see previous posting with little or no result except more pain, then just did the basics like in the video and started to just take off my shoes when I can, home or office, the pain is just going away this is fantastic.
And I’ve been running with my inov minimalist shoes in the past week and it is getting better and better, the only thing that I notice is that my knees are just a bit more sensitive, but I was 6 weeks in the cast and had orthotics in my shoes so I try to switch from running to cycling.
Will maybe get a five fingers vibram shoes in a near future.
Thank you Doc for all the help
I wish they would be more professional like yourself that are aware of what the body really needs.
Great to hear! Thanks Christian.
Hi;
I just ordered heel gel seats to relieve my heel pain. Should I use these in my shoes for relief?
I can’t give you specific advice on what you should or shouldn’t do. But as you can probably tell from reading even just a bit of the Sock Doc site, I never use them in my patients. Sure they’ll help dampen the pain, but they definitely will not correct PF.
Hi. I am intrigued. Have had PF since January, doing stretches, and Strassbury sock X 1 week. I thinkI get it about strengthing rather than stretching, but what about in the meantime? Stretching at least provides some mild, temporary relief, without which I can’t stand the pain. Also, my cushioning shoes seem to be required for the same reason. I can’t walk in the morning without doing some stretches and foot circles. Also, I don’t seem to have the tender points on my calves. So, what does one do in the meantime to make walking bearable, if one is not stretching? Abd if not ice, what about hot compresses to help relax the tissue?
The more you stretch this problem the longer you’ll have PF. You say you don’t have any tender spots on your calves and although you may not, I’ll say that that is highly unlikely – you’re just not in the right area. After all – if you’re getting temporary relief with stretching then it’s precisely those muscles that have the trigger points in them.
Thank you for the reply. Am still wondering, though, what to do to help the pain, if stretching and icing are out. Would warm compresses help to relax the foot? And if I can’t find trigger points in the calf (and maybe I’m just missing them – I’m not a runner, and am new to all of this), what can I do? I’m really in a lot of pain, am walking (more like hobbling) as little as I can.
Thanks.
Find someone in your area who does deep muscle work; rolfing is great too.
Thanks for this site I had pf and went thru the regular routine which did not help. Weekly injections of vitamin B12 did but have a question as a younger I had a serious foot injury which damaged the nerves in that foot and I can not curl the big toe up, would this cause a case of PF? I was a athletic person in tract and basketball high jumping in both sports and a crazy walking fool for miles and miles. I train now with free weights upper and lower body. Improper form can cause injury with free weights and this holds true for any other form of exercise.
The past toe injury might make you more susceptible to PF, but it should not cause it.