Plantar Fasciitis: Recent Research and Real World Tested Solutions to Heal the Root Cause of Plantar Fasciosis

Do you have heel or arch pain when you wake up or after challenging your feet? Below is a real-world tested and research backed multi-tiered approach to get to the root cause of plantar fascia problems. Before beginning, it is important to know that if you have had pain for more than a week or so, you are not dealing with plantar fasciitis---you're likely dealing with plantar fasciosis---and knowing that makes all the difference. 

Plantar Fasciitis Science Backed Healing

Various research(1) has shown that chronic Plantar Fascia problems and pain are NOT the result of inflammation, but rather from poor blood flow & weakness causing tissue degeneration. Because there is no inflammation present, the old term "plantar fasciitis" is inaccurate, and should more accurately be called "plantar fasciosis". This denotes that the tissue is actually degenerating due to weakness and lack of blood flow. This knowledge and terminology completely changes the way this condition should be treated. 

Research has also shown that chronic plantar fascia problems are basically non-existent in people that don't wear shoes with elevated heels and tapered toe boxes(3).Typical modern shoes with elevated heels, tapered toe boxes & support devices have been shown to significantly reduce bloodflow (2) & are believed to weaken the feet. One look at, or google search of the feet of people who don't wear modern footwear makes this quite obvious. 

The soft, deep heel cup, cushy arch, and met pad of Bridge Soles are designed to help the Plantar Fascia relax while the foot is stressed. They also promote better blood flow without weakening the feet like most typical insoles & custom orthotics. While Bridge Soles can provide some relief and promote a healing environment, addressing the root cause is critical. For best results, in conjunction with wearing Bridge Soles when the feet are being stressed, do these research based and/or real-world experience based treatment options: 

  1. Start the day with heat & vibration (like the Myostorm Meteor Mini Ball). Massage often if you can't do heat and vibration. 
  2. Prioritize top of foot toe extensor (toes down) stretches to release the antagonist muscles---allowing the arch side of the foot to relax & heal. This is often the missing element for those that are doing everything else right. 
  3. Increase bloodflow all day! Look at the shoes you wear the most hours of the day. Research has shown that 98% of all running and casual shoes have a tapered toe box that bends the big toe slightly in and reduces blood flow to the Plantar Fascia by 22% (2). The elevated heel in nearly all shoes reduces blood flow an additional 29%. Wear shoes with true foot-shaped toe boxes to improve blood flow, ideally with Correct Toes---which should also be worn as often as possible---with or without shoes. If you've never worn foot-shaped shoes before, they should feel "too big" or uncomfortably loose in the toes at first. Examples of foot-shaped shoes with no heel elevation would be Lems, Altra, Splay,  Topo (some), Xero Shoes (for average to narrower feet), Tolos, etc. 
  4. Although many have had success with this for a couple of decades, and experts have recommended this for 20+ years, new research(4) has shown that 95% of those who did barefoot running on grass for 6 weeks experienced improvements in their plantar fascia pain. Start with 30 seconds of barefoot running (on soft ground like grass or carpet) & add 30 seconds every few days (as long as it is pain free). Many years of experience has shown that slowly working up to 20 minutes of regular barefoot running seems to be as close to a magic bullet as is known for long term healing of plantar fasciosis. 
  5. Increase blood flow and strengthen the weak tissue by going barefoot whenever possible on carpet & grass (as long as pain free) 
  6. Balance on one foot in shoes whenever possible, such as when standing in line at the store, etc.. Also balance on one foot as an exercise barefoot with the eyes closed. For most effectiveness, pull the heel slightly off the ground (about 1/2") and work up to being able to hold that for 90 seconds. Don't overload & slowly work up.
  7. The Rathleff Protocol is an exciting treatment gaining more recent notoriety. It is essentially single leg heel-raises with 1" of towel, etc. under the toes and has shown promise in some new research (5) ( Web search "Rathleff Protocol"

See GoldenHarper.NET/PF for more Plantar Fascia detail & information

Foot strengthening exercises and bloodflow are key to curing plantar fasciitis

1)  Lemont H, Plantar fasciitis: a degenerative process (fasciosis) without inflammation. J Am Podiatr Med Assoc. 2003 May-Jun;93(3):234-7. 
2) Jacobs, J.L., et al. J Foot Ankle Res 12, 50 (2019).       
3)*Shulman, S. 1949 Journal of the Natl Assoc. of Chiropodists
4) MacGabhann, S.; Kearney, D.; Perrem, N.; Francis, P. Barefoot Running on Grass as a Potential Treatment for Plantar Fasciitis: A Prospective Case Series. Int. J. Environ. Res. Public Health 202219, 15466.
5) Rathleff MS, Mølgaard CM, Fredberg U, et al. High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up. Scand J Med Sci Spor 2014:n/a-n/a doi: 10.1111/sms.12313[published Online First: Epub Date]|.