Plantar Fasciitis Relief: From Footwear to Frozen Water Bottles

Rachit Shah, DPM, a podiatrist at Northwestern Medicine, says that plantar fasciitis is one of the most common conditions he sees in his clinic.

“It’s inflammation or swelling of the plantar fascia, a band of tissue that runs from the bottom of your heel toward your toes,” says Dr. Shah. “Its job is to support your arch. But when it gets tight from activities that put repeated stress on the foot, it causes pain — especially in the heel.”

Who Gets It

You're more likely to have plantar fasciitis if you:

• Do activities that require a lot of running, jumping or dancing
• Have new or increased activity
• Spend most of your day on your feet
• Sit for long periods of time
• Carry excess weight
• Have foot issues, such as a tight calf muscle, Achilles tendon problem, flat feet or high arches
• Often wear shoes that don’t fit well

You may not realize that tight calves are a major contributor to foot and ankle problems. “Your calf muscles and plantar fascia work together,” says Dr. Shah. “If one is tight, the other works overtime. Most of the time when both the muscles and tissue are tight, that’s when you can experience heel pain.”

Symptoms of Plantar Fasciitis

A defining symptom of plantar fasciitis is pain with your first few steps in the morning or after sitting for a long time. And the level of pain can range from feeling like a bad bruise to walking on broken glass.

“The pain is usually on the bottom of the heel, more toward the inside,” says Dr. Shah. “It might ease up as you walk, but it often returns later in the day.”

If left untreated, plantar fasciitis can lead to problems like knee, hip and back pain because you may be doing things like limping or leaning to make up for the discomfort.

Four-Part Treatment Plan

Dr. Shah uses a four-step approach to help patients manage plantar fasciitis:

1. Pain management
   This may include oral anti-inflammatory medications like ibuprofen or, when appropriate, prescription treatments like a short course of steroids. In more severe cases, a clinician may recommend a steroid injection directly into the heel. Your healthcare provider can help you decide what’s safest for you.
   
   
2. Supportive shoes or inserts
   Dr. Shah emphasizes the importance of wearing shoes with good arch support, even inside the house.
   
   “If your shoe bends in the middle or twists like a towel, it’s not supportive,” says Dr. Shah. “Look for shoes that only bend at the toes and have a firm heel. It’s also important to wear sandals or slippers with arch support when at home. That’s much better for plantar fasciitis than walking around in socks or being barefoot.”
   
   You can also opt for inserts: Over-the-counter heel cups can reduce the stress on the plantar fasciitis tissue and may give you some relief. Going a step further and getting custom inserts (orthotics) could also be an option if your pain is more severe.
   
   
3. Stretching
   Stretching the calf muscles is essential. Dr. Shah recommends doing stretches before getting out of bed, using a towel or belt to pull your toes toward you and holding the stretch for 30 to 60 seconds.
   
   Even when the pain from plantar fasciitis starts to go away, keep stretching. It may help prevent it from coming back.
   
   
4. The frozen water bottle hack
   This simple trick is gaining popularity — and for good reason.
   
   “Rolling a frozen water bottle under your foot helps in two ways,” says Dr. Shah. “The ice reduces inflammation, and the rolling motion stretches the fascia.”
   
   Compared to tennis or golf balls, the water bottle covers more surface area, reaching the heel, arch and ball of the foot. Dr. Shah recommends doing this regularly to ease pain and loosen the tight tissue.

When the Pain Won’t Go Away

If home remedies aren’t helping, it may be time to see a specialist. Dr. Shah says early treatment combined with resting your feet can usually resolve plantar fasciitis in six to eight weeks. But chronic cases may take longer. In rare situations, surgery may be considered — but only after all conservative treatments, including stretching and clinician-guided therapies, have been tried.

Typically, during surgery, the plantar fascia is partially cut to release tension. As you heal, fibrous tissue fills the space between the heel bone and the plantar fascia. This lengthens the tissue.

“About 90% of patients get better without surgery,” says Dr. Shah. “We tailor treatment to each person’s lifestyle and needs.”

There are also less invasive treatments for plantar fasciitis that may be an option for those who can’t find relief from home care techniques. A few examples include:

• Extracorporeal shock wave therapy
  Uses sound waves to stimulate blood flow and healing. Innovative devices offer deeper tissue penetration with less discomfort, often resolving chronic plantar fasciitis in a few sessions.

• Regenerative injections (platelet-rich plasma and stem cells)
  Platelet-rich plasma from your own blood can promote healing when injected into the fascia.

No matter who you are — a runner, a teacher on your feet all day or someone who spends hours sitting at a desk — plantar fasciitis can affect anyone. The good news? With the right stretches, supportive shoes and a frozen water bottle, relief may be closer than you think.