Other treatments for Plantar Fasciitis...

a) rest The activity that you do today will tell you tommorrow if you have rested enough or done too much or performed an activity that was deleterious to the plantar fascia. Generally, walking on level surfaces with a good running shoe does not cause harm to plantar fasciitis. Walking on eneven ground, inclines or standing on hard surfaces for long periods of time tends to make PF worse. Rest seems to be of greater benefit in acute plantar fasciitiis as acute plantar fasciitis is a basically a strain of the fascia and rest leads to better results in a sprain. When plantar fasciiitis becomes chronic, rest does less although "controlled" rest, that is avioiding the particular actions that stir things up are of more specific value. People often self treat or see there family doctor at this stage of heel pain.

b) shoes Remember that shoes that are too soft allow more strain on the plantar fascia. The ideal shoe is usually a motion control running shoe. Some examples of that include the Brooks Beast, the Brooks Addiction 6, the Brooks Addiction WT, the New Balance 1122 and the New Balance 925. One way to prove this, is to duct tape pillows on the bottom of your feet and go for a walk. If you have plantar fasciitis, your pain will increase. Many expensive name brand shoes may look good but provide too little support for the plantar fascia and can be a culprit in instigating heel pain.

c) physical therapy Ultrasound is a good modality to reduce scar tissue and inflammation. When ultrasound is performed utilizing a steroid gel it is called phonophoresis and can have increased effectiveness. Ultrasound is a high frequency sound emitter that is aborbed by denser (deeper) tissues and is radiated back to the surface as heat. It is a means of heating from the deep tissue out. Superficial heat is not very effective becasue skin and the tissues under it are a good insulator. Occasionally people confuse ultrasound, a sound wave with ESWT which is a shock wave with very different characteristics. Deep tissue massage often helps as it can stimulate deep circulation and help soften scar tissue. Physical therapy may be prescribed by your family physician or podiatrist (foot doctor) as a treatment for heel pain.

d) stretching   Avoid weight bearing stretches as that can strain the plantar fascia. Most weight bearing stretches can lead to mild injury to the fascia and also leads to a reflex tightening of the muscles controlling the heel cord. The key is low grade stretching performed over a long period of time. Non-weight bearing stretches are preferrred.  One way to accomplish that is with use of ankle night splints. See page above on "tight achilles."

e) cortisone shots  There is really not one substance called "cortisone" but a number of substances that come under this name. They are collectively called catabolic steroids, as opposed to the anabolic steroids that are used to build muscle. Short acting steroids include dexamethasone phosphate and have a strong anti-inflammatory action. They tend to start their actions quickly and wear off quickly. Medium acting steroids include substances like Celestone Soluspan and combine the characteristics of short acting steroids and long acting steroids. Long acting steroids include substances like Solumedrol and Kenalog and tend to atrophy (shrink) tissue. Sometimes shrinking tissue is desirable if one is shrinking scar tissue. Sometimes, too much of the good tissue can be atrophied. "Cortisone" shots have a very variable effect on patients with their degree of effectiveness and duration of action difficult to predict. Occasioanlly, they can work too well and fool patients into thinking they have been cured, with the plantar fasciitis returning with a vengeance when they have worn off -- such patients are harder to cure because the cortisone can allow one to injure the body part, in this case the fascia more so, while they are in effect. It is possible to make cortisone shots hurt by injecting them too quickly or by not numbing the area where the shot is to be given first. Cortisone shots often get a bad reputaton becasue they are delivered with poor technique or are over-used. Anything that has the ability to give you help has the ability to cause harm -- it depends on how it is used.