Discussion: Orthotics for plantar fasciitis

I've had plantar fasciitis since January, and my doctor now wants me to have a "slow recovery with orthotics." I remember using my feet a lot orienteering over uneven ground, and I'm wondering if wearing orthotics every minute I'm on my feet will weaken the muscles I need to support my feet while I'm orienteering.

I believe the answer to your question is no. I have had pf since august 06 and am just about recovered. I believe that stretching the toes back towards the knee is an exercise that an article has been written about, this seems to help stretch the bands in the foot. The orthotics I have I wear as much as possible and run in , but not orienteer in. Good Luck

I'd agree with Soupbone. I went through a nasty bout of PF that was solved partially with "the boot" (a foot brace that keeps your foot stretched when you sleep, so you don't heal overnight and then re-tear everything the moment you step out of bed) and partially with orthotics. I got the orthotics because I'm in the Army and I was going to the field for a month for a job that would require me to do a lot of walking, which by that point I couldn't do very well. I liked my first set of orthotics best - a plastic sheet dipped in hot water and molded to the bottom of my foot. They came up rather high around my heel, but that seemed to work fine. After that first month of walking, I ran with my orthotics - developed some additional callouses, but they stopped me from making things worse while allowing me to run. I eventually transitioned out of the orthotics, and although I run with gel arch supports in my daily running shoes, I don't need anything special in my O shoes any more. I still wear orthotics in my daily shoes since I spend a lot of time on my feet. My latest set were made from a mold of my footprint (I had to step in a box of some hard foamy stuff). I can run with them, but I still prefer the first kind I had. They were made by a physical therapist - the second kind came from a podiatrist.

I think the key is to take it slow - it took two years for me to get back to "normal" - but leaning on "the boot" (they now make "the sock" which I've read is a lot more comfy) and orthotics were the only things that allowed me to keep running while getting back to normal. At any hint that my PF is coming back, I pull out "the boot" - a couple nights and not going barefoot around the house seems to do the trick.

Good luck!

So it sounds like orthotics are great for making the recovery, and that once I'm better I can gradually start to work in the activities and shoes that put more stress on my feet.

Thank you!

I'd strongly second the recommendation of the "boot" or "sock". Preventing the fascia from tightening overnigh is very important. Most of the damage to recovery is done in the first few steps you take in the morning.

What's the verdict on cortisone shots for pf? I haven't done it yet... but am wondering if I should give it a try.

Plantar Fasciitis is a mechanical problem that is caused by poor biomechanics of the foot. The damage is done throughout the day but most painful first thing in the morning since the fascia has been in a shortened position all night. Orthotics, stretches and sometimes night splints are the only good solution. Cortizone injections do not correct the mechanical problem. They will only make it feel better temporarily in most cases. Cortizone injections have also been correlated with a higher incidence of plantar fascia rupture.

I tried everything. These are the three things I'd rank as most helpful.

www.superfeet.com
Active Release Therapy (ART)
www.thesock.com

I wear the superfeet orthotic 24/7, even when orienteering. I would not buy it over the web, go to a running store and test one for fit and feel. A custom made orthotic was not helpful, but I noticed improvement from this almost instantly. I'm up to about 90% of volume now, with no significant pain. The recovery is long; I was diagnosed last October, and my case was mild as these things go.
(I have yet to do speedwork since recovery (this is bad for it), but do plenty of hillwork (also supposedly bad)).

As for ART, I saw a "sports chiropractor" for this. I tend to be a bit skeptical of this sort of thing, but it did seem to help. The theory is that it pushes scar tissue out of the fascia, and blood into it. After a couple months of sessions and careful observation, I was able to perform the procedure on myself, and do so daily. The sports chiro should also be able to address alignment problems; I'm not convinced mine did, but local treatment of the symptoms even if the underlying remains still seemed worth it.

The problem with PF is that everyone's case is different, and what seems to work is often different among people. I just kept trying different stuff I read about. Perhaps it was a case of time heals, but I really thing that there is something to the three things listed above. The injury fora on runnersworld.com had tons of try this try that for PF, and I found that valuable.

On stretching: I found stretches that streched the foot/fascia seems bad, not good. I found streches that stretched calf muscles to be good. (Note that I'm not referring to a night splint/strassburg sock stretch as bad, I think that one is good). On rolling a frozen can of juice under my foot -- not convinced that this helped me.

I also did exercises where you pick up marbles with your toes, or lay a towel out flat and try to scrunch the whole thing to your foot using only your toes without moving your foot. Possibly helpful.

Good luck with it.

I've been using a night splint, which I think is responsible for the rapid reversal of damage caused by ill-fitted orthotics. My captain recommended it rather than my doctor, and I picked it up at a running store.

I agree about the cortisone shots not helping long-term. I got 3 in my right foot, and now I sometimes get the same discomfort that I have in my more recently-injured left foot.

Platelet rich plasma (PRP) therapy. I've used this to treat tendinosis in both knees with outstanding results.

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