Living with Plantar Fasciitis

I have a client who complained to me about severe heel pain. We were both determined to get to the bottom of it. Heather* is in her late 40s; she’s in good shape and in addition to the thrice-weekly workouts with me, she and her husband take their three dogs on daily hikes.  

Our first step was to figure out what the cause was. She saw a podiatrist who diagnosed her with plantar fasciitis. The doctor explained that it was not that serious, and he advised her to take NSAIDs, but that doesn’t address the issue; it just masks the pain. Our hope was to trace it back to the source, to eliminate the need to pop a pill every time her feet hurt.

I have worked with Heather for several years. Our workout routine has changed in that time. When I first met Heather, she was overweight, and was a type II diabetic. Our goal was to make exercise a regular part of her life, not drudgery. Additionally, I made suggestions to alter her diet. Within two years, Heather lost 70 pounds, and she went into diabetic remission where she has been for 10 years.

If we could reverse the trend of obesity and diabetes, while we can’t reverse the damage already done by developing plantar fasciitis, we could prevent it from getting worse. The important thing for Heather was to make it something that was routine and could easily be worked into her day. Heather runs a successful graphics design business. As a result, she sits a lot. When she’s not sitting, she’s running a million miles a minute. We often joke that Heather has two speeds: sitting or moving so fast, she breaks the sound barrier.

In order to make suggestions for Heather, we made arrangements for me to spend an entire day with her to see what a typical day is like for her. From there, we could work a “fix” into her daily routine.

First Thing’s First: What is Plantar Fasciitis?

There is a band of tissue that connects the toes to the heel bone. This is called the plantar fascia, and when it gets inflamed and painful, it can cause incredible discomfort, and a stabbing sensation in the heel. Most sufferers say that it feels worst in the morning, and it gets better throughout the day. Heather reported that she feels the pain worst if she stands up suddenly after sitting for a long period of time, or if she’s been standing on her feet for a long time. This made sense because Heather sits at her computer for up to three hours at a time, and then gets ready for our cross-train workouts. Again, the two extremes in motion.

The plantar fascia is like a shock absorber. When someone with plantar fasciitis puts his or her foot down, or flexes it, the plantar fascia stretches, moves, and absorbs the impact of those steps. Over time, the tissue can become inflamed, break down, and get little tears in it. All of this causes heel pain.

The following are risk factors for developing plantar fasciitis:

• Age: the older we get, the shock absorption just wears down
• People who were born with either high arches or flat feet
• A person’s gait may stress the plantar fascia and contribute to excessive wear on the tissue
• Tight calf muscles or a tight Achilles tendon, either of which can prevent a person from flexing the foot properly
• Engagement in high-impact exercise on hard surfaces increases risk
• Walking on hard surfaces without good support and cushioning
• And lastly, excess body weight

In addition to sitting in front of the computer for several hours, I observed that Heather rarely takes a break, even to use the restroom, to get a change of scenery, stretch her muscles or relax her eyes. When she does get up, she walks around barefoot. Her concrete floors are covered in ceramic tile. This combination could easily be “killing her feet.”

After observing Heather’s daily routine, I made some suggestions:

• Stop walking around barefoot
• Buy slippers that are designed for people with plantar fasciitis
• Wear flat shoes and/or sneakers
• Add supports with gel or cushioning in them (that specifically address heel pain or plantar fasciitis) to all her shoes
• Take frequent breaks from the computer; walk around the house, go outside and stretch
•       This applies to anyone who sits at a computer all day
• Stretch her Achilles heels, first one and then the other

I also suggested something else Heather can do while she is working at her computer. Get a roller or improvised rounded object – such as a soda can (cold is optional). Roll forward and back along the surface of the foot for a couple of minutes on each foot. I recommended she also do this as added pre-stretching application prior to our workouts.

We are now integrating low-impact workouts with her cross training. Along with hiking, Heather is also swimming twice a week.

In addition to physical changes, I suggested the following as well:

• Eat more Omega 3s (fish oil found in salmon, for example). This helps control inflammation.
• Incorporate MSM into her diet, which promotes natural healing of connective tissue
• Eat more antioxidants, which fight free radicals, and help minimize inflammation
• Get more amino acids into her diet, which are the connective tissues’ building blocks
• Drink more water
•       By not taking frequent breaks, Heather wasn’t refilling her glass of water frequently enough

We have seen massive improvement in Heather’s heel pain since she ma

de these changes. Unfortunately once someone has plantar fasciitis, there’s no way to reverse it, however with moderate lifestyle changes, you can control it, so it doesn’t get worse.

*Although my client encouraged me to write this blog about her, she asked me to change her name.