Plantar Fasciitis: How Runners Can Learn How To Step Out of the Pain

Plantar fasciitis is a type of foot pain that occurs in the heel and sometimes in or around the arch of the foot as your plantar fascia is the thick connective tissue on the bottom of your foot. Symptoms are usually worse in the morning, and tend to ease off or go away as you walk throughout the day. The pain can be sharp over one specific point, or more diffuse throughout the fascia (sheath of muscle) of the foot. Today this is treated conventionally with “night splints” to help stretch the fascia, and reduce muscle contracture. It is not a very comfortable way to sleep and the therapy is about as beneficial and primitive as a caveman making a square wheel. As with most pain, anti-inflammatories are prescribed as are orthotics, which only support the dysfunction and weaken foot muscles. Here’s why you really get it, and really fix it .

Plantar fasciitis occurs most often from the fatigue of the tibialis posterior muscle. This muscle is behind your lower leg bone and supports the main arch of your foot. Problems arise from injury, lower leg dysfunction, and/or adrenal gland (hormonal) stress. Pretty much if you have plantar fasciitis you are under more stress than you can handle – whether that be from overtraining (too much anaerobic activity, or lack of an aerobic base), working too hard, dietary stress (too much sugar, not enough protein or nutrient-dense foods), emotional stress, or other physical trauma/stress – ANYWHERE in the body, not just in the foot. Even a poor fitting pair of shoes can cause this problem. The calf muscles are often involved as often are other leg muscles in the thigh and hip. The imbalance in the muscles causes the plantar fascia to tighten and spasm as it tries to support the foot. Addressing the reason for the muscle imbalances will address the plantar fasciitis problem, and the reason is not because you need to stretch it more, or didn’t stretch it enough. Often treatment involves dietary modifications, nutrient supplementation such as natural anti-inflammatories, exercise & training adjustments (more aerobic, less anaerobic), and local muscle therapies.

Here’s What You Should Do Instead if You Have Plantar Fasciitis:

– Rub out any muscle trigger points behind the shin bone all the way down to the Achilles Tendon

– Strengthen your foot muscles by walking barefoot as much as possible and trying to pick up small objects (like marbles) by crunching your toes

– Wear minimalist-type shoes with a wide toe box, low to zero-drop, and little support.

–You may need to ease into these if you’ve been in thick-heeled supportive shoes for a long time

– Do not stretch your calves, since this will only lengthen the injured muscle.

Check out the Sock Doc Plantar Fasciitis video here!

Comments

  1. Interesting Stuff. I’ve been cycling competitively for the last 4 or 5 years and decided to try minimalist running. I eased into it feeling better every day, then all of the sudden after back to back 5 mile runs I woke up with plantar fasciitis and bad shin splints that havr been bugging me for 3 months. After a couple days off the shin splints went away but the PF would not. I went to the podiatrist and of course it was orthotics and pills…didn’t really help and the orthotics made my shin splints immediately return after one 20 minute run! What I’m wondering is if there are any lower leg muscles that may have not developed as well as primary muscles such as quads and calves while cycling that need work. And if so, which exercises would be recommended? I’m currently taking some time off running to focus on some spring cycling events but will start running again in a couple of weeks. I’m thinking of wearing some shoes I’ve had good success with in the past that aren’t minimalist but offer only slight support/cushion. Also certainly won’t be using orthotics. I’ve never been a heel striker and I don’t need them. (Podiatrist maybe would have figured that out if he spent more than 5 minutes with me)

    Any suggestions? Thanks!

    • I don’t prescribe exercises to fix injuries because exercises don’t strengthen muscles that aren’t working correctly just as stretching doesn’t relax tight muscles. I would not worry about losing development in any leg muscles. Also you need to be careful with shoes that provide too much support or cushion because they aren’t going to effectively rehab your lower leg and foot muscles and may just contribute to more muscle inhibitions. If your feet hurt barefoot, then only wear shoes to temporarily ease the pain. Check out the new post Barefoot People = Healthy People if you haven’t yet. Remember PF means you’re under too much stress.

  2. Ryan Manahan says:

    I just watched your video on YouTube and what you’re saying makes a lot of sense to me. Ever since I got PF, I kept reading that stretching was the way to cure it, but always thought that seemed kind of backwards in thought. I’ve been doing the exercises for a few days now and already feel a noticeable difference.

    I have a question, though. What are you thoughts on Rest, Ice, Compression, and Elevation? Do you think that RICE is a good method to help deal with PF?

    Thanks

    • I see the Compression to help – which, if you’re specific, is much like working the trigger points – but NOT where the pain is felt.
      Ice and Elevation do nothing for PF.
      Rest – may help, but typically not much.

      • Dear Sock Doc: Would gentle running likely make plantar fascia pain worse, do you think, if the initial morning pain has faded by the time of the run? I ran the other day after experiencing sharp heel pain when I first woke up and it felt totally fine (zero pain) during and after a short 3 mile run, but hurt a lot the following morning, to the extent that I had difficulty walking most of the day. Not sure if it’s related? I don’t want to aggravate the problem, but hate not being able to run at all! (I’m a minimalist runner, and may have strained my plantar fascia due to a combination of some over zealous big toe exercises and muscle imbalances in the lateral lower leg brought on by a speedy run or two in fivefingers, I think.) Thanks for all the good advice!

        • It probably won’t make it worse. My experience with PF is that running/walking is only painful and does not delay healing.

  3. What do you think about Extracorporeal Shockwave Therapy for Plantar Fascitis? Can this help with chronic pain which has not responded to orthotics, steriods, physical therapy, night splints or even the Strassborge sock? I am at wits end and do not want to submit to surgery since there are too many problems it may cause afterwards.

    • I think it’s ridiculous. Just another conventional medical therapy to go along with all the others you mention.

      • I AM experiencing some relief from the Extracorporeal Shock Wave Therapy I had 5 days ago. So much better than surgery! I am also striving to strengthen the muscles in my feet and to work up to minimalist walking.

        • Better than surgery – yes; but still doesn’t address the problem – but you’re on your way to doing that now :)

      • Hi Sock Doc,

        I’ve been doing minimalist running for about 2 years now and it has eliminated 99% of all injuries I ever used to get while running. Evolution is a hell of a lot smarter than Dr Scholls.

        Two weeks ago I went on a rather long run the majority of it was running parallel to a slope. (probably not a great idea) I think this caused my IT band to become inflamed, which then caused me to reduce the length of my runs while it healed but I must have also subconsciously altered my gait as a result of that pain.

        The IT band is now healed. However now the arch has a slight pain in it now. Would it be harmful to continue to run despite the slight pain? Would the exercises in the Planar Fascitis video be applicable to my case?

        Thanks!

  4. cloggy62 says:

    Hello Sock Doc,

    It all started while walking the Camino, from sep to october. I had tendonitis in both legs. After rest it went but towards the end my right foot started aching, more than my left one. The arch was very tender the pain went towards my toe,pulling my foot outwards. The left foot wasn’t as bad.By changing shoes I was able to finish my 5 weeks of walking.
    Back in the UK Feb. 2012 The pain came back. WAs told it was plantar fasciitis and the first metatarsal had dropped on the right. Recommendations orthotic. Very expensive. After getting used to them for 9 weeks the pain has come back. I was told to do exercises but feel the feet are sore..I have just found your video and the leg are certainly tender and painful to touch . What else can you recommend, on top of the calf treatment?

    Kind regards
    cloggy62

    • So you’re in orthotics now? It took you 9 weeks not to “get used to them” but for your body to compensate and now you have other problems from there. As you know from reading my info on orthotics here, they’re not the way to go, especially for PF.

  5. Hi Sock Doc,

    I’ve been dealing with PF for the last 3 months or so, and off and on it has been better and been worse. Unfortunately, 4 days before my next marathon, it is worse and to the point I may not be able to run – my heel and arch hurts pretty severely when I try to run. I’ve tried conventional approaches – stretching, ice, a round of methylpred – all prescribed by a podiatrist – but not any better. Strangely enough, the best it has felt was about 3 weeks ago after running 29 miles. After about 4-5 days, though, the pain started to return.

    Any last ditch things to try that may help me be able to run in my race Sunday?

    Thanks for any advice!

    • Other than the recommendations in the video and the article, I don’t have specific advice for you. If you have PF because you’re overstressed/overtrained then the marathon will be the final nail in the coffin. So if you’re going to race, be prepared to bail if you’re hurting or else you could end up wasting your entire summer being injured.

  6. Ryan Manahan says:

    Hey!

    I just want to thank-you so much for this great article and the video accompanying it. In early April, I went to my doctor and he told me that I had PF and that I needed orthotics. Unfortunately (or possibly forunately) for me, I don’t have insurance and I already thought that the idea of them seemed to be more of a crutch than a solution.

    After deciding not to get OTC orthotics, I was looking for alternative remedies for PF and found your site. After just one month of doing the exercises and massages you do in your video, plus a few more I thought up myself, I was able to start running again and did a full marathon.

    Thanks for everything.

  7. I forget where but I think you said that walking barefoot is okay even if the pain is still there?

    Typically how long will your patients heal? I’m sure it’s case by case… But just curious.

    I’ve been wearing custom orthotics for about 5 years and have been glued to them ever since. I’ve been trying to ease my way out of them everyday, but am thinking of doing a cold turkey- do you think it’s a bad idea to just grin and bear the pain?

    Thanks again for an awesome website!

    • Depends on how bad the pain is.

      Cold turkey after 5 years orthotics? Probably a bad idea. Make sure you read this: http://sock-doc.com/2012/04/lose-your-shoes/

      My patients heal very quickly – but that’s what I do. I see patients who can’t walk w/o orthotics and have had foot pain for years (some their whole life) and they’re well over 75% pain-free sans orthotics on average after 2-3 visits; Sock Doc doesn’t screw around :)

  8. Hello Sock Doc,

    What would you recommend for Heel Spurs? Is it the same as Plantar Fascitis?
    What is your opinion on Shock Wave or ultrasound therapy for it?
    My mother can barely walk because of the heel spur pain and is considering the shock wave therapy, which is rather expensive where she lives.

    Thank you!!!

    • Heel spurs are more of an Achilles Tendonitis issue – so check out that vid: http://sock-doc.com/2011/03/achilles-tendonitis-video/

      Shockwave therapy is one of the craziest things I’ve seen lately. What a waste. Yeah, it helps some “break up the adhesions” but it sure doesn’t correct the problem or even address the tib posterior – which is the muscle involved in PF. PF is a foot SYMPTOM, never the cause.

  9. Your advice is right on. I tried stretching and orthotics for about 7 months. The stretching made it incredibly worse and only tore up my foot further! The orthotics were not helping and made it so I couldn’t even stand to walk barefoot. I figured out on my own that I had to gradually back off the orthotics (am now out of them) and stop stretching entirely. After taking this approach for about 5 straight months, I was considerably better. Unfortunately, I went on a 3 mile hike and over-did it. Now, I’m back to hurting again.

    What would you recommend in way of nutrition and stress (emotional) management? I know for a fact that my diet is not good (however, I am at a healthy weight for my height). I take one ALIVE multi-vitamin a day, but I most definitely do not eat enough protein. My diet is high in carbs, simple sugars, and caffeine. Which foods should I seek to increase/decrease in my diet? And how much of each food item should I aim to eat and how often? Which specific supplements would you recommend as anti-inflammatories, etc. to help me to heal more quickly?

    Thanks again for posting this information! You are right on target. More people need to hear what you’re saying.

  10. Sock Doc,

    I am so thrilled to find your website. I am recovering from posterior tibial tendinitis.
    I am an avid tennis player and wonder if you have a recommendation on tennis shoes?
    Thank you for your website!

  11. Hi!

    I am a runner and I was fine last summer/fall. I didn’t run very much this winter and when I started back up my feet started killing me. My left foot especially in the heal area. I went to the podiatrist that preformed my surgery I had in 2009. He said the tissue is torn in my left foot. He advised me to stretch as much as possible as well as not going barefoot. It hasn’t helped and I got back from running 5 miles and took my shoes off. When I walked across my tile I felt something rip in the bottom of my left foot near the heal. It has been exrusiating ever since. Ice and tennis shoes with arch support have helped with the pain. What would you suggest? I am getting pretty desperate to find solutions so I can get back to running on a regular basis.

    • He said your tore tissue and you should stretch it? Wow – pretty crazy to me. Check out the First Aid For Injuries here at SD and I’d recommend seeing a doc or therapist with a good understanding of how the foot and body are all inter-connected.

  12. Need help with my PF (left foot only). I have had it severe for about 2 years. Podiatrist took xrays and said that I have a bone spur. Had custom orthotics made. Tried icing it, wear night foot rest (arco), celebrex, steroid shots but no help with pain reduction. Got new balance 608 shoes. I am diabetic so need to work out everyday. Shifted from treadmill to elliptical machine or bike for 30 mins everyday.

  13. I started suffering from plantar fasciitis in my left foot 15 months ago. It all started when I ditched my Rainbow flip flops for a “cuter” summer shoe with a bit of a heel. Prior to this, I was generally barefoot or in my Rainbows and only wore sneakers for exercise and NEVER had foot problems. I even wore my Rainbows and went barefoot throughout a pregnancy with twins where I gained 80 lbs and had not one foot issue!

    But by the end of the summer in those”cute” shoes and wearing my sneakers more and more due to pain, I got out of bed one morning and literally could not walk on my left foot. Having no clue what I had, I sought out the help of a podiatrist. Diagnosed with PF, I was prescribed the same things many have listed here; NSAID’s, ice, stretches, custom orthotics, “don’t take one step out of your running shoes” aka never, ever go barefoot, night splint, 2 cortisone shots, physical therapy,soft cast boot for 6weeks and I followed all advice to a T because I was desperate to feel better. But even with my best effort, you can guess, I still had PF. It got so bad, the Dr. ordered a MRI (12 months after initial diagnosis) to reconfirm diagnosis and to rule out a tumor etc. MRI reconfirmed a simple case of PF, thickening of the fascia and some minor inflammation. Nothing too dramatic!!!

    Depressed and frustrated with the pain and the fact that conventional wisdom failed, I got a new pair of Rainbows (what do I have to loose?) and decided to go barefoot in the grass yesterday because I just mentally needed to feel something with my feet again. Something amazing happened, by being barefoot and walking in the grass I noticed immediate relief! I was shocked. My foot hasn’t felt this good in a long time. That is what brought me to your site. A google search on “walking barefoot to help plantar fasciitis” sent me to a message board where someone listed your website. Thank you for the information you have listed here. In my gut, I just knew being in orthotics/sneakers all the time just couldn’t be right. I went out this morning for another “walk in the grass” session and am happy to say it feels even better. So I’m going back to barefoot and Rainbows. I’ll keep you posted on how it progresses! Thank you again!!!

  14. Hi Soc Doc, thanks for your article. And the site in general. Great fresh perspective!

    I am a barefoot tennis player5/days wk. use stem footwear which i love. Have been in only barefoot shoes w correct toes for over a year now. I follow a paleo diet.. no sugar no grains except a little rice now and hen. I have developed PF his last summer and am not sure what else I can do about it. I would have assumed the barefoot running/lifestyle I do would have protected me. I do have a history of a stress fracture which is healed on the same leg that the pain is worse in. The SF was from 1 year ago and I took the 8 weeks off and have done strength training in that leg to try and recover. It does not still hurt though I can feel the bump where it was when I do the trigger massage.

    I have been doing the massage and though I have no pain at the trigger points, the pain returns after tough matches. The massage helped considerably initially, but since I have returned to tough match play, the pain has returned also. I have been told I have very tight calf muscles… But I am not stretching them. Do you have any thoughts or suggestions?

    • I’ll give you a few thoughts here Amy:
      1) you should not have “tight” muscles anywhere. If you do, then there is an imbalance. You should be able to squeeze your calves and have no pain.
      2) if you pain is returning with high intensity activity then the PF is most likely related to anaerobic excess. Check out the SD Training Principles.
      3) as I often say to people – “Sometimes you just gotta be treated by a doc or therapist who looks at the entire body from a structural, nutritional, and emotional perspective and understands how everything is interrelated and attributing to a health issue or injury.” Although there’s not a lot of “us” out there, that’s your best bet. A good doc will be able to get you back in a very short period of time and if not, at least explain why it may take longer.

  15. Stanley Cohen says:

    Hello Sock Doc.

    What good furtune to have found this site. I have drop foot from a ruptured disc (L4/L5) which I had spinal fusion surgery for. I am basically pain free now but have numbness below my knee to my toes in my right leg. About a year after surgery I started to run again and used the five finger shoes. They were the best to walk in after surgery. In August I ran 4 miles and the next day my heel hurt terribly. All the symtoms indicate that I have PF. I haven’t worn the five finger shoes since the pain started because of all I read. I have been doing mild streches with little results. I just came in contact with you web site and am impressed. I will wear the five finger shoes tomorrow to work (school teacher) and the massage and exercises you teach in the video. Question – Will running be beneficial or not? How much? Do you have any advice about the drop foot? They tell me it is caused by damage to the nerve root in the spine that control the muscles that lift the foot up. That muscle it extremely weak, yet is still getting stronger. Anything that could help or words of encuragement would help.

    Thanks, Stan

    • Running will depend on if it is causing your pain and/or your problem to get worse. If it is, then you should stick with walking until you’re able to run. If the foot drop is from the L4/5 problem then that may be permanent from the surgery – your orthopedic doc or surgeon should be able to help you out there. But if you’re getting stronger then you still might have some connection there, and perhaps a chiropractor can help you out.

  16. I’m a mid-40s former couch potato, currently running in VFFs.

    In Oct. 2011 I ran a 1:53 half marathon, which was a total surprise to everyone, given that I usually run around 9:30/mile pace and my 5K pr was over 26 minutes at the time. Right after that, I developed a stress fracture in my lower fibula, which I’m guessing happened because I was trying to re-create that HM pace in all of my subsequent practice runs. I had to take 8 weeks off with the SF, and then starting in mid-February, I worked back up to around 100-120 miles per month, which I reached around April. However, starting in June I started having an increasing amount of pain in between runs. Definitely by August I was having a lot of chronic arch pain, pain on push-off, inability to do a calf raise without pain, having trouble standing up after long periods of sitting down, and having trouble walking down stairs (an inability to support my weight on my forefoot). So I cut back my mileage by a lot in August by taking between 3 and 5 days off in between runs, waiting for everything to heal. I would never have what I would call “pain” during running, just a little soreness during the first mile… and then the following morning, I wouldn’t be able to get down the stairs. At the end of September I started having specific pain in my R ankle that wouldn’t go away, so I went to my Dr. about a month ago and completely stopped running. My primary Dr. said maybe my achilles was partially torn. He sent me to an Orthopedist, who said nothing was wrong, he sent me for an MRI and then to *another* Orthopedist. Waiting for a diagnosis, I haven’t run at all since the beginning of October, so naturally everythng should be healing. The second Orthopedist (yesterday) finally looked at the MRI from Oct 27 and gave me a diagnosis – plantar fasciitis. Then he went on to tell me that all of my pain is caused by poor running mechanics, and running in shoes with no arch support. (He didn’t actually see me run or walk, and he didn’t see anything wrong with my foot, he just reacted when I told him that I ran in VFFs and often run in no shoes at all on my treadmill.) He said that I needed to work with a running coach who would train me to “run correctly”, he specifically said that by “correctly” he meant “on your heels” and he said that if I started running in “conventional shoes”, I could run without pain immediately.

    I asked him how he knew this was NOT an overuse injury, e.g. coming back too fast from my last injury, or maybe (as I had been suspecting) related to my somehow botching my self-treatment attempts all through August and September (too much ice for too long? is an hour of ice bad? I read recently about how that can cause nerve damage… ) His response was, “You had a stress fracture (last January), and now you have PF. So that means you’re running incorrectly. And like all runners, you’re beginning to break down because of your age. You need to get in supportive shoes. End of story.”

    So… He said he sees a “huge number of people” with PF resulting from running in minimalist shoes. He didn’t say these people represent a large percentage of ALL of the people running in minimalist shoes – I’m sure he only sees the injured ones! But clearly he’s made up his mind that they’re dangerous.

    My main priority is simply to run again. I want to get back into my VFFs eventually, but more importantly, I want the chronic pain to be over and I want to run again. If I were to give conventional running shoes a try (just until my plantar fascia are healed) which ones should I use? He made absolutely no suggestions. Just, “conventional” and “get your heels down”… I just want to heal and get on the road again. What should I do? Thanks for any and all information.

    • Overall people need to realize that orthopedic surgeons don’t know much about human physiology in a functional sense, they know nothing about movement and training, and they know nothing about how different parts of the body interact with one another. Sure there are exceptions, but overall they’re great when you need surgery (well hopefully they are). You point to the injury – they look at it. They diagnose the injury, not how you got it. They think injuries happen because of age or lack of support. They think they know how you got injured so they tell you not to do something anymore rather than teach you how to properly do it. Yeah – minimalist shoes are dangerous. They’re as dangerous as your bare feet.

      So what should you do? Find someone who knows a whole lot more than the doc you just saw and try some of the many things I discuss on this site regarding training, injury treatment, diet, etc.

      • Thanks for your response! I went for a short run yesterday in “conventional, supportive running shoes”, as suggested by the Ortho I mentioned in my post. Today I’m still limping from that, with pain in my ankle, having a lot of trouble with stairs… Clearly there’s more going on than just the PF.

        Obviously I would love to find a more effective doctor and get an accurate diagnosis; the icing on the cake would be if I could then follow up by seeing a knowledgeable PT and running coach. I’m in eastern Massachusetts. Is there a list of local practitioners whom you’d recommend?

  17. Hello Sock Doc,

    I need some help/insight into my PF issues, if you would be so kind. I started running about 2 years ago, after deciding that I really need to lose weight. When I initally started, I was wearing regular (horrible) running shoes and they did work well for a while. I did have PF pain when I first started running (probably due to being overweight and stressing my body out by running) and that, coupled with another random foot injury (most likely) caused by my running shoes, caused me to do research into minimalist running. This is because when I injured my foot, I found that walking barefoot or in zero drop shoes, was the only way my foot did not hurt.

    So, I started wearing minimalist shoes about 14 months ago. I worked up my distances slowly and even did my first half marathon in March. I wear zero drop shoes for all other aspects of my life as well, not just running.

    So, here is where I find this whole PF thing odd. The more I run, the less pronounced the PF becomes. As in, when I was running 3 miles or so 3-4 times a week and then doing a longer run (5-8 miles) once a week, my PF almost went away completely. Oh, I should also point out that my PF does not hurt when I run, only walk. But then I dropped off in my running for a while and would run less. Then, i played soccer (recreational) one day and then next, BAM! PF was back in full force. Ever since then, I have been back to running 3 miles about 3-4 times a week (but no long runs yet) and, again, my PF does not bother me when I run, but it has been horrible all other times (well, especially in the morning).

    So, what do I do? Just try to get back to my normal routine of short runs/longer run since that made it go away before? Why is it so bad now? It just makes no sense!

    Oh, I should also add that I have lost 67 pounds since I started running, but still have about 27 lbs to go.

    Any advice/insight? Thanks!

    • That’s a bit unique but not uncommon. PF is typically worse after rest (waking up in the morning) and better with activity – such as running – though usually not better and better the more someone runs, as yours has been. But you’re running on a weak tibialis posterior muscle as I discuss in the video – so you need to find the trigger points and work them out (have you done this faithfully yet?), and follow the aerobic conditioning and dietary advice for injuries I discuss in the First Aid Series and Training Principle Series.

  18. Dear Sock Doc. I am so very grateful for your website! While I’m not a real athlete yet (or again, yet) I am a paleo lifestyle enthusiast, who has been struggling with PF since May of this year. I’ve had physical therapy, custom orthotics and a cortisone shot which all got me basically back to where I was with the initial flare (but minus some serious dollars). I found your video on PF through a paleo site reference and have been faithfully working the trigger points and scrunching towels/picking up marbles for only 3 days, but feel better than I have in months. I’m wondering if running (I’m heavier than I should be and afraid to aggravate my feet) will help or hinder my progress at this point. How often should I be working the trigger points and doing the scrunching exercises. Also, is pain the right guide for when I need to put shoes back on if I’m trying to up my barefoot time? If/when I do go back to running, should I begin with my old running shoes but without the orthotic? What about my old running shoes without any footbed, will that help me progress toward barefoot type shoes? I respect your work and your willingness to go against the grain (so to speak) in the medical community in order to get this information out and to help people. Your site is grand! Makes me want to run, run, run!

  19. Hi Sock Doc
    I have Plantar Faciitis and Achilles Tendonitis in my right foot. 15 years ago i badly sprained my right ankle twice and spent some time on crutches followed by a course of acupuncture. Just over a year ago I bought some arch support insoles from the pharmacy as my arch was aching. Now I developed the above mentioned conditions.
    I saw a doctor who told me to stretch and wear supportive footwear so I went and bought some walking shoes for day to day use (I normally wear flat Vans).
    I went to see a physio therapist and most of what he told me is inline with what you say. He told me to transition back to my vans footwear without orthotics. He thinks my problems occured from having a stiff ankle he gave me a deep massage and cracked my ankle and the following day I could walk a lot easier. On my second visit he located a trigger point in my calf and massaged it out as well as massaging the Plantar fascia.
    He gave me some exercises to do. the first is putting my foot on the opposite leg pulling my toes upwards and massaging the plantar fascia for 5 minutes each day.
    The second is to stand on a step with both feet, raise up unto my toes and then slowly lower back down on just my right foot. 3 sets of 15 reps increasing as I feel an improvement.
    The 3rd is to stand against a surface (wall. kitchen counter. desk etc) with my right foot in front of the left, and bend my right knee to touch the surface, then slide my foot further back and do it again, once I have found the position that is my limit hold it for 30 seconds. This one I do 5 times twice daily. I am not sure if this is for the Plantaar fascia or to increase the range of motion in my ankle (I will ask)

    I was wondering what you thought of these exercises?

    I have also been seeing an acupuncturist. I have had 3 sessions so far but its hard to say how much it is helping, he also gives me a massage before the acupuncture which seems to help. What are your thoughts on acupuncture?

    I have been doing lots of research and some websites say castor oil helps, do you have any experience of this?

    Your website has great information and you really seem to know what you are talking about, I would appreciate it if you could share your thoughts on the above.

    Thanks
    Steve

    • I’m not a fan of those exercises; I don’t think they work and you’re essentially stretching, which only delays healing.

      I like acupuncture – for some it works, some not. Depends what is causing the problem. Typically a good acupuncturist will help with overall health regardless.

      I don’t have experience with castor oil for injuries. I use it for other reasons.

  20. Sock Doc,

    I used your hot spot techniques for PF and found some. When I played around with them i fent a tingling sensation in the affected foots arch. Is that normal?

    Best,

    Brian

    • Well not very common. That would be the tibial nerve in the back of your calf that you may be hitting and that then becomes the medial and lateral planar nerves in the feet. So maybe that’s what you’re feeling. No need to irritate the nerve like that – so stay off it.

  21. I went to the podiatrist and was diagnosed with PF on my right foot. It hurts all of the time. I have the boot orthotics and a Bledsoe pfs thing which goes around my ankle and around my foot. It has not helped at all. I feel no trigger points causing it. I was wearing Sketcher Shape Ups so I quit wearing them. It hurts more when I sit in certain positions. Am thinking of getting ASTYM again. Would that help? It hurts more barefoot too.

  22. Are there any Adidas shoes you would recommend?

    • If they’re firm, flat, flexible, and have a wide toe box that’s what I’d recommend depending on your foot and overall health.

  23. Hey Sock Doc,

    I’ve been searching your site for a good article on posterior tibial tendonitis, but haven’t found anything substantial. You refer to the tendon often, but mostly as an afterthought for PF and the like. I have high arches and am currently suffering from PTT–and have been for months (end of May 2012). I stopped running pretty soon after and haven’t been running since. My podiatrist recommended that I get orthotics and start wearing shoes (I almost always was barefoot). I respectfully declined and hoped rest would do the trick. Not so. I now have capsulitis on my second metatarsal head on my right foot and am feeling the beginnings of the same in the left. I am now wearing shoes ALL the time as that is the only thing to cushion my foot enough to make it bearable to walk. I’ve made appointment for physical therapy in the coming weeks and now have just received orthotics as a “I’ll try anything to stop this ridiculous pain from getting worse.” I had my third baby last year and started playing soccer and running too soon, too fast shortly after.

    So, I now don’t know what to do, as I tried the barefoot thing and it didn’t help. I watched your video on PF as you suggested to somebody else, and though I’ve felt irritation there, that is not my main issue. My right posterior tendon seems to have knots in it. I’ve been rubbing that–just on the inside of my shin….sooo, now what? Do I do PT? Do I wear the orthotics just until my capsulitis chills out? It certainly came up as a result of how I was walking to not further injure my PT.

    I’m open to anything. I know you can’t precisely diagnose me over the internet, but what are my best bets. I’m not sold on the credibility of orthotics beings needed for always, but maybe just in the acute phase of my capsulitis? I’ve had it for about a month, maybe longer.

    HELP!!!

    Thanks!

  24. Dear Doc, I love your style and approach, it is so very different from everything else I have heard so I’m very grateful for your willingness to share your knowledge and much of what you say resonates with me intuitively…you seem to really care about holisitc health, something that is hard to find in a health specialist it seems. Thank you so very, very much!

    So, I believe I have the dreaded PF. I am a hotel spa director and all last year we were short staffed so I ended up doing countless hours of massage (barefoot) on guests and I think the strain of that is what set me on this path. I figured out what it was about a month ago and began self-treatment then as well…I still have to work so I was in a panic to heal the pain and not re-injure/tear my feet. I ordered all the usual things…arch supports in shoes, gel inserts, and night splints…I will say that my feet feel much better in the morning after using the splints…but the inserts seemed too stiff for me and now I will take them out thanks to your great advice. I also tried stretching but that seemed to make it worse…just like you say it will!

    I started massaging my lower legs and wearing supportive shoes while giving massage instead of going barefoot…is this wrong? What do you suggest? I ordered a “stick” and can’t wait to use it since I understand the trigger point theory and have felt some relief after using some of your advice in that area. I know each person is different, but how long until I feel better and can work without fear of re-injury?

    …one more thing Doc….can you suggest some proper body mechanics while I give massage? I am thinking that I am doing something wrong to over stretch my feet and legs as I often have to use my lower body to lean in for deep-tissue pressure when I do bodywork…sorry, should have included this with my last note. Thank you!

    A new fan!
    -Kay

  25. Sock doc, what are your thoughts on a heel spur, would they require the same treatment as PF?

  26. Soc Doc,
    I began running last summer as a member of my high school cross country team. My first shoes were a pair of minamalist New Balance. My theory was that I hadn’t run regularly before, so my feet weren’t used to supportive shoes. Plus I am a ballet dancer so my feet should be strong. I got through the season with a few sore spots but nothing horrible.

    I took a break from running for about a month to let a lingering injury in my ankle heal (stress fracture?). It did, but as I started running again I began experiencing a tight, cramp-like feeling in the muscles under my arch. It happened in both feet, but the right especially. The pain has been building since Christmas. Now, I get cramping on the outside edge of my feet as well as the arch. Sometimes I get a stinging sensation just behind the ball of the foot. (imagine a fraying bungee cord) It starts to hurt after about 2 laps on the track, long hikes and cross country skiing. Basically anything with a repetitive running-like motion.

    So I went to the physical therapist. She said I absorb a lot of the force from running in my feet. I also have a collapsed arch in my right foot. My calves are strong but really tight. My feet are strong in a point but weak flexing and side to side. She gave my calf streches, which I have been doing regularly and seem to help. She also gave me exercises with a band to strenghen the weak areas. She also taped from the bottom of the foot to the top to pull up my first metatarsal.

    What can I do to correct the collapsed arch and how much of a problem is it? if the stretching seems to be helping what do you think? Is this PF? I have a pair of 4mm drop Saucony’s as well as my New Balance shoes. Which pair would you recommend I run in and are there any day to day shoes you would recommend? Do you have any other suggestions?

    Thank you. I appreciate all the time you put into this site. It is a nice change from the usual advice.
    LN

  27. thank you for your reply.
    I have been working my trigger points and will add the exercises you recommend to the ones my therapist gave me. Do you have any exercises to improve ankle stability?

    I read your article about arches, but I’m still a little skeptical. If my arch is collapsed in one foot but not the other one isn’t it going to cause a gait imbalance? (I read your gait article as well) It would be very helpful if you could post a slow motion video of someone with proper gait.

    I read all your articles on stretching and I’m still confused. How can I lengthen my calves without stretching? What hapens within the muscles when you stretch?
    thank you
    LN

  28. Wow, I loved your you tube video, so informative, I went to the Podiatrist yesterday and usually walk barefoot around the house or in thongs and the podiatrist has says to get in supportive shoes for my plantar fasciitis, now i am really confused. I have the trigger points in my leg, so tender so rubbing them. I have a collapsed arch where the bone sticks out, just wondering if you are able to give any advice? Thank you so much.

    • My advice is what I share in the video, of course opposite of what you’ve been told. So it’s now up to you to decide what works best for you. :)

      • Thank you so much for you quick response, so much gratitude and appreciation, it all makes complete sense in what you share in the video, I thought to myself when the podiatrist said I need to be in supportive shoes all the time, what about our ancestors, they weren’t walking around in shoes and their feet were fine!! I am going back to barefeet, thank you again and I just love your website!!

  29. Hi Sock dock,

    I developed a strange case of nerve impingement along the first metatarsal/big toe. I went to many podiatrists and we went down the list cancelling off things like sesamoiditis, sesamoid stress fracture, arthirtis, gout, tendonitis, etc. I got put into a removable cast for 3 months, nothing changed, the pain was so bad I was scared to even bend my toe up. After 8 months of not walking at all, I got an MRI and then was referred to a nerve specialist to finally diagnose a neuroma of the plantar proper digital nerve a.k.a Joplin’s Neuroma. I got a prescription of Lyrica and a referral to an orthopedic surgeon (who I haven’t seen yet).

    Since the pain has subsided a little bit, I been trying to walk again slowly progressing. I been doing anywhere from 250-400 steps a day and developed plantar fasciatis after a week. I have intermittent pain in tibialis posterior and fibularis longus/brevis, but they are not tendonitis, they go away after a day or two.

    I only walk barefoot, and the shoes I have are made by a small company in the USA called softstarshoes, they make only zero drop, minimalist shoes. From reading your responses to other people, plantar fasciaitis is caused by over stressing, and in my case that was only about 250-400 steps a day, since I have been inactive for such an extended period of time. I just had some questions:

    1. I have altered the speed of my gait, so that I am not pushing off too aggressively, this has reduced pain, is this the correct thing to do, or should I be walking full speed regardless if it hurts?

    2. How long do you think it will take me to strengthen the plantar fascia and my lower leg muscles so that I can walk without pain again?

    3. I stretch the plantar fascia for 10 seconds, 2 reps , 3 times daily, and I use a night splint. Should I stop doing these?

    Thank you :)

  30. Hi Sock Doc,

    I’ve made many mistakes with my feet this past year! I went from Nike Frees to orthotics to stability shoes to zero drop this past year. I ran 6M first run out with the Altra Zero Drops 5 weeks ago because they felt amazing! I’ve been dealing with arch pain intermittently since then but continue to wear the zero drops. I’ve alternated with my other shoes with no success. I have a few races coming up in the next month. My pedorthist says I have PF and wants me to go with orthotics or stability shoes. I don’t want to. I just started doing the strengthening exercises on here. Would it be okay to run a 10M and a half soon in the zero drops or am I causing further injury? What can I do?

  31. Do you mind if I quote a small number of your blog posts as long as I provide credit and sources back to your weblog:
    http://sock-doc.com/2011/03/plantar-fasciitis/. I am going to aslo make sure to give you the proper anchor-text hyperlink
    using your website title: Plantar Fasciitis:
    Heel Pain | Foot Pain | Running Injury. Please let me know
    if this is ok with you. With thanks

  32. My feet are killing me! I bought ortho shoes to keep my feet from turning inward, and making me knock-kneed…my feet hurt before and stil hurt now. I have plantars fasciitis, and made an appt for next month. Wha do I do in the meantime? I need my job.

  33. Elizabeth says:

    Dear Sock Doc – I just started running about 7 weeks ago and started a running 101 class through the local running store. Sadly 2 days ago three classes into the running class I began suffering from heel pain and it appears to be plantar fasciitis. I just found your website and will begin following the advise given on your website (and video). Three questions: 1) Should I stop running for a while? 2) If so, what cross training do you believe will help (yoga, biking, swimming, etc.)? 3) I just purchased some compression socks, do you recommend wearing them during the day?
    Thanks so much!

  34. PF started 8 months ago with a new Nike Cross Trainer to prevent over-pronation from highly recommended running store that uses a video and treadmill to select a shoe. After 1 month of “trying” the shoe went to podiatrist and had cortisone shot and a huge night splint. Pain returned in one week. Had MRI showed PF only. Started PT- alot of stretching exercises 2 separate Six week sessions due to insurance pending. 2 more cortisone shots and a day brace. Oh ya and the orthotics were sent back to the lab 4 times. Dr put a lift in the left orthotic due to right leg being longer. This has been from October 2022 till June 2013 and now I will try working out the lumps I feel as you said along calf, foam rolling if necessary and tomorrow will take out orthotics I just had them back two days and will try barefoot. Anything else you could suggest I can perform normal activities( no workouts or exercise) such as walking for maybe 1-1/2 hours on weekends then the rest of my day is excruciating. I do SIT all day at work/desk. Thank you and will post future success!

  35. I did some calf raises. Next day or maybe it was the same day I noticed tenderness in my calf at the inner/upper area and the lower calf. I’m thinking it might’ve been a minor strain? Arch pain always goes away a day after jogging, but I noticed the minor arch annoyance lingering ever since the calf raises. It’s been a week since I did them. I haven’t done any jogging or hard cycling since then. I feel it more in the calves cycling in the upper/inner area than when I did a few second jog. When I did them I did full range of motion and strong contractions at the top. Maybe I overdid it on the contractions. I only did three sets of 10. I now think my arch pain stems from my calves. I’ve had this arch pain for a few years. I did some searching, and a lot of people experience arch pain from calf exercises. I finished C25K last week, and I’ve been using minimalist shoes. I’ve only experienced Achilles issues towards the later weeks, but it’s only a minor annoyance so far. So far I’ve taken a week off. So should I massage the tender parts of the calf?

  36. Allison says:

    I just wanted to post a follow up to my comment 9 months ago. After following your advice, my foot completely healed from PF in 5 months! Considering all the nonsense (and $) I went through during the 15 months under the care of my Podiatrist, this was like a miracle.

    During the 5 months when my foot and body were healing, if I felt pain in my foot, I would massage the calf and do the strengthening exercises as shown in the video and there would be immediate relief. It didn’t heal over night but I stuck with it and it worked. I am so grateful to have the PF behind me! THANK YOU

    THANK YOU!!!

  37. Dear Doc Sock, My first time checking for trigger points I easily found lumps along side of shin and applied pressure in hopes to relieve PF. The next day I had about 5 bruises from knee to ankle. So now I know I over did it but how long should I wait before trying massage therapy again?

  38. There is no evidence from the literature that massaging does anything other than it might feel good to do it, just like stretching which is commonly prescribed. Massaging won’t speed up healing, or fix your PF.

  39. Hello! I am so glad I found your article. I am dealing with a bad /unusual case of plantar fasciitis. I don’t and never have had the pain in the morning. I went to PT and got graston and did a ton of calf stretching all of which made it a lot worse. I got a cortisone shot which did nothing and made it worse for a few days. It never masked the pain. I took Advil and methylprednisolone which did nothing. I’ve iced my foot. My foot got really tight through PT but I stretched it out again and am able to wear a night splint. This doesn’t seem to do anything because I don’t have pain in the morning. I have more pain as I stand for two or more hours. I cannot wear shoes that tie bc they feel as if they squich my toes. I can wear one pair of shoes, a clog. I have had this for about nine months and it has been flared up for four months. I used to run and developed this due to higher mileage . I don’t run, hardly walk and hardly stand. I can’t bike and sometimes feel it in my arch when I swim. Imy hormones are imbalanced due to low weight and exercise. I’m not sure if this has affect on it. I’m recommended for surgery as I’ve tried just about everything. I don’t know what to do. What nutrients would you recommend and what would you recommend I try? I have also tried acupuncture which made my heel sore.

  40. I had my first bad bout with PF about 10 years ago in my right foot. I had a bad bout in my left foot about 5 years ago, but got a cort injection and it cleared it up quite fast. I now occassionally have foot pain, but its not too bad. However, my right ankle has basically been swollen since that first bout of PF (that’s right, swollen, to a greater or lesser extent, for 10 years). Is there anything I can do about that?
    Thanks,
    Bonnie