by Dr. Emily Splichal, DPM MS
Whether this is your first time experiencing plantar heel pain or the return of recurrent plantar fasciitis, your first line of defense to calm things down and minimize your symptoms will be the same.
Acute plantar fascial flare ups occur when we hit what is called a “stress threshold”. Essentially this is the point where tissue stress overloads or exceeds that of tissue recovery. This excess tissue stress can lead to micro-tearing of the fascia, inflammation and pain.
Before making a mad dash to the urgent care or your podiatrist’s office, most acute plantar fascial flare ups can be calmed down with just a few simple steps.
These steps are broken down into those that reduce tissue stress loads and those that support soft tissue recovery and repair. It is recommended to perform all of the steps below, every single day for a period of at least 2 weeks.
Minimize Stress to the Plantar Fascia
Step 1 - Temporarily using arch supports
Because we stress our plantar fascia with every step we take and when standing long hours on our feet, using over the counter or custom arch supports can help give the plantar fascia the rest it needs.
If you are not a supporter of arch supports, remember their use is only temporary. Research has been shown that arch support can effectively reduce tissue stress.
Step 2 - Avoid excessive standing or ballistic movements
Standing, especially on concrete and tile, can be very stressful to the plantar fascia. If your job or day requires you to be on your feet all day then this is where Step 1 will be beneficial to you.
In addition to avoiding excess standing, try to minimize running and jumping during this 2 week period as both activities place high elastic demands on the plantar fascia.
Step 3 - Avoid trying to strengthen the fascia until tissue is quiescent
This is very important to those who associate their plantar fasciitis with weak feet. During an acute flare up, strengthening the feet can further stress the plantar fascia and will only aggravate the tissue.
Wait until you are out of the acute phase before initiating any foot strengthening program.
Allow the Soft Tissue to Repair and Recover
Step 4 - Consider the roll of icing, NSAIDs such as Aleve, systemic enzymes or red light therapy
Inflammation is an important part of the tissue healing process, however persistent or recurrent inflammation can cause a stall or slow down in these highly coordinated steps.
In an acute flare up, various options exist to support the body’s natural response to inflammation including topical or oral NSAIDs such as Aleve or Voltaren gel, systemic enzymes such as serrapeptidase, ice and red light therapy.
Step 5 - Soft tissue release to calves and distal plantar fascia
During this 2 week period it is important to avoid stretching the calves and instead focus on trigger point release or massage of the feet and calves. Standing on a golf ball or lacrosse ball can help reduce stickiness in the tissue and support blood flow for tissue recovery.
Try to release the calves and feet for 5 minutes twice a day if possible.
Remember when implementing the above you want to do so consistently and for a period of 2 weeks. If after that time you do not notice a significant improvement then it is recommended to see your local podiatrist for more thorough evaluation.