I have personally been through this 3 times. The first time was in high school – I saw a PT and was treated with microcurrent and ultrasound, some foot massage, given some calf stretches and fitted with $400 custom orthotics. To my parents dismay, my $400 custom orthotics were pretty uncomfortable and didn’t fit into the shoes that I wanted to wear so those ended up in the back of the closet. The massage was incredibly painful, but it did make things feel better. In the end, the most helpful thing was getting new shoes!
The second time this happened it was SEVERE…I could barely walk in the mornings and I was only 19. I was studying abroad for a semester in Australia and was running every morning in order to work off those beer calories (I was now legal drinking age!) and my foot pain got worse and worse. I was intentionally avoiding going to the doctor because I had gone with my American friend and it seemed like more work than it was worth in a foreign country. By the time I got home and saw a PT they also confirmed that it was a SEVERE case! Turns out that I was running in these very cute Nike shoes every day that were way to narrow for my feet and were far too small. I did few treatments that were very similar to the first time and got new shoes and I was fine after a couple of weeks.
It took 3 times for me to get it through my head that I could not wear the shoes that I wanted to wear and that I needed much bigger running shoes! I was in PT school by this time and now that I understood the mechanics and the physiology behind the condition of plantar fasciitis, it made so much more sense! That is one of the reasons that I concentrate so much on educating my patients about their diagnosis, their individual body mechanics and the mechanics behind the pain and dysfunction. I think that if someone had gotten out the anatomy book or just really explained to me the anatomy and mechanics of why things were happening, I would have understood it much better and wouldn’t have had to go through more pain and suffering!
Now fast forward 13 years (crazy right??) and I can now wear all kinds of different shoes and am able to avoid foot pain. I still believe that proper shoes are imperative to maintain foot, knee, hip and back health, but I also feel that there are ways to be able to wear cute shoes here and there (just not all of the time). My number one recommendation is to get a proper shoe fitting at a running store. I would suggest going on a weekday so that they are not slammed – you really need to be able to go through the slow-motion treadmill test, walk/run outside (if they allow this) and maybe try a few different over-the-counter orthotics (Superfeet are my favorite) in each shoe before making your final decision. I still wear the same shoe that I was fitted with over 10 years ago (Brooks Adrenaline), I just buy a new pair every 6-10 months (depending on how much mileage I’m doing at the time). Also, it turns out that no matter how much mileage you have put on a shoe, they have a shelf-life and the sole dries out and looses it’s cushion (I believe that this is why you can find great brands for much cheaper at certain stores – they are old shoes!). So make sure you get your shoes from a reputable source and get new running/walking/athletic shoes at least 1 time a year.
So the reason I can now wear all different kinds of shoes is that I started working on more things than just stretching my calves! Turns out that there were other reasons for my poor foot mechanics – I had other things going on higher up in my legs and core! I won’t go into all of the specifics because it’s different for every person and people need a specific evaluation in order to find what the source of their issue is, but in my experience plantar fasciitis can be related to just about anything from the mid-back to the foot. If we only work on the plantar fascia and don’t assess the rest of the body, we are doing our patients a huge disservice. I feel this way about everything that I treat – the symptom is almost never at the same area as the source of the pain.
So my advice to anyone that is dealing with foot pain – get a professional shoe fitting from a reputable running store (many of them also have casual shoes and can help you with those as well). Then, seek out a physical therapist that is able to complete a full body evaluation and can spend enough 1-on-1 time with you to find the source of the problem and complete specific treatments to every area of the body that is needed. If you are going to a place that just does a little bit of foot massage, maybe some ultrasound and then gives you a few balance and calf stretching exercises, you might get better but I would suggest looking elsewhere.
Solstice Physical Therapy specializes in private PT sessions with 60 minutes of 1-on-1 care. People tend to improve much quicker in this situation, as we are able to get much more done in a private 60 minute session. Solstice PT is also out-of-network with insurance companies, which means that we have no limitations! Many times PTs are limited by insurance with the amount of time that they can see you and with the treatments that they can perform. If I find the that problem is stemming more from your hip and low back, I can treat it with no questions asked and I can complete a full, comprehensive treatment in 60 minutes which is very difficult to do when you are in-network with insurance companies.
If you are in the Denver Metro area and are looking for evaluation and treatment that is more inclusive, contact Dr. Lisa Wilcox with Solstice Physical Therapy. We treat pain, injuries, muscle and joint tightness or just general physical dysfunction and improve performance with athletics and daily life!