Saturday, April 13, 2024
Bottom of Foot Pain FOOT PAIN

7 Tell-tale Signs That Your Plantar Fasciitis Is Healing

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Plantar fasciitis, which is degeneration of the ligament on the bottom of your foot, can be incredibly frustrating to live with. It is estimated that 1 in 5 people will develop plantar fasciitis during their lifetime (1).

When you have plantar fasciitis, you may experience a dull, achy pain in the bottom of your heels or your arches.  

The problem with plantar fasciitis is that when the ligament becomes inflamed, it can take several months for the pain to resolve. You may be doing all the right things and are wondering if the plantar fascia is starting to heal.

In this article, we’ll discuss some tell-tale signs that your plantar fasciitis is healing and whether or not you’re on the right track to recovery. 

heel pain bed

1) You Are Experiencing Less Heel Pain in the Morning

One of the major causes of plantar fasciitis is tight calf muscles. The two calf muscles (gastrocnemius and soleus muscles) make up the Achilles tendon, which inserts into the back of your heel. 

When you are sleeping on your back, your feet are in a “plantarflexed” position. This means that your feet and toes are pointed downwards. This position tightens your Achilles tendon and plantar fascia. 

When people have plantar fasciitis, the tightening of the calf muscles and the fascia can cause pain when first getting out of bed in the morning. 

If your plantar fascia is healing, you may start to notice that getting out of bed is not as painful anymore as it once was. This is a good sign that despite some contracture of the fascia that occurs overnight, it has healed enough to the point that it is no longer causing pain.  

ibuprofen

2) You Are Not Having to Take Pain Medication for Plantar Fasciitis

When people suffer from plantar fasciitis, they often take anti-inflammatory medications such as Motrin, Naproxen, and even prescription steroids. All of these medications help to reduce pain in the ligament and can provide some temporary pain relief for plantar fasciitis.

If you find that you simply don’t need to take pain medications anymore to help manage the discomfort in your feet, it’s a good sign that the inflammation in your plantar fasciitis is starting to subside.

walking shoes

3) You Can Walk Longer Before You Notice Heel Pain

Many people who suffer from plantar fasciitis, especially when it occurs on both feet, cannot walk leisurely the way they used to. Walking uphill can be a challenge and many people end up cutting down on their mileage. 

If you can walk longer before you notice any discomfort in the heel, it’s a good sign that your plantar fascia is healing. If pain is controlled, you can slowly try to increase your mileage.

weight loss

4) You Have Lost Weight and Experience Less Foot Pain

Obesity is present in up to 70% of patients with PF. There is a strong association between increased body mass index (BMI) and plantar fasciitis in the non-athletic population (2).

Every additional pound that one carries puts strain on the arches and heels. Also, if you overpronate (roll inwards as you walk), your plantar fasciitis symptoms may worsen with excess weight. 

If you have lost a few pounds recently and have noticed that your heel and arch pain has been reducing, it’s a good indicator that your plantar fasciitis is on its way to healing.  

ankle exam

5) Your Range of Motion Is Improving

As I mentioned previously, plantar fasciitis can be aggravated by the tight calf muscles that make up the Achilles tendon. When you have tight calf muscles, your ankle range of motion is limited when you bend your foot and ankle in an upwards direction.

Your doctor will check your range of motion at the ankle joint before starting treatment for plantar fasciitis.

If you have been consistently stretching your calf muscles and plantar fascia daily, you may notice your range of motion in your ankle has increased and your plantar fasciitis pain has decreased. 

heel bruise

6) Your Heel and Arch May No Longer Be Bruised or Swollen

When you have plantar fasciitis, the plantar fascia becomes thickened.

The normal plantar fascia usually measures 3.3mm-3.9mm in thickness. A thickness greater than 4mm is considered abnormal (3). This increased thickness can be visualized in the heel as swelling. 

Bruising due to repetitive pressure in the heel can be visualized as well.

If you notice that your heel swelling and bruising are reducing, it’s a good sign that your plantar fasciitis is healing. 

Read the Top 5 Reasons Your Heels Hurt From Walking.

calendar

7) It Has Been 6-18 Months Since You Developed Plantar Fasciitis

Plantar fasciitis is not a quick fix. When you have plantar fasciitis, symptoms can linger for several months. On average, plantar fasciitis can last for 6 to 18 months (4). Of course, this may not be true for everyone, but for many people it is. 

Many people suffer through the pain for a while before they seek help and initiate therapy. However, if it has been over 18 months since you started treating your plantar fasciitis, you can expect that symptoms should improve. 

Grade your pain level from 1-10 every week from the time you initiate therapy. Write this down for your record. You should notice a reduction in pain by the end of the first year. 

Tips On How You Can Heal Plantar Fasciitis Faster

STRETCH STRETCH STRETCH!

Make sure you are stretching your Achilles tendon and plantar fascia daily.

You should aim to perform stretching exercises three times daily for at least 15 minutes at a time. 

Check out this article on how to properly perform stretching exercises. 

Here’s a video by NHS Ayrshire & Arran demonstrating how to perform stretching exercises correctly.

Make Sure You Are Wearing the Correct Shoes and Inserts

Your foot structure is highly individualized. If you suffer from plantar fasciitis, you should obtain shoes from a shoe store. Go to the shoe store at the end of the day when your feet are the most swollen to have your feet measured. 

Your feet will be measured using a Brannock device. Here’s a video by SanLuis Podiatry on how to use a Brannock device properly. 

If you want to buy your own Brannock device, you can buy it here on Amazon. 

After obtaining the correct shoe size, the sales representative at the running shoe store will assess your foot structure and provide shoe gear recommendations. You can also speak to your local foot doctor about what shoes they recommend for your foot structure. 

Picking the correct shoes is incredibly important if you suffer from plantar fasciitis. If you buy an unsupportive shoe, or shoes that are inappropriate for your foot structure, you could make your plantar fasciitis pain worse. 

Shoes with thick and well‐cushioned midsoles may offer pain relief for individuals who have to stand or walk for long periods of time (5).

If you buy inserts, make sure to take your inserts with you to the shoe store. You will want to make sure that the inserts fit comfortably inside the shoes. If your shoe liners come out, you should take them out before putting your inserts in the shoes.

Insert recommendations

  • Mild to moderate flat feet: I would recommend the Powerstep ProTech orthotic. This orthotic has a firm arch with a deep heel cup that will help with pronation and will limit strain of the plantar fascia. It will last 6 months to 1 year. 
  • Severe flat feet with overpronation: I would recommend the Powerstep Pinnacle Maxx orthotic. In addition to the firm arch and deep heel cup, it has an extrinsic post (added heel pad) that prevents overpronation. It will last 6 months to 1 year. 
  • High-arched feet: I would recommend the Powerstep Pinnacle High Arch orthotic. It has firm high arch support that contours most foot structures well. This orthotic will reduce strain along the plantar fascia. It will last 6 months to 1 year. 

If you wish to obtain custom orthotics for your feet, contact your local foot doctor. Custom orthotics are ideal, as they are custom-made for your feet.

The only downside is that if your insurance doesn’t cover them, they can be costly. 

Massage Your Plantar Fascia Everyday

Make sure you are regularly massaging the plantar fascia every day to help release the tightness of the ligament and stimulate blood flow.

If you prefer a foot massager, I would recommend the heated Shiatsu Foot Massager. You can buy it on Amazon. It works well and massages the plantar fascia effectively. The added heat feature helps with achy feet.

You can also massage the plantar fascia by rolling your foot over some marbles or even a tennis ball. Another option is to use a frozen water bottle to massage the bottom of your foot. This can help to reduce pain. 

Use a Night Splint

If you have pain in the morning, a night splint would be a good option for you. A night splint assures that your ankle remains in a dorsiflexed position. A night splint stretches out the calf muscles as well as the plantar fascia all night long. 

After wearing the night splint for a while, you should notice that the pain in your feet when you first get up in the morning should be less. 

Rest

This seems fairly obvious, however, many people simply do not rest their feet enough. If you suffer from severe plantar fasciitis pain, make sure you rest your feet! Your body does a good job of healing itself, and it simply will not heal if you continue to bear weight on your feet every chance you get. 

Modification of activities is advised. Repetitive impact, such as running (even on a treadmill), should be avoided during the treatment phase (6).

If you wish to stay active, try low-impact exercises like swimming or even biking. Do this for 4-6 weeks, and the pain will start to subside. 

heel pain woman

Conclusion

Plantar fasciitis is difficult to live with, but it can be treated. Although the pain can last several months, symptoms typically do improve in most people. By taking the appropriate steps to help heal the plantar fascia, you can help speed up the healing process. 

Related articles: Cortisone Shots for Plantar Fasciitis:  Pros & Cons of a Foot Steroid Injection

Do you suffer from plantar fasciitis? What helped to alleviate your pain? I would love to hear your thoughts! Leave a comment below!

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References

  1. Riddle DL, Pulisic M, Pidcoe P, Johnson RE. Risk factors for Plantar fasciitis: a matched case-control study. J Bone Joint Surg Am. 2003 May;85(5):872-7.https://pubmed.ncbi.nlm.nih.gov/12728038/
  2. Tahririan MA, Motififard M, Tahmasebi MN, Siavashi B. Plantar fasciitis. J Res Med Sci. 2012.Aug;17(8):799-804.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3687890/
  3. Sabir N, Demirlenk S, Yagci B, Karabulut N, Cubukcu S. Clinical utility of sonography in diagnosing plantar fasciitis. J Ultrasound Med. 2005 Aug;24(8):1041-8.https://pubmed.ncbi.nlm.nih.gov/16040817/
  4. Young CC, Rutherford DS, Niedfeldt MW. Treatment of plantar fasciitis. Am Fam Physician. 2001 Feb 1;63(3):467-74, 477-8. Erratum in: Am Fam Physician 2001 Aug 15;64(4):570.https://pubmed.ncbi.nlm.nih.gov/11272297/
  5. Poenaru, D., Badoiu, S. C., & Ionescu, A. M. (2021). Therapeutic considerations for patients with chronic plantar fasciitis. Medicine International, 1(4), 1-5.https://www.spandidos-publications.com/10.3892/mi.2021.9
  6. Lim AT, How CH, Tan B. Management of plantar fasciitis in the outpatient setting. Singapore Med J. 2016 Apr;57(4):168-70; quiz 171.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4853481/
  7. Schwartz EN, Su J. Plantar fasciitis: a concise review. Perm J. 2014 Winter;18(1):e105-7.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3951039/
  8. Melvin TJ, Tankersley ZJ, Qazi ZN, Jasko JJ, Odono R, Shuler FD. Primary care management of plantar fasciitis. West Virginia Medical Journal. 2015;111(6):28-33.https://mds.marshall.edu/cgi/viewcontent.cgi?referer=&httpsredir=1&article=1024&context=sm_orthopaedics

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Vaishnavi Bawa
Dr. Vaishnavi Bawa is a Podiatrist who specializes in treating foot and ankle pathology. LifesLittleSteps mission is to educate the public about foot health in an easy-to-understand manner using evidence-based medicine.
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