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plantar fascitis - arch supports, night splints or other suggestions?

bridgetconrad
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06/07/2009 - 1:16pm
plantar fascitis - arch supports, night splints or other suggestions?
I have been suffering from plantar fascitis for a few months.  I have been doing some of the standard exercises but it is not getting better.  I have inserts in my shoes, but am wondering about night splints or the small arch supports that wrap just around the arch.  Do you have any suggestions?
Esther Gokhale's picture
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09/10/2008 - 8:36pm
The root cause of the problem is that your plantar fascia, being a ligament, is not very elastic and with suboptimal weight-bearing in standing and walking, the foot may spread to a longer length than your plantar fascia will stretch to accommodate. Plantar fasciitis occurs when the plantar fascia tears away from the points of attachments (most commonly the attachment to the heel). At night, while you rest your feet, the torn attachments will mend, but in the morning, if you over-stretch your plantar fascia again by standing/walking poorly, you start the cycle of tearing and mending all over again. With repeat tearing and mending, you can get scar tissue, pain and debility.

The important things are to
1) Learn to leave your weight on the heels while you stand so you don't over-stretch and tear your plantar fascia. This can get tricky once the heel area is inflamed. Try a slightly external or internal portion of your heel and wearing good cushioning in your shoes.
2. Learn to leave the weight on the heels and engage your arch muscles at push-off so your foot doesn't bend backwards at this moment (again over-stretching and tearing the plantar fascia).
3. Wear good arch supports at ALL times (including getting out of bed to go to the bathroom since you probably can't count on remembering to engage your arch muscles to keep your foot short at this time.)
4. Strengthen your arch muscles with exercises and by using them at push-off in your gait.

I don't favor boots because
1. I prefer the approach of cultivating a normal (shorter) foot rather than getting your plantar fascia to heal artificially long because your foot is artificially long. That is like giving up on reconstructing your feet.
2. They are likely to disturb your sleep.
3. I'm not convinced this approach works as well as being strict about arch supports.
Charles Clemens
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09/06/2013 - 11:43am

Many years ago, I was diagnosed with plantar fascitis.  I don't even remember what the symptoms were, but I have been wearing prescribed orthotics ever since.  Recently, I have been having terrible pain in my ankles that wakes me up several times in the night.  When I lay on my side, whichever foot is on top begins to hurt as the muscles relax.  Getting up and walking resolves it, but it makes for a long night.  Is this plantar fascitis?

 

Esther Gokhale's picture
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This doesn't sound like typical plantar fasciitis. Sounds like something you should get a physician to examine. Good luck!

Mom_3boys
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09/22/2009 - 11:12am

I have been walking around with really tender ankles for at least a few months now and suspect posterior tibialis strain. I’ve been working trigger points in my posterior tibialis, hips, calves, and IT band, as described by Jill Miller in the "Roll Model" (new book).  Also, based on research I did on the internet, I have been walking barefoot at home when I can, to build up the muscles in my feet, but now I seem to have progressed to plantar fasciitis in my left foot at least (pain on top of the foot). I also get pain in my hips, IT band, and piriformis.  Today I bought a pair of so-called 'minimalist' shoes, that are zero drop, very flexible sole, boast a wide toe box, and have a kidney-shaped last, but because of the narrowing in the midfoot they are VERY supportive in my arches.  Hip pain/low back pain went away immediately.  But I am so confused about the debate as to whether one should use arch support on the one hand, and just go barefoot on the other so as to build up the muscle tone in your feet so you don't become overly dependent on orthotics.  Your approach in your book seems to take a middle road.  Can you offer any updated advice about how you feel about supportive shoes vs. barefoot?  It really does seem to make sense to me that if I wear shoes, at least while I am addressing my muscle imbalances, that are supportive, it will allow my muscles to heal and inflammation/scar tissue to decrease.  THEN perhaps I can transition to more barefoot walking.  Do you agree?  In other words, am I doing myself any damage by using these shoes that are supporting my arches in such a way that I cannot overpronate?  They are Merrell Bare Access 3 running shoes, by the way.  I do feel like they help me effortlessly keep my weight in my heels, too, when I am standing, for some reason.

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