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P’s and F’s of Plantar Faciitis by John Post, MD

“Wish I didn’t know now what I didn’t know then.” Bob Seger

They say there’s no accounting for taste. This is a shot of my favorite runner in
the Ironman Hawaii Underpants Run. It’s done two days before the race
to raise money for a local charity and it’s plenty of fun. Just don’t choose this

Tips to rid your life of plantar faciitis

As most of you know, many from personal experience, PF
is pain on the sole of the foot, usually at the back of the arch and front of
the heel. It’s usually worse the first few steps you take out of bed in the
morning. So, some recommend 1) tracing the alphabet in the air with the toes of
your raised foot. 2) Immediately after getting out of bed, step into supportive
footwear. Walk on the outside of your foot for the first ten steps. 3) Don’t go
barefoot or in slippers unless the slippers have arch supports. 4) In your
morning shower point the nozzle at your heel and arch and let HOT water soak
the injured area for at least a minute or two. 5) Wear arch supports in ALL of
your shoes, especially those you wear the most when not exercising. Do not
put weight on your feet unless they are properly supported! This is particularly
true with your “knock around” shoes. Leave the flip flops in the closet while
trying to recover from this serious injury. 6) Again, supportive shoes in the house
and don’t go barefooted. 7) In the evening and before you run, stretch and
massage.The old wall push up, half with the leg straight and the remainder with
the knee bent 30 degrees. These may hurt little so go slow and gradually stretch
this area. No hurry as this is not the no pain, no gain situation.

Lastly, every evening after you’ve stretched, apply heat then ice (no more than
10 minutes) to the arch/heel of your sore foot. I’ve seen people use a frozen
water bottle very effectively.

I’ve had good success having athletes sleep with a plastic brace on their ankle
in a plastic brace, an AFO, to keep the ankle in neutral.  The running shoe
stores have something called the Strassburg sock which seems to offer the
same night time support but I have no experience with it.

In my practice, if this isn’t effective when combined with decreased running,
I ask the athlete to head back to his trusted shoe guy for a reevaluation of
shoes and gait before getting into anything that hurts (like an injection) or
costs money (like an orthotic.)