I love to exercise, so staying off my feet while I wait for the foot pain to disappear while my plantar fasciitis heals is a challenge. And it’s not just because I write for MedShadow, where I’m frequently extolling the benefits of a lifestyle based around more physical activity, less stress, and a solid foundation of fruits, vegetables, and omega-3s. I’ve always been this way. As a member of a very average high school swim team, I decided that swimming for two hours a day, six days a week wasn’t enough. I petitioned my coach to add morning practices two days a week. Sadly, she declined, to the relief of many of my teammates who did not share my enthusiasm for the idea of waking up at 5 a.m. in the dead of winter to jump in the pool.
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Managing Conditions with Exercise
As an adult, I still manage to fit some form of exercise in three to five times a week. The habit has probably gone a long way toward helping me manage my polycystic ovary syndrome (PCOS), but more than that, it plays a major role in my mental health. Whenever I start to feel a dip in energy and mood, a feeling that the stress of life is becoming more overwhelming than it was before, I ask myself “have I exercised in the last few days?” Typically, the answer is “no,” and even 20 minutes of walking, running, biking, yoga, weightlifting, or swimming—I like variety!—is all it takes to get my spirits up.
Still, I struggle to stay motivated unless I have a race on the calendar, my favorite being triathlons, and I started training for one a few months ago. During a long, hot Sunday morning run, I watched the sun rise. Then, I felt a familiar twinge just between the heel and arch on the inside of my right foot.
Plantar Fasciitis Strikes
My body had betrayed me. It was plantar fasciitis, an injury characterized by inflammation along the plantar fascia, tissue that runs along the bottom of your foot connecting the Achilles tendon to your toes. It’s common in both runners and walkers, and mine is clearly triggered by adding miles to my running route. This particular injury is well-known to take weeks, at minimum, to heal. Some people struggle with the pain for a year or longer. The prospect of not being able to run for weeks or months is terrifying to me. I panicked.
Hoping for a Quick Plantar Fasciitis Fix
When the pain didn’t immediately subside after a day or two, I started scouring the internet for quick fixes that would let me lace up my running shoes again. I read article after article in running magazines and medical journals, hoping one would finally tell me the secret to healing my foot overnight. Each expertly laid out the stretches and strengthening exercises I’d need to do day in and day out, while waiting for my foot to heal on its own. Inflammation plays a role in plantar fasciitis, so, desperately I searched for whether taking a non-steroidal anti inflammatory drug (NSAID) such as ibuprofen before running could prevent it from flaring up again.
OTC Options
Given my position at MedShadow, I am well-aware of the myriad dangers of overusing over-the-counter (OTC) painkillers. However, “I’d only take it on days when I run,” I pleaded to myself. “And that’s only a few pills a week. It’s not anywhere near the maximum dose!” Then I found this article in Runner’s World. Not only do the typical risks of OTC pain killers still apply to exercise enthusiasts, but the dehydration that goes along with a long or intense workout can exacerbate some of the risks. Plus, NSAIDs might even worsen post-run inflammation, without helping pain, in certain cases.
NSAIDs such as ibuprofen are associated with a risk of kidney damage. Those with kidney disease are typically advised to avoid using them. When you’re dehydrated from running, your kidneys may get less blood flow—and therefore limited nutrients—than they typically do. That means taking an NSAID before a run can raise the risk of harming your kidneys.
Also important is the fact that NSAIDs are associated with an increased risk of blood clots, especially in women who use hormonal contraceptives (which is a common treatment not just to prevent pregnancy but also to treat the aforementioned PCOS). Researchers found the highest risk with diclofenac.
Tylenol (acetaminophen) is not an NSAID. It works by blocking pain signals to your brain. Exercise and dehydration isn’t known to worsen any side effects of the drugs, but since it doesn’t target inflammation, it wouldn’t contribute to any plantar fasciitis healing. Additionally, dehydrated or not, using it regularly raises your risk of liver injury.
Too Many Side Effects
So, I’m stuck with the typical pharma-free strategies that should help my foot heal, slowly but surely. In addition to eating my anti-inflammatory Mediterranean-style lunch as I write this (a grain salad with farro, kale, beets, chickpeas, pesto and garlic-herb goat cheese), I’m using the following time-tested techniques.
Calf and Foot Stretches to Heal Plantar Fasciitis
The plantar fascia is connected to your calf, and research has found that most people with plantar fasciitis have tight calves. Physical therapists and orthopedists emphasize that stretching your calf muscles multiple times a day can help loosen this area, and relieve some of the pressure on your plantar fascia. We can also stretch the plantar fascia itself using our hands to push our toes back toward our ankles.
Bedtime Boot or Night Splint
When we sleep, our blankets often push our feet down, so we point our toes as if we are swimming. This shortens the plantar fascia. As you sleep, it starts to heel in this position. When you stand up in the morning, flattening your foot and placing your body weight on it stretches your plantar fascia causing pain again. It’s thought that a night splint can keep your foot in a neutral, flexed position while you rest or sleep to help it heal while still stretched out, limiting pain, though clinical trial results have been mixed. Because it’s not always easy to sleep in, I wear mine while writing all day!
Supportive Shoes
One of the biggest risks for developing plantar fasciitis is worn out or inappropriate, unsupportive footwear. The first thing I did when I noticed the pain was to trade my flat flip-flops and high heels for sneakers and shoes with arch support, which immediately reduced my pain between runs.
Massage
Using your thumbs to dig into the arch of your foot can also help reduce pain from plantar fasciitis. Experts recommend starting closer to your toes, where you don’t feel pain, and working your way down toward your heel if you can tolerate it. You can also place your foot on top of a tennis or lacrosse ball and roll it to massage the area. Some people like to freeze water bottles to role under their foot. The ice helps reduce swelling, while you massage.
Hopefully my plantar fasciitis will heal in time for the next start line, but if not, I’ll just have to add another race a little later in the year.
