QUESTION: “Hi Dr. Neal, it’s always such a joy to listen to your podcast in the mornings. I’ve gained so many new perspectives and knowledge that I can take on to create a healthy, sustainable lifestyle for myself and I am so grateful. I wanted to ask your opinion on what a good shoe to purchase might be. My mom and I both have a history of getting plantar fasciitis and we enjoy going for walks, being outdoors, and enjoy strength training at the gym. Would you recommend a certain shoe type for support? Thanks so much.“
DR. NEAL: Thank you so much for listening to the podcast and for your kind words.
As someone that recently experienced the worst case of planta fasciitis I’ve ever had, I can absolutely relate to your question. I’ll share some of the knowledge and experiences I gained as I sought the advice of experts and went through the healing process.
Let’s start by talking about what plantar fasciitis actually is…
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What is Plantar Fasciitis?
Plantar fasciitis is a fancy way of saying that there’s inflammation happening in the foot. The “-itis” in plantar fasciitis is a fancy way of saying inflammation.
“Plantar fascia” is referring to a specific part of the foot.
Across the bottom of the foot, we have this long band of connective tissue that’s referred to as fascia. This fascia, or connective tissue, connects the heel to the toe. And this fascia is located on the bottom of the foot, or the plantar area. Just like any connective tissue in any other area of the body, the fascia can become inflamed.
Besides connecting the heel to the toe, the plantar fascia also acts as a shock absorber. So, when you walk or run, for example, this connective tissue on the bottom of your feet helps maintain the arch in your foot and absorbs some of the impact. But sometimes, little tears can happen in the fascia which can lead to inflammation.
I should also mention that, many times, plantar fasciitis can happen for unknown reasons. Meaning, you weren’t doing anything out of the ordinary but for some reason you wake up with plantar fasciitis.
Speaking of waking up, plantar fasciitis pain is usually worse in the morning. That’s what happened in my case – one morning, I woke up with blinding pain in my right foot. I couldn’t put any pressure on it. It felt like my foot was in a permanent flexed position. These are all common symptoms of plantar fasciitis.
Alright, enough talk about what it is and how painful it can get. Let’s talk about treatments and your specific question: the importance of wearing proper shoes.
Shoes for Plantar Fasciitis
When it comes to finding an appropriate shoe, the keys are comfort, first, and heel support second. The reason I spent so much time discussing the causes of plantar fasciitis is because, if we know the causes, we can usually figure out what an effective treatment might be. So, in this case, if we understand that the plantar fascia helps to act as a shock absorber, then having more shock absorbing support may help prevent a future case of plantar fasciitis later.
The problem when it comes to finding an appropriate shoe is that everyone’s comfort level is different. So, when you’re looking for an athletic shoe, take your time and find something that actually feels like the perfect fit.
I’m very picky about shoe comfort. I’m one of those people that has try on like 10 different pairs of shoes to find the right fit. When I do find a shoe that feels comfortable, I wear them for a long time because I don’t want to have to spend half a day shoe shopping all over again! But wearing out your shoes to the point where there is very little heel and arch support can increase the risk for developing plantar fasciitis. This may have been what happened in my case.
When I went to receive treatment, I made an appointment with a doctor that specializes in feet: a Doctor of Podiatric Medicine – which is a fancy way of saying a Podiatrist. I think George Constanza on the sitcom Seinfeld called this medical professional a “Chiropidist.” Chirpodist, Podiatrist – all mean the same thing – again, a person that specializes in feet and ailments that affect the feet. So, that would be the first person I would speak to if you have any issues with your feet – plantar fasciitis or otherwise.
After running some tests and careful assessments, my Podiatrist recommended that I begin using shoe inserts for more arch support. They felt that a shoe insert that provided medium arch support would be most helpful.
This is important: the amount of support the inserts provide will make a huge difference when it comes to healing and preventing this from happening again. Some shoe inserts provide just a little bit of support and feel a bit softer. Others feel like you just slipped a wooden plank into your shoe. The one my doctor recommended was in between those two. So, it’s always wise to get the advice of a foot specialist so that they can determine what your needs are.
Something else my podiatrist recommended was to periodically massage the fascia. Here’s how to do it: using both thumbs, press directly on the plantar fascia in the middle of your foot. Then, while maintaining pressure on the plantar fascia, slide your thumbs to either edge of your foot – imagine you’re trying to flatten and spread the fascia using your thumbs to supply the pressure. Spend 5 minutes every morning performing these foot massages.
Why in the morning? Because that’s usually when it flares up.
The Bottom Line
I know I didn’t recommend an exact shoe type or brand, but that was by design. It’s difficult to know what’s going to feel the most comfortable for you.
I would suggest finding a shoe that feels super-comfortable. Then, make an appointment with a podiatrist and ask them their thoughts on whether or not shoe inserts would be helpful for you to prevent future plantar fasciitis flare-ups.