Understanding Plantar Fasciitis: Treatments That Could Worsen Your Heel Pain

Plantar fasciitis treatments are often painful and don't improve the heel pain very much. Even treatment guided by healthcare professionals tends to be focused on treating the symptoms and not the root problem. Sometimes patients are even guided to do treatments that are very painful and end up keeping the pain longer than it needs to be. In this blog post, we're going to explore the top nine treatments that can actually make heel pain from plantar fasciitis worse.

The Misguided Approach to Treating Plantar Fasciitis

An important distinction to make about our approach towards treating plantar fasciitis is that I treat it like a sprained ankle or like a sprain to tissue under the heel of the foot. After all, it's made up of nearly the same kind of material that ligaments are made from. So it should be treated that way. If you think about it like a sprain, it makes sense not to do some of these things that I'm going to tell you next.

1. Runner's Stretch

A runner stretch is often given to patients who have plantar fasciitis problems. It looks like this: you stand in front of a wall holding on to it for balance, put the problem foot back, and then start to bend the knee to get a stretch in this area. Most people feel a big stretch happening in the calf muscle and sometimes there's a stretch in the plantar fascia too. Although this can feel good because of the stretch sensation you're getting in the moment, you don't want to stretch out the plantar fascia more because it's an injured ligament. It's like a ligament although it's called fascia, it's made of the same tissue. So you don't want to overstretch an already stretched piece of connective tissue like the plantar fascia. Doing this potentially is going to make your plantar fasciitis problems stay there longer than it needs to.

2. Night Splints

Night splints are a device that you put on your ankle and your lower leg, and it holds your foot up in this position with a strap that attaches to itself. The idea is you're going to sleep with your foot in a stretched position. This treatment is often recommended by doctors, podiatrists, and physical therapists. However, the idea behind the treatment is not good because you're putting more stretch on the plantar fascia, which is going to further injure it potentially. Plus, most patients doing the night splint treatments don't like it. They do get an improvement at times, but it's questionable if the improvement is really coming from wearing the night splint or other things that they're doing that are possibly allowing them to heal.

3. Towel Crunches

Towel crunches are a common exercise you'll see in physical therapy clinics, and they'll send this home with patients. The idea is you're trying to scrunch a towel or grab a towel with your toes and bunch it up on your foot. Usually, it's done on a smooth surface like tile floors or wooden floors. This is a good idea at first thought because you're trying to get the toes to work. However, it doesn't really push strength a whole lot and doesn't teach you how to use your toes when you're walking and standing. This isn't a bad exercise to start with, but it's not one that you'd hang out with indefinitely while your plantar fasciitis problem is still there. You eventually need to progress to stronger exercises that give you more resistance and tire out your feet more.

4. Marble Pickup

The marble pickup is usually a variation of the towel crunch exercise. What happens is, you have a bunch of marbles dumped onto the floor and a cup or a bowl. The idea is you're grabbing marbles with your toes and then moving them over and dropping them into a cup or a bowl. This exercise often does not engage all toes equally and can lead to imbalanced toe strength. Each toe should be able to grab and grip the ground effectively. If you have a plantar fasciitis problem, there might be one toe that doesn't curl properly, which needs to be guided into full range of motion in order to heal properly.

5. Using Stiff or Hard Insoles

When using insoles or orthotics, these are the things that you shove inside your shoe to give your foot and heel more cushion. It just doesn't make sense to put something hard and stiff in there. As you see, some of these custom-made insoles are very hard and have no padding on the outside edge. You should be using a very soft, cushiony insole, which will automatically feel better. Most patients often say that when they have plantar fasciitis, it feels like they lack padding on the bottom of their heel. Using a cushioning insole can help alleviate this sensation.

6. Waiting to Lose Weight

Often, patients say they won't start treatment yet because they need to lose weight. While losing weight is a fantastic idea, it's not advisable to wait on treating the root problem of plantar fasciitis. You can work on both simultaneously. Waiting to address the root problem can lead to the plantar fascia becoming more chronically irritated, making it take even longer to correct the problem naturally.

7. Relying on Pain Medications Every Day

Taking pain-relieving medications like Tylenol, ibuprofen, acetaminophen, or diclofenac may be beneficial in the short term to manage pain levels. However, relying on pain medications every day can be problematic. Besides the harmful side effects that some pain medications have, the root problem of plantar fasciitis is not being addressed by these medications. It's important to focus on getting stronger in the right muscles to fix the root problem and achieve true long-term relief.

8. Cortisone Injections

Cortisone injections are a common treatment for plantar fasciitis. They are effective at reducing pain but have a serious side effect of degrading connective tissue like ligaments. Too many cortisone injections can increase the risk of tearing the plantar fascia. It's crucial to address the root problem so that you don't have to rely on these injections.

9. Surgery for Plantar Fasciitis

Surgery for plantar fasciitis often creates other problems besides the plantar fasciitis issue. The surgery commonly involves a plantar fasciotomy, which means cutting the plantar fascia. This can lead to losing a major structure that stabilizes your foot, potentially causing other issues like tendinitis. Surgery might be right for some individuals, but it's essential to weigh the risks and pursue addressing the root problem.

For more information on how to address plantar fasciitis effectively, check out our other blog articles and videos. Don't forget to share this information with someone who might benefit. Please subscribe to our channel and hit the notification bell so you don't miss out on any of our videos when they're released.