Interview with Dr. Cunha: Why might people be experiencing Plantar Fasciitis while working from home

What is plantar fasciitis, and why might people be experiencing it right now when they're working from home?

Plantar fasciitis is the most common cause of heel pain. The plantar fascia is a shock-absorbing bowstring like thick ligament that connects your heel to toes. When you stand your arch collapses causing this bowstring to stretch out leading to the formation of micro tears in the ligament that can result in weakness, swelling, and irritation of the plantar fascia.

The most common sign of plantar fasciitis is stabbing pain in the bottom of your foot when you get out of bed in the morning, after standing for prolonged periods of time, or when you stand up after sitting for a while. It's also common to experience pain after you exercise, not during your workout.

There are two reasons people will start to experience this now:

1) Because they are walking barefoot at home. Walking barefoot on hard surfaces allows our foot to collapse which can lead to a tremendous amount of stress not only to the foot but to the rest of the body. Our feet naturally pronate during the gait cycle, however when we walk barefoot we pronate for a longer period of time which then alters the biomechanics and distribution of pressure and weight across the foot.

2) Because they are doing at-home workouts in inappropriate footwear. Whether they are creating their at-home workout, doing barefoot exercises while working out to their gym's Instagram videos or going just a little too hard on the weekends, it's important to mimic the routine you normally had pre-quarantine AND wear the appropriate foot gear. Barefoot exercises are almost worse than walking barefoot as you're putting more strain on your plantar fascia.

What are some of the most effective ways to treat PF on your own?

For those treating foot pain at home, my go to method is to freeze a water bottle while it's laying down. Then proceed to roll your foot on the frozen water bottle for about 20 minutes, 3 times daily.

Apply a topical or oral anti-inflammatory. I suggest taking an ibuprofen to help deal with the pain.

I also recommend stretching not just the plantar fascia but also the Achilles tendon which can oftentimes be the culprit. Tightness of the Achilles tendon can limit ankle range of motion which can place added stress onto the plantar fascia. You can stretch the Achilles tendon simply by placing your toes on the wall with your heel on the floor and then bring your hips towards the wall as you keep your knee and leg extended. Another way is to sit down with your knee and leg extended in front of you and then pull back your toes with a towel, belt, or theraband. To stretch the plantar fascia directly, I recommend first sitting and crossing your leg and placing the painful foot onto your opposite knee. Then with your hand bend your toes and massage the arch with your hand by kneading the arch with your thumb. Apply deep pressure with your thumb along the course of the plantar fascia from the heel all the way towards your toes. Repeat these exercises five times daily and frequently ice the tender area.

When should someone seek professional assistance for Plantar Fasciitis?

If these at home treatments do not ease the pain after one week, I would suggest you visit a podiatrist to discuss custom orthotics, physical therapy, cortisone injections or Shock Wave Therapy. If these treatments do not improve your condition, your doctor may recommend minimally invasive Tenotomy and Fasciotomy procedure. This is a highly effective at fully resolving chronic foot pain with a faster recovery time enabling patients to get back to work and being active.