WHEN the FIRST STEP OF THE DAY HURTS the MOST

Stone heel, bruised heel, first step of the day pain…Sounds like Plantar Fasciitis. 

Unfortunately with initiating activity, comes the risk of injury to our body.  One of the most important things we can do to avoid this, is to begin small, but consistent daily activity and flexibility.  It is better to do 10 minutes every day of the week, than one hour once a week.  Our bodies were made to move daily, and when we don’t, we begin to lose the ability to resume movement…we get stiffer, and stiffer, and stiffer!

One of the most common maladies I’ve seen lately is …Plantar Fasciitis.  Plantar Fasciitis (PF) is the inflammation of the band of tissue(fascia) that runs on the bottom of the foot & supports the arch, from behind the toes to the heel base.  This fibrous band can become inflamed and tender, and the first noticeable sign is early morning heel pain with the first step of the day, that often resolves throughout the day.  This stubborn condition can take 6-12 months to resolve WITH careful attention.  If ignored, it can become a lifetime problem.

What can cause this nagging issue?  There are many culprits!

  • Old Shoes or Unsupportive Shoes
  • Tight Calves
  • Overpronation (walking to the outside of the foot)
  • Tight Hamstrings
  • Very High Arches…or Flat Feet
  • Recent Weight Gain
  • Poor Running/Walking Form
  • Rapid Increase in Activity
  • Overtraining (Inadequate Rest)
  • Extended Standing On Hard Surfaces

What can be done? 

The first key step is to figure out the cause…and eliminate it if possible, change shoes, gait, surfaces, etc.

Then rest the foot from any impact.  (This does not mean NO exercise, it just means NO impact).

Ice the arch frequently (3-4 times/day) for 15 minutes at a time.  Continue this icing after any activity (even when it doesn’t hurt).

AND, religiously stick to a daily regimen of stretching (foot/ankle/calves/hips), massage, and strengthening.  If you follow a DAILY, and CONSISTENT routine for two weeks, and aren’t well on the road to healing, you need to see a specialist. 

Unfortunately , PF can easily recur, and you need to start the therapy and preventive measures all over again at the slightest twinge.  As for the daily routine…it needs to be a part of your new maintenance program for your body.  Think of it as your daily Italian therapy…your fascia is like a spaghetti noodle…you either heat it, soften it, and keep it flexible every day…or it breaks a little every day.

Exercises/Stretches:

  • Ankle Rotations
  • Foot Flexion and hold…90 seconds
  • Arch Massage with hands
  • Arch Stretch using the big toe, with hands or floor surface
  • Foot Raises with slow lower
  • Foot Eversion (sole faces out)
  • Foot Inversion (sole faces in—keep the knee stationary)
  • Arch Raises, press the big toe to the floor simultaneously
  • Toe Raises with Toe Separators
  • Top Toe Contraction  (towel pulls)
  • Step Stretch with heel drop (with and without bent knee)
  • Forward lunge (with and without bent knee)
  • Wall Calf Stretch
  • Tennis Ball Massage, Up and down, then side to side, with and without toe flexion/extension.
  • Ice roll (using frozen water bottle)

Food/Supplements:

Protein >60 gm/day, Fish Oil, Vit B5, Vit C, & Magnesium

More advanced:

  • Night socks, or splint.
  • Massage with a golf ball versus a tennis ball.  Up and down, then side to side, with and without toe flexion/extension.

In conclusion:

Once you’re on the road to recovery, you need to start working towards walking on soft surfaces in your bare feet or socks.  Start with just a few minutes at a time, to develop your tendons and ligaments to become stronger.  Or use a barefoot shoe like a Vibram or Merrill—do not go walking very long with these initially (think in minutes, not miles), and definitely don’t go running this way at first.

Keep notes…identify which surface, which shoes, which activities are a problem for YOU.  And above all, once you’ve had plantar fasciitis, do NOT stop the preventive, daily maintenance to stay pain free. I recommend 60 second foot pumps, 90 second foot flex and hold, and 60 second plantar massage before getting out of bed EVERY day.  As they say, an ounce of prevention is worth a pound of cure!

A good calf stretch routine (you may have tight calves):  https://www.youtube.com/watch?v=DY5tNQ7f5wM

The daily silly Six Feet Drills I recommend:  https://www.youtube.com/watch?v=h3hmvZ4og-w   (do 40 steps forward, and 40 steps backward in each position).

One of many simple but helpful foot exercise videos:  https://www.youtube.com/watch?v=T-Cgpz03P4A

-Melissa

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