What Not to Do with Plantar Fasciitis - and What to Do Instead
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Whether you’re treating Plantar Fasciitis at home yourself, or getting treatment from a doctor or a physical therapist, what you should and shouldn’t do to expedite your Plantar Fasciitis recovery can be confusing. Here are the 11 things not to do with Plantar Fasciitis, and what to do instead - based on the current science and the 20+ years of clinical experience of our co-founder and physical therapist, Luke Ferdinands.
We’ll start with what not to do when you’re self-treating Plantar Fasciitis, and end with a few notes on treatments at a doctor’s office. Let’s dive in.
Why not:
Plantar Fasciitis develops when there’s an imbalance between the load on your plantar fascia (the thick band of tissue at the bottom of your foot) and your body’s capacity to handle that load. Resting reduces the load, but it also erodes your capacity if you are inactive for too long, so when you go back to your normal activities, the pain often gets worse.
Do this instead:
Taking a break from activities that cause you pain when you first develop Plantar Fasciitis pain is a good idea. However, don’t rest completely for more than 2 weeks. Instead, modify your activities, and wear a Plantar Fasciitis brace to reduce the load, so you continue to be active and maintain your capacity while the injured tissue starts healing.
Why not:
It’s true that NSAIDs (nonsteroidal anti-inflammatory drugs, like ibuprofen and aspirin) aren’t a treatment to resolve the root cause of your pain. Essentially, NSAIDs are symptom-maskers that work by reducing the pain signals and inflammation.
Some studies (like this one) have found that NSAIDs can slow down tissue healing, and you may be worried that taking NSAIDs for too long might hold you back from getting over Plantar Fasciitis. However, NSAIDs don’t disrupt healing unless you take it for more than 4-6 months.
Do this instead:
Take NSAIDs as needed, whether to get through the workday on your feet, or to engage in activities that bring you joy. But don’t forget to incorporate the three elements of proactive treatment, so you are also working to resolve the root cause of Plantar Fasciitis.
Why not:
It’s tempting to try to push through pain when you first develop Plantar Fasciitis symptoms. Occasional frustration is also a part of Plantar Fasciitis recovery, which is usually not super-quick or completely linear. But pain is a signal that the tissue is aggravated, and needs a break.
Do this instead:
When you have arch or heel pain from Plantar Fasciitis, respect that signal. Wear a brace (or get a PT tape job) to reduce the load on the aggravated tissue, so that you can do what you need to do with much less pain, and lower your risk of further aggravation.
To relieve pain and release tension throughout the day, give your foot a quick massage. A 2-to 3-minute massage with our Arch Massager is an effective way to not just relieve pain, but also promote tissue healing, just like a physical therapist’s Instrument-Assisted Soft Tissue Mobilization work.
Why not:
One of the three key components of Plantar Fasciitis recovery is progressive strengthening exercises. By building up strength and stability in your foot, ankle, and all the way up your kinetic chain, you’ll reduce the load that the injured plantar fascia has to support.
Overdoing the exercises or doing the wrong exercises for your current capacity, however, can aggravate the already sensitive tissue, resulting in more pain. It’s also demoralizing! It may sound silly, but when you’re working toward pain-free over multiple weeks, keeping your mental game strong is a big part of your success, so overdoing the exercises and getting demoralized is not the way to go.
Do this instead:
Build strong defenses by following a structured PT exercise program for Plantar Fasciitis. Trying to figure out the best Plantar Fasciitis exercises for where you’re at can be confusing, and knowing when to graduate to the next level of challenges is tricky.
We recommend simplifying your recovery work by following a pre-built program that guides you through the “just right” challenges, step by step.
If you are working with a physical therapist, that’s what they do. If you'd rather do the work on your own but want to make sure all your effort counts, our Plantar Fasciitis Guided Recovery Program is a unique digital program that replicates the in-person guidance and structure for home use.
Why not:
Plantar Fasciitis stretches are still popular, but clinical efficacy of stretching has been debunked in recent years. Some stretch moves, like calf stretches, can relieve Plantar Fasciitis symptoms like tightness in your calves, but stretching alone will not resolve the root cause of Plantar Fasciitis.
Do this instead:
If you have a few stretching moves that help with your symptoms, by all means, keep doing them! But make sure to incorporate strengthening moves into your routine, so that you are building more capacity to handle the load. That’s what keeps pain and recurrences at bay.
Why not:
Most of the Alleviate users come to us after trying generic massage solutions, ranging from $5 lacrosse balls rolled underfoot to $300+ electronic massage guns, and getting only temporary pain relief.
These massage tools aren’t as effective for multiple reasons. Most aren’t precise enough and can’t reach the hot spots that need work. Lacrosse balls in particular don’t stay in place, so you can’t apply the right amount of pressure to where it’s needed. Lack of stability and precision means generic massagers aren’t very effective at breaking down scar tissue and releasing adhesions.
Do this instead:
Do what physical therapists do to break down the root cause of your pain: Instrument-Assisted Soft Tissue Mobilization (IASTM). IASTM uses stainless steel instruments against the problematic tissue to reduce scar tissue and promote the growth of healthy, stronger tissue.
You can get this treatment at some physical therapy offices, but you can also give yourself the healing massage, using our Arch Massager, a PT-designed massage tool built specifically for chronic foot pain conditions like Plantar Fasciitis.
Why not:
With the right treatments applied consistently, you’ll likely see quick improvements early on. However, full recovery from Plantar Fasciitis typically takes 8 weeks or so, and it’s usually not a straight path.
Some setbacks are normal, and it can be surprisingly easy to forget how much progress you’ve made, when you’re in the midst of a setback. When you’re frustrated and demoralized, sticking to your treatment plan gets harder. This is where tracking or journaling comes in handy.
Do this instead:
Make a note of your activities (for example, “an extra hour standing at work,” “wore heels,” or “PT exercise level 2”) each day, and your pain level. Tracking your activities, recovery work, and your pain level over time will help you understand your condition better:
What aggravates your pain and what helps it
What kind of loading you are and aren’t ready for
Where your pain level was when you started
How far you’ve come
Seeing the progress you’ve made with your work should give you the motivation to keep up with the treatment plan, even on a particularly hard day of setbacks. This is why pain and progress assessments are built into our Guided Recovery Programs (with a handy chart that visualizes your progress!). You can do this with a simple notebook, too.
Why not:
Plantar Fasciitis night splints are devices that you wear when you sleep. They are designed to keep your foot in dorsiflexion (where your toes point upwards). Some people find night splints helpful in reducing their morning, “first out of bed” pain because night splints can ease the transition between the completely unloaded plantar fascia (when you’re on your back) and fully loaded (when you get up in the morning).
However, night splints have a number of drawbacks:
They don’t treat the problematic tissue like a professional foot massage, so the issue remains unresolved
Unlike low-profile braces, you can’t wear them during the day to relieve pain and stay active
They are bulky and can impact the amount and quality of your sleep (and we all know sleep is important for recovery!)
Do this instead:
If you find night splints helpful in reducing your morning pain (and if you aren’t waking up groggy or stiff), keep using them! But remember that night splints aren’t resolving the root cause of Plantar Fasciitis, so you’ll need to incorporate massage, load management, and strengthening exercises to get to full resolution.
For morning pain or tension in your arch or heel, 2-3 minutes of massage with the Arch Massager is particularly effective as an alternative to wearing a night splint.
Why not:
As we said earlier, Plantar Fasciitis is caused by an imbalance between the load on your foot and the capacity it has to support that load. So, to treat your pain now and prevent recurrences in the future, we first reduce the load (that reduces pain now, and protects the unhappy tissue) and gradually build your capacity to tolerate more load. As your capacity increases, we re-introduce more load, with deliberate intention.
When we say “load,” it’s not just the amount of weight that’s supported by your plantar fascia and how long the arch is loaded. You’ve probably noticed that your pain is more or less when you wear a particular pair of shoes, or when you walk on a particular type of surface. All of these are variables that a skilled physical therapist will help you be aware of.
Bringing back more variables before you are ready can set you back, aggravating the sensitive tissue and causing pain.
Do this instead:
Pay attention to your symptoms, and be aware of variables that may be contributing to any changes to your symptoms. Try to limit variables as much as you can during your recovery journey; doing this will simplify and accelerate your recovery, and prevent unexpected setbacks.
What does that mean in practical terms? Aside from keeping track of your activities and pain levels that we touched on earlier, it means a couple of things:
Find the comfortable pair of shoes you can wear on most occasions (preferably one that you can wear with your brace), and stick to that pair
You don’t have to completely avoid walking or running on different surfaces (unstable beaches, hard concrete, or soft grass - they all have different kind of impact on your biomechanics), but do be aware
Ease into new activities, and only gradually increase the intensity and amount of activities that you’re familiar with
Get 8 tips on managing variables in chronic injuries here!
Why not:
Cortisone shots are one of the two most popular treatments for Plantar Fasciitis at doctor’s offices. However, they are not a great treatment option for quite a few reasons:
Cortisone shots destroy surrounding tissue (necrosis), making you even more susceptible to future Plantar Fasciitis flare-ups, or to other problems
For many people, pain reduction is only temporary, and the pain that comes back can be more intense
While some people get lasting pain reduction with just one cortisone shot, there’s no test to determine whether you’ll be one of them
Cortisone shots only reduce pain, and don’t treat the problematic tissue or prevent flare-ups like conservative self treatment can
Do this instead:
Unless your doctor has an evidence-based, convincing reason for recommending cortisone shots, avoid them. Instead, use the effective, conservative physical therapy treatment methodology and actually resolve the root cause of Plantar Fasciitis.
Why not:
Orthotics (or Plantar Fasciitis insoles) are the other common treatment at doctor’s offices. While you don’t risk actively harming your tissue like with cortisone shots, and many people get symptom relief from orthotics, by themselves, orthotics also don’t bring you recovery that lasts.
Unlike braces, Plantar Fasciitis orthotics also can’t reduce the load on the plantar fascia - so they aren’t as good at giving the injured tissue space it needs for healing.
Do this instead:
You can absolutely wear your orthotics if they help you get through your day and stay active! Just don’t forget to incorporate the three key components of Plantar Fasciitis treatment.
If you haven't purchased an orthotic, or the one you have isn't working for you, we recommend a Plantar Fasciitis-specific brace instead, like our Loft 2. A brace lifts the arch and reduces the load, instead of simply pushing up against the arch - a critical design difference that makes a difference in efficacy.
Don’t Over-Rest: Rest briefly, then stay active with a Plantar Fasciitis brace to prevent further weakening.
Strengthen Smartly: Use a guided exercise plan to build strength without overdoing it.
Choose Effective Treatments: Avoid relying solely on cortisone shots or orthotics; tools like the Alleviate Plantar Fasciitis System 2 provide effective, long-term relief by addressing the root cause..
Track Progress: Monitor activities, wear supportive shoes, and reintroduce new challenges gradually to avoid setbacks.
Alleviate was founded by a patient-and-clinician duo to bring the effective chronic pain treatment from physical therapy offices to everyone's home. With our Plantar Fasciitis System 2, that includes the Guided Recovery Program, you can use the Alleviate Method to recover from Plantar Fasciitis at home. No physical therapy appointments required!
Luke Ferdinands, Physical Therapist & Co-Founder
A New Zealand-trained physical therapist with over 20 years of experience, Luke developed the Alleviate Method to bring the gold standard of physical therapy care to everyone's home. Luke leads the development of physical tools and digital physical therapy content, focusing on driving clinical outcomes for people with chronic musculoskeletal pain conditions like Tennis Elbow, Plantar Fasciitis, Runner's Knee, and more.
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