Have Traditional Treatment Methods for Plantar Fascitiis Failed You? Here’s Why (opinion)
If you’ve had plantar fasciitis (or any pain) for a while, chances are you’ve tried one or more of the traditional treatment methods. Have you wondered why they’re not ‘working’? While this post is plantar fasciitis specific, the opinions expressed here would be the same for just about any pain in the body.
Don’t address symptoms, address the ROOT CAUSE!
While this isn’t a complete list, I wanted to address some of the most commonly used traditional methods for relieving plantar fasciitis and why they typically don’t work long term. Please keep in mind this is my opinion, and I am in no way suggesting you disregard the advice of a medical professional.
While rest can be helpful, I do not believe it solves the problem at its root. Movement reveals and heals! So while I will always condone appropriate rest, I remain a fan of movement and staying mobile. Movement allows your body to tell you something is wrong (or not), and movement can often help heal.
Using cold, either icing your foot or rolling it on a frozen water bottle, will provide temporary reprieve from the pain because ice dulls our pain receptors. The pain is still there, we just can’t feel it as strongly. As soon as the effects of the ice wear off the pain will likely come back. It’s also not addressing the root cause.
Brace or compression sleeve:
Wearing a brace or compression sleeve is a tempting plan for many looking for an ‘alternative’ approach. Most of the time we’ll wear a brace while working out, but some people like how it feels so much they wear it all day AND while sleeping. (Or, have you been told to wear the kind that places your foot in dorsiflexion all night?! I am very much against that…more on that in a minute).
Wearing a brace or compression sleeve may feel good temporarily, but the reasons it feels good are the same reasons this can kick the pain can down the road and/or make things worse (when you take it off). A brace, especially a tight one, partially immobilizes whatever joint you’re wearing it around; so you can’t move like you normally would. It may also cut off blood flow and block some nerve communication. It’s also forcing your fascia into a tight mold, and if you wear it long enough – that mold will become your new normal, the fascia stops being elastic and flexible, it loses its spring due to lack of proper blood flow and generally puts you into a scenario that will make eliminating your pain at the source even more difficult.
A night brace or sleeve that attempts to force you into dorsiflexion all night is a personally horrifying choice to me, because it’s like trying to hold a static stretch for 7-8 hours! I’m against static stretching to begin with, and trying to force your tissue (while cold and immobilized) to hold a stretch that long is just asking for something worse to happen. Muscle tissue has a tendency to resist static stretching, and more than likely it’s not your muscle tissue that’s the problem anyway…so even if you accomplish the job of lengthening those muscle fibers, chances are slim it will relieve or eliminate your pain; and it just might make things a lot worse, since the chances of irritating your attachments are now very high.
I won’t be going into detail on the various kinds of painkillers. Bottom line is: pain pills work by blocking pain receptors in your brain. The pain is still there, we just don’t feel it anymore. So it may give us temporary relief, but pills will never address the root issue.
This option may sound like a good choice at first. Maybe you buy new shoes and suddenly your pain seems better! Until you take the shoes off.
If you baby your pain and try to silence it during the day while wearing specific shoes, while NOT addressing the root cause – then you’ve set yourself up to rely on soft shoes in order to feel less or no pain, but again, this isn’t addressing the root cause and the more you baby the pain the more likely it is to get worse in the long run.
Besides: don’t you want the option to go barefoot or wear flip flops or whatever shoes you want to wear?
Orthotics (shoe inserts):
Similar to the cushiony shoes, orthotics are not addressing the root cause and it’s another bandaid solution that makes you reliant on wearing it to feel less or no pain.
If your plantar fascia is really tight, or you have “flat feet” – those things are symptoms of mobility issues or a result of how you move through life or sports. They’re reversible too!
Not only will orthotics create another scenario of babying the pain (and when you take them out or try to go barefoot the pain usually comes raging back), but – it’s entirely possible you’ll experience new pain you never had before. Orthotics change your gait pattern, and any time you change your gait pattern you monkey with your joint and alignment. I’ve had lots of clients get orthotics for a foot issue, only to end up with knee or hip pain, or their spine going out of alignment.
Again – it’s not addressing the root cause of plantar fasciitis (or any pain).
This is possibly a controversial stance to take, but it’s been my position for years: these shots are meant to be “merely” anti-inflammatory in nature, but there are a whole bunch of possible side effects that simply aren’t worth it (in my opinion). I am not telling you not to go for it if you want to, though I would hope you’d do so after investigating for yourself and knowing the risks (especially for shots in the feet!)
Click here to read the full list of potential side effects on the Mayo Clinic website.
Even IF these shots came with zero risk and simply took the inflammation down, it would still be my position that this isn’t addressing the root cause and by decreasing inflammation without addressing the root cause, we could make things worse in the long run.
Consider these possible side effects:
- Joint infection
- Nerve damage
- Thinning of skin
- Necrosis of nearby tissue
- Necrosis of nearby bone
- Tendon and ligament rupture
- AND – the risk of experiencing any of these side effects goes up with every injection
The reason I am horrified by the thought of cortisone injections in the feet specifically is because we have so many small bones, tendons, ligaments, TONS of nerves, lots of fascia, many small joints etc. The chances of damaging any or all of these areas is significantly higher than say, getting a shot in your knee or shoulder – IN MY OPINION.
And remember – a shot does nothing to address the root cause, and may simply kick the pain can down the road, OR make things worse if you experience any of the potential side effects.
I won’t go into detail on this since I’m not a surgeon, but as I understand it – surgery for plantar fasciitis is a plantar fascia separation. I take this to mean they are attempting to create space through surgical separation of the plantar fascia – and you can absolutely do this naturally, on your own, with a lacrosse ball (click here for the how to). However – tight plantar fascia is typically a symptom of the underlying issue and NOT the root cause. So even doing this naturally will likely need to be accompanied by other techniques as well.
What all of the above have in common are NOT addressing the root cause of pain and merely treating symptoms.
Have you been “stretching” as a way to relieve your plantar fasciitis? Here’s why it might be making things worse:
As most of you know by now, I’m not a fan of static stretching for most people (for any reason, but especially not if you’re in pain).
I see a lot of blogs and videos out there recommending you stretch your calves and feet to relieve plantar fasciitis. I NEVER recommend doing this.
The plantar fascia or heel is already irritated from tight tissue upstream pulling on it. So yes, the tissue upstream does need to be released. It’s the fascia however that needs to be ‘stretched’ and/or released, NOT your muscle fibers. Not only will stretching your calves not address the actual problem, it might make things worse.
Static stretching tends to pull on muscle fibers forcing them to lengthen in a linear manner. Much of the time your muscle fibers will resist being stretched like this, and in the case of plantar fasciitis it can often make your pain worse because you’re now pulling on the tissue that’s already irritated from being pulled on!
Plantar fasciitis is a fascial issue, and to get lasting relief it needs to be addressed by looking at and releasing key areas of fascia. So, looking at the calves is very much going in the right direction. But go after the fascia, not muscle fiber if you want lasting relief.