Michigan Answers: Questions About Plantar Fasciitis

The start of a new day can feel a little less hopeful when it’s marked by stabbing pain in your heel. Plantar fasciitis is one of the most common causes of heel pain.  

  • What causes plantar fasciitis?
  • Can you prevent plantar fasciits?
  • Why do some people get plantar fasciitis and others don’t?
  • How do you make plantar fasciitis heal pain go away?
  • What are the best types of footwear for people with plantar fasciitis?
  • Should someone with plantar fasciitis exercise or rest for the best relief?
  • Can you still be a runner if you have plantar fasciitis?

Podiatrist Garneisha Torrence, M.D., joins us to answer the top-searched questions about plantar fasciitis in this week’s episode of the Michigan Answers podcast.

Listen to the podcast

Episode Transcript

Dr. Preeti Malani: 

More than two million people start their day off the same way. The first thing they notice when they get out of bed is a stabbing pain in their heel. Sound familiar? If so, you'll be interested in learning more about this week's topic, planter fasciitis.

Dr. Preeti Malani:

Plantar fasciitis is one of the most common causes of heel pain. Unfortunately, it's usually not limited to pain only when you stand up, and for millions of people each year, plantar fasciitis can prevent them from doing the activities they love. Why is this happening? How do you make it go away? And what can you do to prevent it in the first place. Dr. Garneisha Torrence, a podiatrist at University of Michigan Health, will help us answer these questions and more.

Dr. Preeti Malani:

I'm Dr. Preeti Malani. Thanks for joining us on the Michigan answers podcast.

Dr. Preeti Malani:

Hi, Dr. Torrence. Thanks for joining us today.

Dr. Garneisha Torrence:

Hi Dr. Malani. Thank you for having me today.

Dr. Preeti Malani:

So I've got my list ready. I know you have a pretty good idea of the things we're going to talk about because you hear these questions all the time in clinic.

Dr. Garneisha Torrence:

Yes, I do.

Dr. Preeti Malani:

We've researched the most asked questions about plantar fasciitis on popular search engines, and we're hoping you can help us out with some answers. Okay, let's dive in. Question one, what causes plantar fasciitis?

Dr. Garneisha Torrence:

As you kind of mentioned, plantar fasciitis, a lot of people think of it as just heel pain. The plantar fascia itself is actually a ligament that runs from your heel bone to the ball of your foot. And that ligament is very important for maintaining the arch of your foot, actually maintaining the structure of your foot. So plantar fasciitis is caused when this ligament is inflamed for whatever reason. And so those reasons can be very, very different. So too much pressure, increased activity, repetitive activity - all of those things can lead to inflammation and that's what causes plantar fasciitis.

Dr. Preeti Malani:

Next question, is there a way to predict who might develop plantar fasciitis? So it can be prevented.

Dr. Garneisha Torrence:

That question is actually kind of difficult to answer, but I will say that there are three types of arches that we're all familiar with. So there's a very low arch, like in a flat foot person and the lucky people who kind of have a normal arch, and then you very high arch person. Patients or people who usually have this low arch, they're more prone to getting plantar fasciitis. If you think about having a low arch, I mentioned that the plantar fascia supports the arch. So if you don't have an arch that plantar fascia is getting worked out overtime. And if you don't really have an arch, you're more likely to pronate. And pronate just means that you're putting more pressure on the inside of your foot. And so if you have a flat arch, you tend to pronate more, you're more at risk of developing plantar fasciitis.

Dr. Preeti Malani:

Okay, so if you can't prevent plantar fasciitis, how do you make it go away?

Dr. Garneisha Torrence:

So I know that's the number one question everybody wants to know, how do you make it go away? So first just be patient because plantar fasciitis doesn't develop overnight. So it takes some time. I typically have three things that I tell people, how do you make it go away? The first thing is that you need to support your arch. You need to have a proper shoe that really does provide a stable structure for your foot. And sometimes you actually may need some help through an insert. Now this insert can be custom or you can get it over the counter. The second thing is the ligament needs to be stretched. What typically happens is that the ligament can get very, very stiff and this stiffness makes it less flexible so that when you're walking, it's more prone to injury or inflammation. And so stretching exercises can be very helpful in preventing plantar fascia, plantar fasciitis, from developing. And because plantar fasciitis is an inflammatory process, you really need a good anti-inflammatory regimen. An anti-inflammatory regimen can be as simple icing, or you may have to have some kind of oral medication or even get some more invasive anti-inflammatory regimens through your doctor.

Dr. Preeti Malani:

Can we talk about what that might look like?

Dr. Garneisha Torrence:

Anti-inflammatories, as we all know, they get rid of inflammation and so ibuprofen or Naproxen, those are typical ones that we know from the store. So more invasive ones are through a steroid injection, or even a stronger, lower dose steroid that you can take by mouth, but it has to be prescribed by your doctor.

Dr. Preeti Malani:

Thanks for walking us through some of the common treatments. Do some people end up needing surgery for this, and if so, what's involved with that type of procedure?

Dr. Garneisha Torrence:

So there are so many things you can do to treat and manage plantar fasciitis before you consider surgery. I mentioned stretching, proper shoes, inserts, definitely an anti-inflammatory regimen. Some people require a course of physical therapy to help them learn how to stretch better. Also physical medicine and rehab. They have some techniques that can help you in some procedures, actually, that can also help treat your plantar fasciitis. The surgeries for plantar fasciitis, they vary. Some are very simple and minimally invasive and others are more invasive, involving an incision to your heel. Most people, the overwhelming majority of my patients do not require surgery to manage or treat their plantar fasciitis. Just keep in mind that you have to be patient. That's the number one thing you need when dealing with plantar fasciitis is patience, because you have to kind of go through different techniques before you get to a happy medium and surgery usually doesn't even enter the conversation.

Dr. Preeti Malani:

Yeah. That's helpful to know. I think patience is difficult for this condition especially.

Dr. Garneisha Torrence:

Yeah.

Dr. Preeti Malani:

Okay. So this is a really popular one and there appear to be a lot of shoe companies also trying to answer this question, what are, so this is a really popular one and there appear to be a lot of shoe companies also trying to answer this question. What are the best types of footwear for people with plantar fasciitis?

Dr. Garneisha Torrence:

So I usually tell people that the uglier to shoe, the better for your foot. But seriously, the shoes that we think are more comfortable, flip flops, loafers, sandals, the really low profile, cute, flexible shoes. They're typically not what you want to wear if you're dealing with the symptoms of plantar fasciitis. I typically have my patients take off their shoe. And if you can bend your shoe and a half in the middle, that shoe doesn't give you the proper support. So I tell patients that it doesn't matter the price of the shoe, when you go into a store, just pick up the shoe and if you can bend it in half, that's the kind of shoe that you want to kind of steer away from when you're dealing with plantar fasciitis.

Dr. Preeti Malani:

Lots of searches on this question too. Is walking barefoot good or bad for people with plantar fasciitis?

Dr. Garneisha Torrence:

Well, believe it or not, I actually have plantar fasciitis myself sometimes. And walking barefoot does feel good, but I have to say, no, do not want barefoot in the home. Similar to, as I just said, a flexible shoe isn't the kind of shoe that you want to wear. Like your slipper. Those are usually very flexible. So as I mentioned that you need something stable on your foot and that's indoors and outdoors. And so I usually recommend a clean, stable sandal or a slipper that has enough support that's not flexible. Even for myself, when I'm doing a lot of activities, washing dishes, my chores, I have a clean athletic shoe that I wear just for inside the house. So barefoot, if you have plantar fasciitis, you may be able to get away with it one or two times. But for the course of your day, if you're home for eight hours, you really should put a shoe on your foot.

Dr. Preeti Malani:

Last question. What about running? Are your days of running over if you have plantar fasciitis?

Dr. Garneisha Torrence:

Oh, no, not necessarily. You may have to take a break. I think running is a great activity. I encourage it, but it's hard to do anything and especially run when your feet hurt. So yes, you can get back your running. But as I said, be patient. Actually, one of the things to kind of calm inflammation, including plantar fasciitis is taking a rest. Now this rest doesn't have to be for weeks and weeks, but it just helps to calm inflammation down. And while you're doing this, you can partake in low impact activities, such as cycling and swimming to continue exercising, but you really want to focus on treating the symptoms, the inflammation. So while you're stretching and finding appropriate shoe for you and taking part of an anti-inflammatory regimen, and as you start getting back to thinking about running, just remember not to overdo it. A lot of people, they beat plantar fasciitis, they're happy, and then I see them back and I'm like, what happened? Oh, I went for a 15 mile run. I'm like, okay, don't do that. So just gradually build your activity up. Once you treat those acute or short term symptoms, basically just getting rid of the pain, start getting back to running, but just be gradual about it.

Dr. Preeti Malani:

Yeah. Runners have a hard time not running.

Dr. Garneisha Torrence:

Yes. I know.

Dr. Preeti Malani:

So Dr. Torrence, thank you so much for sharing your time and expertise. I know we all learned so much today and thank you to our listeners for tuning into this week's episode of Michigan Answers. If you enjoyed today's episode, please subscribe wherever you get your podcasts. We'll be back next season, unpacking more of the most searched for health topics on the internet. And if you're interested in learning more about how Michigan Medicine is improving lives and advancing health, you can visit us at michigananswers.com. See you next season.

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