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This article is a transcribed edited summary of a video Bob and Brad recorded in November of 2023. For the original video go to https://youtu.be/Eq0SssY4ZXs
Brad: Oh, this foot pain. This plantar fascitis is just killing me, especially in the morning.
Mike: We're going to show you five options on how to walk pain-free again.
Brad: Now, plantar fascitis can be a really painful problem and lasts for months. It typically affects people between the ages of 40 and 70.
Mike: First, we're going to show you what is causing the problems with a little anatomy lesson.
Brad: That's right. Let's get to it, Mike. All right, my favorite part of the program. Mike has volunteered to sacrifice the bottom of the foot so we could put some colors on there. The green represents the location of the plantar fascia. It's a very tough tissue that connects from the base of the toes all the way to the calcaneus, or the heel. The red part represents where a vast majority of my patients have a very tender spot. That's where the fascia is actually tearing away from the bone or the calcaneus.
Mike: So when most people think of the plantar fascia, they just look at the part we showed on my foot, but realistically, it's part of a longer chain, and it runs from your great toe here up around the Achilles tendon into the calf and goes behind the knee. All this connects into one long segment.
Brad: And this is critical for how you treat it. So now we're going to show you five options on how to treat plantar fasciitis at home so that you get rid of it as soon as possible. And you're going to see why we demonstrated or showed the whole length of the tissue that's involved with the treatment. You'll see it all makes sense. Now, a very common symptom is when you get out of bed in the morning, you put weight on your foot, and you get severe foot pain. If that's you, this is something that will help. Because if you don't do anything about that, that'll make the healing process go on for weeks or longer. So let's explain it briefly. When you sleep, your foot is plantar flexed.
Brad: The plantar fascia actually starts to heal in that fashion. Now, when you stand up and dorsiflex and put weight on your foot, that stretches the plantar fascia, and the injured hotpot actually gets torn apart, re-injuring it every morning, limiting the healing process, and it can last forever. So what do you do about it? We put a splint on. They call it a night splint. They're very common. You can buy a number of them on the internet or wherever you'd like to. Now, this is Mike's. He's been wearing one, not right now, but you've worn this. Now, without the brace, you would sleep with your foot plantar flexed. Now, the brace is adjustable. You essentially pull it up and strap it down so your foot is in a neutral position. Mike, can you tell us what works well for you on this?
Mike: So this isn't going to feel like a stretch. It's just going to keep your foot in a neutral position. So it's not like it's going to be tight when you put it on. Typically what you can do is wear it right away when you go to bed. You may wake up and your calf may feel tight. If that's the case, maybe not start with it right away. But if you wake up in the middle of the night for whatever reason, say you use the bathroom, maybe put it on then before you go back to bed. That way your foot is in its position before you get up in the morning because this is how you want to be to not tear that plantar fascia again. Now, I don't have plantar fascitis, but it also works for other ankle or calf issues.
Brad: All right. Now, I've had a number of patients that the only change they made for treatment for their plantar fasciitis is to wear a night splint. And they noticed it immediately getting out of bed in the morning. Much less pain and it started to heal, and throughout the day, much greater progress in taking care of the problem. Okay, now, if you do not have a splint like Mike has, and you don't want to get one, you can heal this without one. But before you get out of bed in the morning, you do need to do some range of motion and specific stretches. This morning treatment, before you get out of bed, we're going to do some stretching. Now, keep in mind, that we have the blue fascia whole train right here. Now, what you're going to do to start is simply range of motion. Up in the air. You can rest your foot here. And do at least 10 repetitions.
Brad: It's going to be a little sore at first, especially when you go up. Do it until it feels better and loosened up. Then the next step is actually doing some stretching. Now, the thing is, remember the plantar fascia goes up to the toe. You could stretch to get the fascia and the heel, as well as the calf, and hold it. You can hold for 15 to 30 seconds, or stretch and relax, stretch and relax. If it's really painful, start gently and then progress on. After about 10 repetitions, it should be good. Remember the big toe, or as Mike calls it properly, the great toe, pull it back and stretch that. That's a critical stretch, and it's easy to do as well, which is really nice.
Mike: Now, the next step to do before you get out of bed is to do a little bit of massage to the plantar fascia region on the bottom of the foot. You don't have to work the whole chain or train, as Brad just said before. So what you could do is circular motions, just the whole plantar fascia, which I've highlighted here. Or you could do a splaying massage, in which you kind of bring your thumbs together and then pull apart. Whatever feels better for you, do that.
Mike: You can do this for two to five minutes. If you want to work around the painful area, and it feels good, especially after you massage it, that is fine. If it just makes it worse and irritates it, you don't have to do that area. Just do the surrounding areas. Get that plantar fascia loosened up and ready to move before you start walking.
Brad: Good job. All right, so that is critical, that you stretch before you get out of bed. Do the massage for a couple of minutes. I don't know if you can go five minutes, your fingers will probably get sore. We're going to show some better options for that throughout the day. Whatever you do, once you get up, put your shoes on relatively quickly so that helps support the fascia, so you're not walking around barefoot initially. Do what feels good on your foot. Now we're going to show you some more massaging you can do, because the more you can massage this throughout the day, maybe two or three times, the better it is. So obviously you need to take your shoes off. You can do this with your socks on. Whatever works well. Simply use a golf ball, tennis ball, or lacrosse ball. Mike has an actual massage ball. You could use a softball. The rule is the harder the ball, the more aggressive and the smaller. Like, the golf ball is going to be the most aggressive. At work, you could just simply take your shoes off and put a ball underneath your desk, if that's the type of work you do, and massage it every couple of hours. Mike, do you have any more input?
Mike: They even sell little massage balls that are only like 3 to $5 with little nodules on them. That's what I have at home. It actually feels pretty good.
Brad: Right. When using the ball, the hardness of the ball and the size of the diameter makes a big difference. The most aggressive would be the golf ball. It's hard. It's small in diameter. But I would suggest starting with a tennis ball that gives a little bit, and then you can work that. And when that doesn't feel like it's hard enough or aggressive enough, then you can go to like a lacrosse ball and work that. And the most aggressive is the golf ball. Okay, now another good option. If you happen to have a massage gun at home, take advantage of it. It'll save your hands and fingers. Either use the roundhead or the airhead that's soft. And don't get too aggressive right away. Don't overdo it, even with your hands. You can work that plantar fascia. And I would not go straight in on it. With the ball head, you can go sideways. Now, with the airhead, that doesn't work so well. But the airhead's softer. It's more forgiving. It should not hurt. You should feel like a good massage. As Mike said, don't go over that painful spot if it hurts, only do that if the massage actually makes it feel good after a few seconds. You can work on that. Work that massage.
Brad: Now this is a critical part. Seeing how we're working this, we're also going to work the muscles up the chain. Because when these muscles get tight, that puts stress on the tender area and then will make a significant difference in making it feel better. So you're going to work this large calf muscle. Mike, do you have any input? You do this a lot.
Mike: I have some knots in my calf, so that's a little touchy for me. So I'm not going to push as hard there.
Brad: Right. So if I have a knot, and it really hurts to go over that, don't beat it up. Work around that knot. Be gentle with it, and then you can get closer as it loosens up. You may spend three to five minutes with this and not get a sore hand. They're a wonderful tool.
Mike: So after you massage the calf muscle, it is good to stretch it as well. You can do this throughout the day. If you do not have any devices, you can simply go up to a wall to stretch. Let's say I'm going to stretch my left calf, I'm going to put it behind me. Have a straight knee. Notice that my toe is pointing forward. I'm not turning out like this. And the more I start to lean forward and look up, the more calf stretch I'll feel. If I'm back, I don't feel anything. As soon as I start bending more and pushing, I will feel a good calf stretch there.
Brad: You must keep your heel on the floor like Mike is doing here. If it lifts up, that does not make an effective stretch. Now, another great benefit, stretch with a straight knee, and then try and keep your heel on the floor and slightly flex the knee.
Brad: That stretches a different muscle. You get the soleus that way versus the gastrocnemius. You don't need to know that, but just do that a few seconds each way to be complete. Now, if you happen to have an incline board, this is mine, I actually made it. We have a video on how to make one very cheaply if you're handy and you have a few tools. Otherwise you can buy them pretty cheap. This is my favorite way to stretch a calf. It just works better. It's not so much work, and it's a little more effective. Mike, do you have any comments on the incline board?
Mike: To make it more aggressive, if I'm standing here, I feel nothing. The closer my other foot gets even with the board, or in front of it, you're going to feel much more of a stretch. Again, you're going to straighten your knee out. And this hits it well.
Brad: Yeah, they're a wonderful device. Now, this technique we're going to show you is how to change your walking to take the stress and pain off that plantar fascia. Almost everyone, they heel strikes when they walk, and the force goes through their body, through their heel, and that puts a lot of stress on that fascia, that tender area. We need to change that. Mike is an excellent person to do this because he's changed his walking to the soft knee, which helps the plantar fascitis strain. Ooh, go ahead, Mike.
Mike: So when you're going to land when you're walking with soft knees, you're going to land more on your forefoot, or you can land with kind of a flat foot like. The whole goal is to not be heel-striking like this.
Mike: So forefoot or flat foot, whatever's comfortable for you. When you're actually walking, what you're going to do is take smaller steps. Notice I'm not going to be stepping as far as normal. I'm going to be taking shorter steps, and I'm going to be landing on my forefoot. As you get comfortable doing this, you might start to go more of a flat foot. It will take some time to get accustomed to. Your gait pattern is going to slow down initially, but over time, it'll start to return and feel more natural. Just make sure you're landing on your forefoot and you're not locking your knees out when you're walking. I'm having nice bent knees.
Brad: A good way to learn how to do this, I have found personally, is I walk around the house with my stocking foot or barefoot on a hard floor, and you can feel when your heel strikes in, in that normal pattern, versus the forefoot. It's much more comfortable, and it's like a quiet, soft walk, taking the stress. And you'll feel pain reduction on that painful heel as well. Nice job, Mike. Now, if you're one of those people that's had plantar fascitis that's been bothering you a few weeks, take these steps to heart. Do them every day. It will improve, and you'll have progress and success. Good luck. And Mike has some more to say, don't you, Mike?
Mike: Yes. Another important key feature of plantar fascitis is your footwear you are wearing. We're not going to talk about it here, but if you want to check out our video "You Are Walking All Wrong & It's Causing Pain", we explain it all in detail.
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