How to Manage Plantar Fasciitis Pain

First, I would like to say that Plantar Fasciitis is the absolute goddamn worst.¹ It can cause an intense amount of pain out of nowhere, and even if you do everything “right,” it can take years for the pain to resolve. If you are reading this, I expect you know what I’m talking about. It’s one of the most frustrating conditions/injuries that I have. Improvement takes time, a LOT of patience, and tons of trial and error.

I have been struggling with plantar fasciitis in both feet for about 12 years. At first it was simply an annoying, a nagging pain, but it built up to be absolutely excruciating. The pain is now back down to annoying with occasional flare ups. The bad news is this means I don’t know of any easy solutions. The good news is that some relief is possible. I will share what has worked to improve my pain, but nothing on this post or site should be interpreted as medical advice. Please have a discussion with your health care provider(s) before making any changes.²

Find a healthcare professional

There are plenty of things you can do on your own to help with plantar fasciitis, but if your pain is not resolving, it’s recommended to see a healthcare provider. You can start with your Primary Care Physician, a physical therapist, or a doctor who specializes in sports medicine, orthopedics, or podiatry. If you have hypermobility or another complicating disorder, it can be helpful to make sure your care is guided by someone who is hypermobile-aware.

Overview of Plantar Fasciitis Management

The following articles give an excellent overview of management strategies for plantar fasciitis, including specific techniques for stretching and strengthening. I have used many of these strategies, and in the sections below I list the products I’ve found the most helpful. As an Amazon Associate I earn from qualifying purchases, but this program does not change the price you pay. Paid links will be marked where applicable.³

Plantar Fasciitis (Cleveland Clinic)

Treatment of Plantar Fasciitis (American Family Physician)

Best stretches and exercises for plantar fasciitis and heel pain (Medical News Today)

Some notes based on my own experiences

• One of the first pieces of advice you’ll get from a doctor or from reading some of these articles is to lose weight. This is not necessarily bad advice, but for people with chronic illness and pain, it can be nearly impossible to lose a meaningful amount of weight. Please don’t punish yourself by focusing on this part of the plantar fasciitis directive and deny yourself the benefits of a more wholistic strategy for reducing your pain. You don’t have to lose weight to improve plantar fasciitis. I weigh 30lbs more than I did when my pain was at its worst. Centering medical care around weight perpetuates stigma without improving patient care.
• Cycling is recommended as a less-impactful alternate to running, to put less compressive strain on the tendons and fascia in your feet. This is excellent advice, but with a hypermobile body I have run into some issues following it. First, an upright bike did not work for me. I bought a Peloton, and I loved it, but no matter how I adjusted the seat or how conservatively I trained, I kept straining my hamstrings and hurting my SI joint, so I had to switch to a recumbent bike. Also, cycling still aggravates my plantar fasciitis sometimes, because you’re still putting some strain on those tissues. It’s important to wear supportive shoes appropriate to your foot shape even for cycling.
• Ultimately I still needed a steroid injection in one of my feet to control the pain and inflammation. These injections don’t cure plantar fasciitis, but can help manage the pain to give the rest of your supportive care time to work. Getting a steroid injection without continuing other treatment can further damage your tissues while you are unable to feel the pain, so it’s important to continue to work with your healthcare team to manager your condition.
• Consider the order of operations for your self-care. If you ice first, the tissue will be numb and stiff, and massage and strengthening will not be as effective. A healthcare provider such as a PT can give you a specific routine, but in general the recommended order is: massage, stretch, strengthen, ice.
• The contradictory advice around stretching for hypermobile bodies is confounding, but here are a couple of good resources on the topic. Be gentle with your body, and if needed, work with a PT or other care provider to help you stretch safely with your hypermobile joints.
  • Fibro Guys on Stretching
  • EDS Society notes on exercise and movement

Ice

Ice cup massage is one of my favorite pharmaceutical-free pain relief techniques. I am so grateful to the physical therapists who taught me about this years ago, and I’m often surprised how many people have not heard of it. Instead of passively using an ice pack for 20 minutes, you take a cup of frozen ice, and directly massage the inflamed area with the large ice cube, for 2-10 min. In addition to the anti-inflammatory effect of the ice, you can also dig into the tissue with as much pressure as preferred for fascial massage.

Since the cooling effect is not going to penetrate deep into tissues, this works best for injuries or conditions that are near the skin, such as plantar fasciitis, but also tennis/golf elbow, IT band syndrome, and contusions. I do this so often that I got tired of going through paper or styrofoam cups and bought a re-usable Cryocup made for this purpose.

During my youth career in select-team softball, cold spray was a stable of the coach’s bag. Much like how it is used in professional soccer, cold spray provided some immediate relief to the sting of high inside fastball that landed squarely on your shoulder blade or a bruise from a rough slide into home. It’s not as effective as truly relieving inflammation as ice massage, but when you’re in acute distress, cold spray will help numb the pain until you can get off the field, so to speak. The Medi-First spray is just an aerosol coolant, but the Biofreeze also includes menthol for an icy-hot effect.

Massage

Massaging the plantar fascia is important for loosing up the tissues and allow strengthening and stretching to work. The articles above walk through specific techniques for using these massage tools. I recommend having a couple of different objects to work with. If you don’t want to spend any money, good options are a frozen water bottle (which doubles as ice and massage), plastic golf balls, or racquetballs.

I use a roller like the Theraband one below, which can also be frozen, as well as a set of larger, stiffer balls, and smaller, squishier ones. You can also use the OPTP Mini Balls, the small squishy ones, to do “MELT method” exercises on both hands and feet, if desired.

Stretch

I have a hard time stretching my calves because my knee and ankle joints will hyper-extend before my calf actually gets a stretch. I’ve found that using a slant board like this while consciously holding my knees in a straight but not hyperextended position works best for me. I have one of the blue rocker stretchers (paid link), which takes up a lot less space, but I’m nervous that a joint will slip out of place and I’ll pull or twist something.

The stretch out strap is my favorite way to stretch all the muscles in my legs and hips. It’s incredibly versatile, and I use it almost every day. Being able to stretch while on my back makes me feel a lot more in control as well, so I don’t have to worry about keeping my balance on something at the same time as stretching.

If your healthcare provider recommends it, you can also use a sleeping boot to help stretch out your plantar fasciitis while you sleep, so you won’t wake up in as much pain. The stretch was always too intense for me to sleep in, but I would put it on when I woke up and sit in bed for 15 minutes before getting up, and that worked wonders. Another neat passive stretching device are the yoga toes, which help stretch out all the small muscles and fascia of your feet.

Compression

Compression socks and sleeves can help improve blood flow and reduce inflammation to relieve pain. I wear the socks on the left often for a few hours at a time, but if I leave them on all day the compression can get too intense. The ankle sleeve on the right is designed to give additional support to your ankle and the arch of your foot for more stability if you need it.

Taping techniques

If your pain is intense and stubborn, your healthcare provider may recommend trying to relieve as much pressure from the plantar fascia as possible to allow the inflammation to reduce before proceeding with more weight-bearing exercises. This can involve being put in a boot (I had to wear one for 6 weeks), or using rigid taping methods. I don’t recommend trying taping without guidance from a professional first because it takes practice to do correctly, and if you haven’t had a physio or someone else do it first, you won’t know what it’s supposed to feel like. Taping was immensely helpful for me in reducing my pain while I worked on stretching and other techniques for long-term relief.

It’s important to use rigid tape here instead of Kinesio Tape because the tape needs to be able to stand up to weight bearing to keep pressure off the arch of your foot. Rigid tape is more likely to cause skin irritation, so an under-wrap tape is typically used with it. There are other types of taping techniques besides the one I’ve linked, so be sure to ask exactly what type of tape and under-wrap (if any) to use.

Wear supportive shoes

In many of the resources I link to in this post, you will find the advice to wear supportive shoes, always. Not only should you wear supportive shoes, you should find inserts to give you the right amount of arch support for your foot. I worked with physical therapists and podiatrists over the years, and I have several things that work for me. I have insanely high arches, so all these recommendations are based on that foot type.

Walking/running shoes: Asics (Gel Kayano) & Hokas (Bondi 8)

Sandals and other casual shoes: Chaco & Clarks

You should also wear shoes even when walking around your house. I have a couple of pairs of comfortable house shoes, and some orthotics I slip in and out of them. For house shoes and more formal shoes, I shop at the Good Feet Store. They have a (very expensive) system of custom insoles which didn’t work super well for me, but all of their stores have a small selection of shoes that are good for your feet, and I’ve loved every pair of shoes I’ve bought there.

The best non-custom insoles and inserts I’ve found are these two below. The Spenco insoles have extra cushioning right under the heel and a high arch support. Heel cups can help take the pressure off intense heel pain and can be used alone if you don’t need the extra arch support. There are plastic ones which may work better for some people, but they always caused more pain for me personally, so I used gel.

Strengthen

Finally, with all that stretching and massaging and icing, don’t forget to strengthen! Strengthen the small muscles of your toes, ankle, and feet for overall fascial support of your poor hypermobile joints. Refer back to these links or talk to your healthcare provider for specific exercise instructions.

Conclusion

If you are at your wits’ end, ready to give up and either just deal with the pain or give up on walking, I feel you. I spent many years in the 5-7 pain range, playing whack-a-mole with the issues causing 7-9 range pain, and the plantar fasciitis just seemed impossible to fix. I hope something in this article has been helpful, or I hope you find your own path to relief!

Footnotes

1. You know, except for tennis elbow, patellar instability, MECFS, fibromyalgia, cancer, famine, the Yankees, war, etc.
2. Disclaimer: No content in this post is intended as medical advice. If you are experiencing an injury that relates to the topics discussed, please consult with your health professional(s).
3. I make commission on items you purchase from Amazon when you click on the sponsored links. I don’t make a profit from running this site, but the commissions from Amazon help to cover the costs of maintaining the site.