• My plantar fasciitis treatment

    On Twitter, I was asked how I’m (successfully!) treating plantar fasciitis. It’s not simple, but it is working. Here’s what I’m doing:

    Rest: I stopped walking multiple miles/day and stopped standing at work. Basically, minimized foot use in every possible way. I am swimming for exercise instead.

    Stretches: There are dozens out there, but I settled on two:

    • Standing calf stretch (#1, pictured here)
    • Seated plantar fascia stretch (pictured here)
    • 10 reps, 10 seconds each (both sides), 3x per day. I do it after each meal.
    • These are both described in this clinical trial, which is why I chose them, as well as recommended by a doctor I saw.

    Night splints: I use a dorsal splint type, but there are others. I can’t sleep more than about 3 hours with them, but I sensed even that much did some good. I will look into the research literature to see if there’s a minimum duration for efficacy. There are other types, but with every type of night splint, people say they can’t sleep with them, though others say they can. After a couple weeks of regular use, I only wore them on nights that followed a day during which my feet felt tired (from use).

    Trigger point therapy (basically, massage): I watched a video and then just massaged the crap out of all the sore spots in my calves and feet. I used any type of object that felt good, including, believe it or not, a rounded stone that jammed into my feet very nicely. I cannot tell you how good this feels. I also used various balls and rollers. Though I haven’t looked at research yet, I felt this did a TON of good. Even if it didn’t, it sure felt good. I did this as much as I felt like. I still do it, but not as much as a week or two ago. There just aren’t many sore spots left.

    Orthotics: Studies show that over-the-counter ones are just as good as custom ones and a lot cheaper. I own both, but I agree with the studies. I have settled on Superfeet Blue, but there are lots of kinds.

    Taping: I taped my feet for more support in advance of days I thought I’d, unavoidably, need to use them more than I should (like traveling through airports). There are various taping methods, but I settled on this one and used Physix Gear Sport Kinesiology Tape, but there are lots of kinds. The tape stays on for days, even through swimming and showering. I usually pulled it off after ~3 days just because it seemed not right to keep it on longer, but I’m making that up. I have no idea if there are studies of taping, but I will look.

    NSAIDs: I took some ibuprofen and naproxen sodium. I felt it relieved the pain, but I don’t believe it speeds up healing (I will check the literature on that). I only took these for a couple weeks.

    Strengthening: After my feet started to have multiple days in a row without pain, I added some strengthening. I’m starting with this approach, which is quite a work out. I am sure to add other things in the future, but I’m not there yet. Note: the approach described at the link fails to mention that you’re supposed to do three sets (of 12 reps) of the exercise. After 2 weeks, go to 4 sets of 10 reps. After 2 more weeks, do 5 sets of 8 reps. Add weight in a backpack as each of these gets easy. (At the moment, I can only get to 3 sets of 11 reps. It’s not easy!) All this detail is from the study protocol.

    Tracking: I tracked my pain on a 0-10 scale, as well as estimates of how long I could stand pain free, each day. It didn’t matter if I actually did the standing (I tried not to stand at all!); I just estimated how long I thought I could stand. It’s pretty obvious when you can’t stand for more than a few minutes without discomfort. I kept a log of my stretches and night splint use. It was very gratifying to see progress over the weeks. Yes, there was some amount of two steps forward, one back, but that’s normal. The log keeps me honest too. I don’t want to miss getting a that check mark for each stretching session, which brings me to …

    The long view: The log is what will help me keep at this for as long as necessary. Though I’ve been at this for about a month, I expect to keep doing all of the above for several months more, gradually shifting to more strengthening. It’s normal for plantar fasciitis treatment to take that long.

    Then I’m going to pay attention to my feet. The first sign of any issue and I’ll ramp back up the full treatment. I am not getting this again!

    @afrakt

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