Heal the Heel: Plantar Fasciitis

This post is brought to you by Cole Haan dress shoes. No, not really. On my last visit to the big apple I only packed my smelly gym shoes and my (handsome) taupe Cole Haan oxfords. First off, the energy of New York City is both overwhelming and infectious. Infectious enough that you find yourself walking countless miles, spending ungodly amounts of money on food, being engulfed in every culture, looking up and around at world renound art and architecture, but most importantly you forget to protect simple human anatomy. In my case it was my right foot.

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Over a long weekend in Manhattan, I walked 20 miles in those Cole Haan oxfords, which has me currently nursing a very painful heel. This pain is known as plantar fasciitis: inflammation, tear, or strain of a thick band of tissue that connects the heel bone to the toes best understood by the image below.

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If you've never had plantar fasciitis, you're probably thinking "shut up, Jacob, quit complaining". But let me tell you, this shit is painful, albeit quite common.

About 10% of the population will suffer from plantar fasciitis. The good news is 90% of the time it's treatable by simple in-home methods [2]. Note: It appears experts highly discourage against getting surgery especially if you're in decent shape.

Why It Happens?

The plantar fascia is a tissue along the arch of the bottom of your foot encompassing all tendons and helps to distribute forces across your foot you walk, run, or any time you're upright. Over time and over use can cause your plantar fascia to tear in what's known as plantar fasciitis. Most of the time the pain is in the area circled in red above located in the inner heel. 

All Pain No Gain

This occurs for multiple reasons that you hear from the doc. 

You're lazy, fat, or sedentary causing your feet to become weak. You wear overprotective and over-supportive shoes not letting your feet handle normal barefoot walking or the opposite. You may have high arches or flat feet.

OR

Lastly, it could originate, like me, from shitty-hard-sole shoes AND leg muscle tightness AND insufficient nutrition AND overuse from a drastic increase in walking and running. Yes, even your athletic endeavors can cause plantar fasciitis leading to all pain and no gains! 

All these variables can irritate plantar fascia tissue on the sole of your foot leading to inflammation, tears or strains turning into plantar fasciitis heel pain. Most notably in the morning when you first step out of bed or have been sitting for a prolonged time, you may stand and feel excruciating pain during your first few steps. Normally this pain dulls as you continue to walk throughout the day, but don't get fooled and think it's healed. Focus on prevention and fully recovering.

How to Fix?

I'm in week 2 of my nursing, so I'll to run you through the tips and tricks I've learned to be the most beneficial to heal plantar fasciitis. Because feeling like you're walking on a nail all day isn't fun.

Due to how common plantar fasciitis is, there are many articles and YouTube videos explaining how to prevent and relieve this heel pain. I suggest you YouTube on your own here. There are even full channels dedicated to "Plantar Fasciitis Life".

I've incorporated multiple perspectives on contracting vs stretching the fascia and supporting vs not supporting the arch with insoles. This is where I'm torn: the barefoot/minimal vs padded/supportive shoe type. 

Currently I'm down the path described below to relieve my heel pain, but I am careful not to over-support and over-protect with insoles and footwear. My plan is to transition (slowly) into a minimal, more barefoot style of shoe as currently I'm using inserts in my Nike Flyknit RN's. BUT like everything, what works best for me may be best for you and/or easy to implement in your life circumstance.

I've also included a Heal the Heel Kit to save you a little digging in the weeds of best stretch and massage gear. Let me know what works best for you.

In-home treatment & RELIEF

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Rest & Ice Stay off your feet as much as you can in the first couple weeks. Avoid any high level or intense working out involving your feet. Apply ice to encompass your heal and mid-sole to reduce the inflammation and pain. I do this for about 20 minutes 3 times a day.

Stretch & Massage All areas of your foot and leg need stretching and massaging. The foot tissues are connected more than you may know. It's important to stretch the calf by wall presses or stair toe-hang stretches. The plantar fascia needs stretched both directions by using a roller pin, a ball, or your thumbs on the bottom of your foot and then bending your foot downward to compress the plantar fascia and stretch the top foot tissues. This massage and stretch will build flexibility, help with pain and remove lactic acid build up in your tissues. I perform this routine after my icing about 3 times a day starting with deep self-massage with thumbs, pins, and ball then going into a stretching.

Orthotics (or not) Protecting your heel is important at least for your recovery phase. The appropriate arch support may be important for short term or long term depending on your needs. I'm using orthotics and KT tape wrapped around my achilles compressing the plantar fascia for at least a couple weeks before I migrate back to my normal footwear without support. The goals is to minimize pain and let your plantar fascia heal. I will then ditch all orthotics and try to incorporate minimal/barefoot style shoes to build back my foot strength. Also, trying out yoga can help grow your foot muscle.

Heal the heel Kit

  • Therapy & Massage
  • Stretching
    • Towel to Toe
    • Stair Calf Stretch
    • Wall Calf Stretch
  • Wear
    • Tennis Shoes or Minimal/barefoot shoes
    • Supportive Socks
  • Nutrition
    • Anti-inflammatory and recovery (good mitochondria) foods: leafy greens, fish, ALA, turmeric, curcumin, ginger, resveratrol, spirulina, magnesium, fish oil, and many more.
    • Avoid sugar and carbs
    • Healthy, healthy, healthy ... here's a smoothie idea.

Pushing Through

Have you experienced any heel pain like plantar fasciitis? Tell me your story and what worked best for you. Injuries are never fun. And it's good to know, being in good shape doesn't protect you from a painful injury. Going forward I plan on being smart and stopping once I feel any discomfort before pushing through. Instead push through the burden of recovery to heal your heel properly by resting, icing, massaging, stretching and being cognizant of your limits.


REFERENCES

[1] Wikipedia: plantar fasciitis

[2] HeelThatPain