How To Cure Plantar Fasciitis FAST & FOREVER [Heel Pain & Heel Spurs]

Summary

Dr. Tom Biernacki's comprehensive guide on plantar fasciitis and heel pain offers insights into symptoms, causes, and a five-stage treatment plan. He emphasizes the importance of biomechanical assessment, pain relief, foot support, rehabilitation, and strengthening exercises. Debunking the need for surgery in most cases, he recommends home remedies, proper footwear, and orthotics to alleviate pain and promote healing without invasive procedures.

Takeaways

• 👨‍⚕️ Dr. Tom Biernacki's guide emphasizes various aspects of plantar fasciitis and heel pain, including diagnosis, treatment, and prevention.
• 👣 Plantar fasciitis often presents with heel pain, which can be mistaken for other conditions like heel spurs or nerve pain, and requires proper diagnosis.
• 🔍 Imaging techniques such as X-rays and ultrasounds are used to diagnose plantar fasciitis and identify related issues like heel spurs or stress fractures.
• ⏱️ Recovery from plantar fasciitis typically progresses in stages, with noticeable improvements expected after the first, second, and third months of treatment.
• 💊 Non-surgical treatments are effective for the majority of patients with plantar fasciitis, making surgery a rare necessity.
• 👟 Proper footwear and orthotics are crucial in managing plantar fasciitis by reducing pressure on the heel and supporting the foot's biomechanics.
• 🧘‍♂️ Stretching exercises, particularly for the calf muscles and plantar fascia, are an integral part of treatment and prevention.
• 🏋️‍♀️ Strengthening exercises for the lower leg, foot, and surrounding muscles can alleviate pressure on the plantar fascia and support healing.
• 🧊 Modalities such as icing, anti-inflammatory creams, and shockwave therapy provide pain relief and promote healing of the plantar fascia.
• 👣 The condition can be associated with biomechanical issues upstream, such as hip or back problems, which need to be addressed for comprehensive treatment.
• 👟 Night splints and supportive braces can help reduce morning stiffness and support the foot during the healing process.

Q & A

What is the main focus of Dr. Tom Biernacki's guide?

Dr. Tom Biernacki's guide focuses on providing tips and tricks for treating plantar fasciitis and heel pain, including diagnosing the condition, understanding its causes, and offering various treatment options.

What are the common symptoms of plantar fasciitis mentioned in the guide?

The common symptoms of plantar fasciitis include pain and stiffness in the heel, especially upon waking up or after prolonged periods of standing or walking.

What are some potential causes of heel pain other than plantar fasciitis?

Other potential causes of heel pain include heel spurs, nerve pain, Achilles tendonitis, stress fractures, and skin issues like corns or warts.

What does Dr. Biernacki suggest regarding the necessity of surgery for plantar fasciitis?

Dr. Biernacki suggests that 99.9% of people do not need surgery for plantar fasciitis, even if they have heel spurs or advanced plantar fasciitis, as the treatments he provides are effective for most cases.

What is the general timeline for recovery from plantar fasciitis according to Dr. Biernacki?

Dr. Biernacki states that patients should expect to be about 25% better after the first month, 50% better after the second month, and 75% or more better after the third month.

What is the role of the plantar fascia in the human body?

The plantar fascia is a thick, web-like ligament on the bottom of the foot that connects the heel to the toes, acting as a shock absorber and preventing the feet from turning out or dislocating.

What are some of the risk factors for developing plantar fasciitis?

Risk factors for developing plantar fasciitis include having tight hips, lower back, hamstrings, being overweight, running frequently, and having poor footwear.

What is the difference between plantar fasciitis and a heel spur?

Plantar fasciitis is a condition where the plantar fascia becomes inflamed and micro-tears occur, while a heel spur is a bony projection that can develop where the plantar fascia attaches to the heel, often as a result of long-term plantar fasciitis.

What are some of the non-surgical treatment options for plantar fasciitis discussed in the guide?

Non-surgical treatment options include biomechanical examination, pain relief methods (like icing and anti-inflammatory medications), foot support with proper shoes and orthotics, physical therapy, and stretching and strengthening exercises.

What is the significance of a biomechanical exam in treating plantar fasciitis?

A biomechanical exam is crucial in identifying underlying issues that may be contributing to plantar fasciitis, such as hip or back problems, and helps in making informed decisions about the appropriate footwear, orthotics, and treatment plan.

What are some home remedies and lifestyle changes suggested for managing heel pain?

Suggested home remedies and lifestyle changes include using anti-inflammatory creams, essential oils, Epsom salt baths, modifying activities to reduce strain on the feet, and ensuring proper footwear and orthotic support.

Outlines

00:00

👨‍⚕️ Introduction to Plantar Fasciitis Guide

Dr. Tom Biernacki introduces his comprehensive guide on plantar fasciitis and heel pain. He discusses common issues like heel spurs and bottom of the foot pain that often don't improve and emphasizes his expertise in helping patients recover. The guide will cover symptoms, causes, risk factors, and diagnostic methods for various foot conditions including nerve pain and plantar fasciitis. Dr. Biernacki assures viewers that he will share effective tips and tricks for managing heel spurs, plantar fasciitis, and nerve pain, and will also provide home remedies. He highlights the potential for misdiagnosis and the importance of proper treatment to avoid complications.

05:01

👣 Understanding Plantar Fasciitis and Related Conditions

This paragraph delves into the specifics of plantar fasciitis, heel spurs, and other related conditions. It explains that plantar fasciitis is a common condition affecting over 40% of people, often for extended periods. Dr. Biernacki clarifies that heel spurs are a separate issue that can develop alongside plantar fasciitis but are not the primary cause of pain. The paragraph also touches on other potential causes of heel pain, such as nerve pain, Achilles tendonitis, and biomechanical issues stemming from the back, hips, or knees. The importance of a proper diagnosis and treatment plan is underscored, with a focus on addressing the root causes of the pain rather than just the symptoms.

10:01

🔍 Diagnosis and Progression of Plantar Fasciitis

Dr. Biernacki outlines the diagnostic process for plantar fasciitis, emphasizing the importance of immediate relief and gradual improvement over the first three months. He discusses the use of imaging techniques, such as X-rays and ultrasounds, to assess the condition of the plantar fascia and rule out other issues like heel spurs or arthritis. The paragraph also covers the expected timeline for recovery, stating that most patients should see significant improvement within the first few months. Additionally, the potential for complications, such as stress fractures or nerve issues, is addressed, highlighting the need for a thorough biomechanical examination.

15:02

👟 Importance of Footwear and Insoles in Treatment

In this section, Dr. Biernacki discusses the critical role of proper footwear and insoles in the treatment of plantar fasciitis. He explains that the right shoes and insoles can prevent further damage and support the healing process. The paragraph differentiates between minimal shoes, which may be suitable for young, healthy individuals, and maximalist shoes, which provide more cushioning and support, ideal for older individuals or those with existing joint issues. Dr. Biernacki also recommends a gradual transition from soft to firmer insoles over a three-month period to allow the body to adjust and promote healing.

20:03

💊 Pain Relief and Supportive Treatments

Dr. Biernacki provides an overview of pain relief methods and supportive treatments for plantar fasciitis. He suggests using ice for inflammation reduction, anti-inflammatory medications for temporary relief, and steroid injections for severe cases. The importance of cushioning, such as gel pads, is mentioned to prevent further damage. Additionally, the paragraph covers physical therapy techniques, including massage, modalities, Epsom salt baths, and red light therapy, with a particular emphasis on shockwave therapy for its ability to stimulate healing in the affected area.

25:03

🏋️‍♂️ Strengthening and Stretching Exercises

The final paragraph focuses on the importance of strengthening and stretching exercises in the treatment of plantar fasciitis. Dr. Biernacki recommends exercises that target the calf muscles, plantar fascia, and other leg muscles to alleviate pressure on the foot. He also discusses the benefits of modifying activities to reduce strain on the affected area and the use of night splints to prevent morning stiffness. The paragraph concludes with a reminder that healing takes time and that a biomechanical examination is crucial to identify and address underlying issues contributing to the condition.

Keywords

💡Plantar fasciitis

Plantar fasciitis is a common condition characterized by heel and arch pain. It is often caused by inflammation at the attachment of the plantar fascia to the heel bone. In the video, Dr. Tom Biernacki discusses plantar fasciitis extensively, emphasizing its symptoms, causes, and the fact that it usually doesn't require surgery. He mentions that it's a common cause of heel pain and that proper treatment can significantly improve the condition.

💡Heel spur

A heel spur is a bony protrusion that can develop where the plantar fascia attaches to the heel bone. It is often associated with plantar fasciitis, although not everyone with a heel spur experiences pain. The script explains that heel spurs are a strengthening of the plantar fascia as it inserts into the heel and that they are not necessarily an indication for surgery.

💡Biomechanical exam

A biomechanical exam is a thorough assessment of the body's mechanical functions, particularly the musculoskeletal system. In the context of the video, Dr. Biernacki stresses the importance of a biomechanical exam in diagnosing and treating plantar fasciitis, as it helps identify underlying issues that may contribute to the condition, such as hip or back problems.

💡Inflammation

Inflammation is the body's natural response to injury or infection, characterized by redness, heat, pain, and swelling. In the video, Dr. Biernacki talks about inflammation in the context of plantar fasciitis, where the plantar fascia becomes inflamed, leading to pain and stiffness, particularly in the heel area.

💡Orthotics

Orthotics are devices designed to support, align, or improve the function of the foot. They can be used to alleviate pain and discomfort associated with various foot conditions, including plantar fasciitis. The script mentions orthotics as part of the treatment plan to provide additional support and cushioning to the foot.

💡Stretching exercises

Stretching exercises are physical activities that lengthen and stretch the muscles and tendons to improve flexibility and reduce stiffness. In the video, Dr. Biernacki highlights the importance of stretching exercises, especially for the calf muscles and plantar fascia, as a key part of the treatment and prevention of plantar fasciitis.

💡Physical therapy

Physical therapy is a treatment method that uses physical means, such as exercises, stretches, and manual therapy, to help restore function and reduce pain. In the context of the video, physical therapy is discussed as a beneficial treatment for plantar fasciitis, including modalities like massage, hot and cold therapy, and shockwave therapy.

💡Anti-inflammatory medications

Anti-inflammatory medications are drugs that reduce inflammation in the body. They can be used to alleviate pain and swelling associated with conditions like plantar fasciitis. The script mentions over-the-counter medications like ibuprofen as examples of anti-inflammatory drugs that can be used to manage the symptoms of plantar fasciitis.

💡Night splints

Night splints are devices worn on the foot and lower leg during sleep to help maintain the stretching of the plantar fascia and calf muscles. In the video, Dr. Biernacki recommends night splints as a treatment to prevent morning stiffness and promote healing of the plantar fascia.

💡Barefoot walking

Barefoot walking refers to walking without shoes, which can help improve foot strength and awareness of foot mechanics. However, the video script notes that while it can be beneficial for some, it may not be suitable for everyone, especially those with certain foot conditions or arthritis.

💡Maximalist shoes

Maximalist shoes are shoes that provide a high degree of cushioning and support. They are designed to minimize the impact on the feet and joints. In the video, Dr. Biernacki discusses maximalist shoes as a suitable footwear option for individuals with plantar fasciitis, especially those over 50 or with certain musculoskeletal conditions.

Highlights

Dr. Tom Biernacki provides an ultimate guide for plantar fasciitis and heel pain.

Common mistakes made in treating heel spurs and plantar fasciitis are discussed.

Heel pain can be caused by various conditions including heel spurs, nerve pain, and Achilles tendonitis.

The importance of diagnosing the correct cause of heel pain through imaging and examination.

Plantar fasciitis affects over 40% of people and typically lasts for at least three months.

Surgical treatment for plantar fasciitis is rarely needed, with 99.9% of patients improving with non-surgical methods.

Biomechanical issues upstream like hip or back problems can contribute to plantar fasciitis.

A timeline for recovery is given, with expected improvements of 25% in the first month, 50% in the second, and 75%+ in the third.

The plantar fascia's role as a shock absorber and its vulnerability to microscopic tears is explained.

Risk factors for plantar fasciitis include age, weight, activity level, and pregnancy.

The difference between plantar fasciitis and a heel spur, and the development of a heel spur over time.

Diagnosis of plantar fasciitis involves physical examination and imaging techniques like X-rays and ultrasound.

Treatment methods range from pain relief, supportive footwear, to strengthening exercises.

The five-stage treatment guide for plantar fasciitis includes biomechanical exam, pain relief, foot support, rehabilitation, and muscle strengthening.

Surgical options are discussed, such as gastrocnemius recession and plantar fascia lengthening, with their pros and cons.

A variety of home remedies and their effectiveness in treating heel pain are mentioned.

The importance of proper footwear and orthotics in the treatment and prevention of plantar fasciitis.

A sequential five-step treatment approach that has proven effective in avoiding surgery for plantar fasciitis.

Recommendations for supportive shoes and insoles, including the ortho feet brand, for different types of patients.

The significance of stretching exercises for the calf muscles and plantar fascia in the recovery process.

Dr. Biernacki's personal invitation for consultation in Michigan for foot and plantar fasciitis care.

Transcripts

This is Dr. Tom Biernacki

And today I'm going over my ultimate plantar fasciitis and heel pain guide.

Do you have heel spurs, plantar fasciitis?

Bottom of the foot pain.

That's just not getting better.

I see mistakes all the time and I have patients coming in every day

getting better from this.

Here's my tips and tricks that I know will work for you and will help.

And we're starting now.

Symptoms Causes Risk Factors.

Heel spurs versus heel pain versus nerve pain versus plantar fasciitis.

How do I diagnose it?

What kind of imaging do we do?

How long is it going to take you to get better?

All the tips and tricks for heel spurs, for plantar

fasciitis, for the nerve pain and the potential complications.

If you don't do anything about it, make sure you stick around

all the way to the end, because I'm going to give you my best home remedies.

Your pain is pain, swelling, stiffness in one of the heels.

If this happens, the most likely cause is plantar fasciitis.

But it can be a heel spur.

It can be nerve pain.

It can be Achilles tendonitis on the back of a heel.

You can have a calcaneus heel spur.

So the actual bone can have a stress fracture.

You could have broke it.

You could have just bruised it up really bad.

There are some skin issues.

So I've seen people with corns, warts.

If you have any of these problems, check my links below,

especially if it's nerve pain that's radiating numb at night too.

That's something more than just plantar fasciitis.

I have guides on all this stuff.

Had a diagnosis how to treat it.

We're focusing on heel spurs,

cleaner fasciitis and bottom of the heel biomechanical pain.

This is a horrible disease.

It's said that over 40% of people in the world are going to have this

and they're going to have it for at least three months at a time.

I'll tell you, 99.9% of the time, people do not need plantar fasciitis surgery

even if they have heel spurs,

even if they have advanced plantar fasciitis that hasn't been there 40 years.

I'm telling you, this stuff works because have so many people

coming in everyday in this stuff just work.

I'm going to go over some of the surgical techniques.

99 plus percent of people will not need it.

If you have pain on the back of your Achilles tendon in the back of your leg,

if you have pain radiating at nighttime, this could be Achilles tendonitis.

It could be a compressed Baxters nerve.

It could be peripheral neuropathy

sometimes if one leg shorter than the other or

you have in your arthritis or your foot's turning in or your hand he's turning out.

Or if you have severe hip problems,

this is a more upstream biomechanical problem.

It could be compression in the back sciatica, a pinched disc in your spine.

I have guides for all of these.

These are important to take care of, not just your plantar fasciitis.

If you have them.

How long does it take to get rid of plantar fasciitis?

Here's what I always tell my patients.

You should have immediate relief at the beginning.

For a good chunk of your pain.

But then after your initial relief with the pain methods

we're going to talk about, you should get a total of 25% better

the first month, about 50% better the second month,

and about 75 plus percent better the third month

because we're going to target the underlying causes.

There's two phases to treatment.

You should be able to do stuff for pain control at the beginning,

and we'll talk about that, which gives you a jolt forward.

But then 25% the first month, 50% the second

month, 75%+ the third month.

If that's not happening, we're probably missing

something in the diagnosis or the biomechanical exam.

For example, in this case, people might have a slip disk in their back.

They might have severe hip arthritis where their leg does not work properly.

They might have a nerve disease such as diabetic peripheral

neuropathy or chemotherapy induced peripheral neuropathy.

There's so many different things that can mimic plantar fasciitis.

But that's the goal we're going to expect healing wise.

Studies show

that for most people within a month or two,

you should start getting a whole lot better.

And that's in a 2015 meta analysis that looked back on a lot of studies.

What is plantar fasciitis?

The plain or fat shot is a thick web like ligament

on the bottom of your foot that connects your heel to your toes.

It acts as a shock absorber when your foot

turns out, it prevents your feet from turning out

and basically prevents your feet from dislocating and hitting your shins.

Studies show that over 40% of people will have this for at least three months

continuously in their life.

And the trick is, if you have a tight hips, lower back

hamstrings, weakness, weak thighs, hamstrings,

your planer fascia is going to absorb more wear and tear.

If you weigh more.

If you're running like 500 miles a month jobs where you're on concrete

all day, you're going to absorb more.

So these treatments are going to be more important.

This leads to microscopic tearing in the plantar fascia.

If this gets worse, it can lead to bone damage as it inserts.

Then it can lead to rupture and immobility

that if more than six months go by, it changes from plantar fasciitis

where you're actually inflamed and tearing and to plantar fasciitis.

So fashion is actually the death of the planer fascia.

So it actually gets thicker, more swollen.

When I evaluate people,

I actually use an ultrasound to check the thickness of the plantar fascia.

Normally it should be about four millimeters

from top to bottom, and there shouldn't be a heel spur.

But as people have this for months or years, it gets so thick or it's

maybe now 2 to 3 times thicker, that could be fasciitis

and you could get develop nodules that look like something called plantar fasciosis

plantar fasciosis, and you'll develop huge spurs growing in there.

The primary symptoms of plantar fasciitis are pain

at the bottom of the heel, usually in the bottom or the midfoot.

It's usually one foot worse than the other, but it could easily be two.

Usually starts in the get up out of bed.

You're stiff, you're sore, and as you start walking,

it starts to feel a bit better because that swollen blood and fluid

pushes out of there.

But you're not healed.

As you start walking, you start to create new damage

so that when you go to sleep at night, it actually causes that pain.

Again.

It's worse in the morning and with prolonged activity

as you get going during the day can start to get swollen again.

What are the causes?

The simplest way to think about this is the fracture is stretching, it's tearing.

You discover that you have microscopic tears.

When we do imaging, there's actually fluid and microscopic tears in the tissue.

And if it goes on for over six months, you actually develop that death,

which is fast.

It's most common in people between the ages of 40

and 70, people who are more overweight, people who are more active.

It's more common in women than men.

It's very common in pregnant women, and it's very common in people

who have tight joints or tight lower back back problems, hip prompts,

hamstring problems back in the knee problems,

all these things are more likely to put more pressure on your foot,

leading to plantar fasciitis, talking obesity, overweight

joint problems, other cases of arthritis, stiff iron, other joints upstream.

This causes basically unbalance throughout your legs unequal

leaning into your heels more common if you have knee issues, hip issues,

limb length issues.

If you have a higher foot or a really flat foot, you're more likely to have it.

If you have Achilles tendonitis,

tight muscles, Basically anything that makes you walk on evenly.

What I think the real causes,

if you walk unevenly, you're more likely to have plantar fasciitis.

And it's such a common disease

that anybody who has these issues will probably get plantar fasciitis.

And it's also correlated with poor foot gear.

And I'll get into Barefoot Shoes versus a very supportive shoes.

What's the difference between plantar fasciitis and a spur?

When you get plantar fasciitis for a long time, it actually starts to rip

out of the heel and the bone almost twice the heel touches it.

That's a heel spur.

There's a lot of studies on heel spurs that can be a little bit confusing,

but the bottom line is one out of about ten people will develop

a heel spur in their life, but only about one out of 20.

So about 50% of those who will develop pain.

A spur is actually strengthening of that plane or fascia as it inserts.

And that's really the trick.

You don't need surgery.

I see so many people with heel spurs, but don't panic.

There's so many things we're going to talk about in this video

that can help with both your heel spur and plantar fascia,

where you can skip the dangerous surgeries and you can be athletic again.

You can be strong, you can move like when you were a teenager.

The economy says that one out of ten people have a heel spur

and one out of 20 will experience heel spur, pain.

Heel spurs essentially have the same causes bad foot gear overweight

are three right is incorrect unnatural gait due to hip back knee problems.

Having plantar fasciitis

will strongly associate your need to have a heel spur develop.

But that doesn't mean you need surgery, so don't panic.

How do doctors diagnose plantar fasciitis?

Well, the first thing is I check loading up your big toe

joint and checking how tight the plane or fashion is.

That's called the wind less mechanism.

You can feel the plane or fasciitis with your thumb.

Almost always at this case, it will be sore if it is not sorted.

There's a good chance it's not plantar fasciitis.

It could be a nerve issue.

It could be a heel stress fracture.

It could be the heel spur, it could just be bruising.

Sometimes I've seen it be a walk, a corn, a callus.

Sometimes people step on things and that could be the problem.

It's almost something in there.

It could be fat pad

like I have videos about all those things, including the fat pad loss.

There's lots of things you can do if you don't notice

that plantar fascia hurting so we can get an x ray.

An x ray will show us if there's heel, spur or arthritis somewhere else.

We'll check it.

The knee hearts, arthritis, The hip has arthritis.

If you have a back problem,

if you have problems here, it's going to put so much more weight on that foot

because you have to compensate for that joint.

That's not mobile.

If you have weak muscles, your thigh, your hamstring, your knee,

your calf muscle, it's going to put more pressure on that foot

turning out and it's going to stretch that plane or fashion more.

That's really the trick.

You can't just heal the plane or fashion, but not heal

everything upstream and that's what we focus on in the diagnosis.

We also check for nerve function.

So your reflexes, your muscle tone, your sense of touch, your coordination,

your balance is your spine working properly.

And with imaging, we use an x ray.

So what I'm looking for on the x ray, you can't see the plane or fascia,

but you can see is there a heel spur at the bottom?

Is there an Achilles tendon heel spur in the back of the heel?

Is there ankle arthritis, foot arthritis, some type of break?

Do you have a flat footed?

Do you have a higher arched foot which could put more pressure on it?

I always do this also in the office, an ultrasound.

I will actually take my ultrasound probe and I will measure how thick vertically

that plane or fascia is.

Usually, if somebody has a lump, those areas are 2 to 3 times thicker

or if it's in the heel rather than being four millimeters

vertically thick, it's more like eight, nine or ten millimeters.

Now, as time goes on, I actually see that thickness disappear.

That means those hairs and that scar tissue are healing.

It's getting more flexible.

An MRI can be important to check.

Is there an impinged nerve?

So Baxter's nerves are very common.

Is there a stress fracture in the heel?

That's a possibility as well.

The good news is I'm going to go over my treatment.

So my stage guide that works for 99.9%

of people, it's so rare for me to ever need to do surgery.

I just don't think it's necessary because all of these things work.

But let me talk about the surgery so that you understand what it's actually

a tight calf muscle makes your foot turn out

and puts more pressure onto your plane or fashion.

One surgery that's proposed is the gastrocnemius recession,

the lengthening the calf muscle lets your foot move

through the ankle easier and puts less pressure on the plainer fascia.

This works great if you've tried everything.

The gastrocnemius recession will definitely.

But this is extreme.

It's going to take you so long to heal and it's just like rupturing

your Achilles tendon, you're going to lose strength through your foot.

So why not just do the easy stuff

that lengthens your calf muscle and corrects your posture

anyway, I really think that the benefits of the calf lengthening

are the fact that, number one, we lengthen your calf, making you walk straighter.

And number two,

it puts you in a cast for months where your heel has time to heal anyway.

So why not just do that without having a more dangerous surgery?

The studies for Gastrocnemius recession are pretty good.

In a 2018 study, they looked at patients and the majority of them had good

pain relief. I would agree with that.

I used to do this procedure, but there are complications

like nerve pain in the calf or difficulty healing that do happen.

The second type of procedure is a plane or facial lengthening.

You could essentially cut near the heel and lengthen the plane or just shave it,

put the person in the cast until it heals in the elongated form.

The problem is you're permanently creating a flat foot for yourself.

You're essentially releasing everything so that your arch collapses.

It eventually does heal your heal. Pain goes away.

But now you have all the foot pain.

You have more inside of the knee pain, you have more heel pain.

Very, very proven, very common.

This is my five stage ultimate plantar fasciitis and heel spur treatment guide.

It works great.

Number one is a biomechanical exam.

This is the real key if you have plantar fasciitis,

but you have like

a slip disc in your back

where your nerves are coming down to your feet,

you have almost no chance of getting better.

Even if your plantar fascia heals, you will not be happy with your doctor.

And this is the type of stuff I see with people.

You have to actually check your lower

back, your hips, your knees, your feet and your plane are fresher.

That doesn't mean you can get your plane or air better, but these are reasons

that you have to target.

It's going to help with shoe gear. It's going to help with insoles.

It's going to help with all your decision making.

If you have a really tight lower back and hamstring,

which most people with plantar fasciitis do and you don't try

and get those more loose in healed and feeling better,

you have absolutely no chance of your pain not coming back.

Even if you're going to boot for three months, you'll feel better

for a little bit.

But as you start walking with your tight back and hips,

your foot's going to start getting sore again.

That's the problem.

And the example I like to give here is if you have a brother, sister

punching you in the shoulder or repeatedly,

my shoulder is going to get so sorry that I can barely lift it.

After a little while, I can use the best brace for my shoulder,

the best injections, the best creams, the best surgeries,

the best everything, the best home remedies.

But if someone's punching you in the shoulder ten times a day,

nothing else matters.

And that's where the biomechanical exam and the pain relief come in.

And we're going to talk about that proper

biomechanical exam will help with all decision making.

Check your hips strength, your knee hamstring, calf foot strength.

This is what I always start with.

We do a physical exam, make sure there's no broken bones joints,

no dislocations, no severe problems that will prevent us from getting better.

Then number two, you want to do pain relief.

So these are kind of your injections, your pain relief from modalities.

Number three is

you want to support the foot to prevent it from twisting and rupturing.

Number four is your rehabilitate

and strengthening in number five is get that muscle strength going.

You have to strength train for the biomechanical exam.

with your injured plantar fascia is consider modalities like icing.

Icing works really well.

15 to 20 minutes at a time, 3 to 4 times per day.

Your inflammation and soreness will come down.

Now it's less inflamed, but you still have those microscopic hairs.

You potentially still have that spur.

What you also want to do is prevent it from getting rid damage.

That's kind of where cushion

on the bottom of your heel gel pads can help at the beginning.

And I have a lot of my favorites linked down below.

A good thing to try is anti-inflammatories.

That's your ibuprofen, your Motrin, your Advil is always recommend.

Take 400 milligrams every 4 hours or 600 milligrams

every 6 hours or 800 milligrams every 8 hours.

Never do this for more than a week or two.

It starts putting your kidney out.

Real medications aren't the answer.

Naproxen is one of these as well.

Tylenol can help, too, but you don't want to use Tylenol long term.

You could even use Tylenol and ibuprofen together.

Steroid injections can work really well

If someone's in severe pain, like they can barely walk and move.

I love a steroid injection into the heal, but this is like a one time thing.

We don't want to keep doing this for the rest of your life.

We just want to give your heal a turbo boost so that inflammation calms down.

But we also want to combine with good shoes, good orthotics

to keep pressure off.

And another easy treatment is creams.

Anti-inflammatory creams like Voltaren work really well.

There's other ones too bio freeze, menthol

creams, capsaicin, which is the chili pepper extract.

These creams can work really well.

But again, you want to stop that punch to not just relieve the pain.

There's a lot of other pills, like pain meds for more severe things.

Like if you actually cracked your heel, you might need a narcotic pain medication

for the first couple of days and then things like physical therapy.

So with physical therapy, I'm going to lump my favorite treatments under here.

So these are massage.

I think hot, cold modalities,

Epsom salt baths, red light therapy.

I love red light therapy.

It might not be the best for the bottom of heal,

but big muscles like your thighs, your glutes, ultrasound therapy

can be very beneficial, but again, it doesn't get to the root cause.

One thing that I am a very huge fan of and I use almost immediately

on everybody in my clinic is Shockwave therapy.

Shockwave therapy essentially uses sound that goes through

gel on the bottom and the heel, and that sound basically stimulates

that ligament to, number one, feel a little bit more numb and better.

The first statement and number two, what it does do is it stimulates

the fibroblasts, the regenerating cells in your heel

to stimulate more blood vessel growth into that area.

I've seen thick, scarred heels that have had numerous

surgical events just can't massage.

And as a couple of weeks

or months go by almost immediately, they get more flexible.

They shrink down in height.

When I measured on the ultrasound, same thing for the back of the heel.

Shockwave therapy is outstanding. I love it.

Some side effects concludes bruising, swelling,

pain, numbness if you get too crazy with shockwave therapy.

But I love it.

It's something I swear by another thing you want to consider is modified activity.

If you're on your feet all day, you might need to take some time off.

If you're a runner, you might need to switch to swimming.

This is an injury just like a broken ankle is.

You have microscopic pairs through your plane

or fashion that need time to heal.

Now, if you're on a standing desk, maybe a sit down job, if you're sitting

or standing in a weird way, maybe you need a standing mat.

I personally love standing mats for people at work

so you can fidget and lean and stretch different muscles

rather than standing in one spot the whole time.

Massage, guns, butt massagers, ice balls.

I have a lot of these great things link to below.

They work really well,

but again, you want to get to the root cause and stop that punch.

Epsom salt soaks can work really well turmeric and ginger tea.

Turmeric is just as effective as an anti-inflammatory

as basically the anti-inflammatory medications.

Gentle foot strengthening with resistance bands gets that blood

flowing, almost serves as a way to massage that plantar fascia

cayenne pepper paste can work really well and proper foot positioning.

Barefoot walking can essentially help you walk straighter

so that you're not loading your plane or fashion.

You're more conscious

if you're missing fat pad or if you're arthritic in your knees and feet barefoot.

Walking's not good for you.

But if you're a younger, healthier person and you can be more conscious

of your walking,

that's where barefoot walking can make a big difference for a lot of people.

Shoes and insoles.

This is where shoes and insoles are very beneficial in the first appointment.

I think this is the most important critical thing

because shoes, insoles, braces or boots are what?

Stop the punch.

So we talk about pain relief, a good biomechanical exam.

If you're a young, healthy person with good muscle strength

and you just want to Disneyland for like three days and walked 6 hours

a day

and more minimal shoes can be beneficial for you can be conscious of your walking

and you're going to get better no matter what.

But if you're an older person who basically has arthritis

in your ankle, your knee and your hip,

you're going to have a hard time walking with barefoot shoes.

That's where a more maximalist, supportive shoe will come in.

And I'll tell you, over

75% of my patients fall more into the maximalist shoe category.

Maximalist shoes means a lot of cushion under the heel, a lot of support.

The heel is usually a little bit higher.

It means they have a strong arch.

The back of the heel holds you straight so your feet don't over prone or turn out.

And at the same time, I like to put an insole in there

with a little bit of padding under the heel.

It's a lot, but basically right away people feel better,

their pain starts to disappear and that lets you be active

and move around while you preventing new damage.

Previously we had maybe done an injection, maybe some cream, maybe some shockwave

therapy, just doing these things along for like 90% of people.

You're going to feel like a million bucks.

You're going to feel really good.

These things are what's important.

If, for example, you have a limb length discrepancy,

if one signs taller than the other and you put a big, thick,

bulky shoe, the heel might not fit, it might not ache.

That's where a biomechanical exam is really important.

And at the same time, if you have knee pain, hip pain, a big, thick, foamy,

cushioned shoe might put more pressure on your knee, your back or your hip,

rather than just getting the maximally supportive shoe in the world.

The most aggressive insole you want to maybe start soft

and light until your knee and hip gets used to walking.

I always take people through about a three month journey.

I start soft and gentle for most people and then gradually move

to a firmer, more supportive shoe as time goes on.

And it's not that you have to buy three or four different shoes, but when you come

see me in the office, I go start with a soft gel insole,

then maybe a softer, less supportive insole,

then gradually a softer, more supportive insole,

then gradually a firmer, more corrective insole at the end of three months.

And during that time people get more flexible through their knees, their hips,

their hamstrings.

They start gentle stretching.

During that time they start walking so their hips and knees loosen up.

One of the shoes I love is ortho feet.

Ortho feet is a great company and hey, actually work with ortho feet.

This is not a shoe for everybody.

This is more on the maximalist

and it's a supportive shoe with a lot of cushion throughout the heel.

This works best for people usually over 50 that needs support,

that have some tightness through their hamstrings, their lower back, their hips.

This is a great shoe.

They make both slippers, They make heel supportive shoes.

They kind of meet all these criterias and you can see the insole inside.

The shoe is removable.

It does unbelievable job.

It gets pressure off the heel, the arch.

I love ortho feet.

I have a lot of patients that wear them.

Listen, they are an orthopedic shoe.

They're not a lightweight shoe.

They are for people with severe ball to foot paint, heel pain, arch pain,

ankle pain.

If you have tight, stiff joints, this is a phenomenal shoe that's very high rated.

They're actually the number one orthopedic shoe.

Check down below for the links for ortho feet.

This is one I really enjoy and I really like.

And what you also want to do is you don't need to wear big, heavy shoes

all the time.

There are supportive slippers, sandals that you can wear.

This makes a big, big difference in getting pressure off your feet.

Have something supportive pretty much all the time

until the swelling and pain calms down and gradually you want to do this for

at least the first month or two until you can start walking

with a little bit less support, getting your knees

and hips stronger, braces and supports for plantar fasciitis.

Night splints are another treatment that can help stretch your calf

and the arch of your foot.

This is a great option.

I highly recommend this.

This can prevent morning stiffness if you're wearing it.

I recommend for most people don't actually wear it at night.

Wear it during the day while you're watching TV for like 2030 minutes.

That's usually a great amount of time of stretching orthotics in a way.

Also help you stretch.

I have a lot of my favorite orthotics down below,

but essentially they promote your feet from stretching out.

They hold your foot straight.

I always recommend a good supportive shoe,

good supportive orthotic that really helps the plane or fashion.

If you have a stress fracture or an actual rupture, this is where a boot comes in.

So I love the big supportive boot with an insult in.

It makes a big difference for the vast majority of people.

Number four in the treat Cascades.

So four out of five is massage and stretching exercises.

This is foam rollers, message sticks, massage guns, foot massagers.

I love foot massagers simply sitting on your couch and using a foot

massager that can really loosen up your foot ligaments.

Your ankle ligaments makes a huge improvement.

Stretching exercise.

Here's what you want to focus on.

The biggest and most important thing is stretching

your calf muscle and your plantar fascia.

It's important to take a break from exercises like running,

like standing all day on concrete, if you can, and switch to stuff

like swimming train, set more, try and get a rubber mat if you can.

You can try yoga and gentle stretching.

You can try a stretch splint or a nice splint while you're watching.

In an extreme examples, rather than doing the surgery,

I actually put a cast with people stretched up and in that stretches

or plantar fascia and their calf muscle just does an example.

Two days at 48 hours of straight stretching, how does your 5 minutes

of daily stretching compared to 48 hours of straight stretching

that makes a bigger difference and basically a year's worth of stretching

important stretches to do at home are focus on your calf muscles.

That's your gastrocnemius.

There's a lot of different ways to do it.

That includes your soleus muscle, that includes your Achilles tendon,

which connects your gastrocnemius and soleus, and that also includes

your flexor hallucinates longus, which is underneath that muscle belt.

You also want to stretch your plantar fascia.

And I have videos that go over all this below.

Your tibial is posterior.

You want to stretch and strengthen.

You want to stretch your peroneal muscles.

That helps quite a bit.

You want to strengthen that as well.

You want to strengthen and stretch your hamstrings.

That really helps take pressure off your knees, your hips.

Did you hear about the knees over toes guy?

He basically says to work out your anterior muscle groups.

That's your anterior tibia and extensor digital arm long essentially that's

lifting weights with your feet or standing against a wall while lifting your feet

so that standing on your heels that makes a big difference.

You also want to strengthen your glutes.

Your hip flexors squats are a great way to do that.

You also want to strengthen your quadriceps.

So squats again, the best possible exercises,

and then you want to strengthen the actual plane or fascia. So

there's a lot of exercises like toe curls, marble pickups, short foot exercises.

I have a guide that goes over all of these in depth down below.

Make sure you check out that video.

It makes a big, big difference.

So here's the big secret in home Remedies.

The plane or fascia is a damaged ligament.

It needs time to heal.

There's no five minute tricks.

The ligament actually picked some months to heal.

The real trick is getting it supported.

So you're not taking damage nonstop.

The number one most effective way I see to do

that is to do a biomechanical exam and see what the underlying problems

are for most people to type back tight hips, sciatica,

tight hamstrings or weak inflexible muscles

as you protect your plane or factor out with good shoes, get orthotics,

you have to start strengthening your muscles.

And I have great videos on how to do that.

That is the way

to beat your plantar fasciitis, your foot pain and your leg pain forever.

I'll tell you personally,

if we break it down to a sequential five steps, none almost none.

I can't even think of one in years that has needed surgery.

Just about always gets better.

It's not expensive.

It's not dangerous for most people relatively, you know, shoes and insoles

cost a lot.

But we're not talking like getting a $5,000 product or a $10,000 surgery.

This stuff just works.

I'm telling you, I see so many patients with heel pain, it works.

Well, if that didn't help you, check out my favorite home remedies, where

I go over stuff like do essential oils work, do creams, work, do injections work?

What about lavender, lemongrass?

What about turmeric? Does all that stuff work?

The answer is yes.

A lot of it can work. And we're going to do our count down.

Even CBD oil, the CBD oil.

There's actually great studies.

All of that stuff works well.

Check out that guide on my top ten Home

Remedies for Heal Pain that Relieve Pain.

Check that out.

Come see me in Michigan for any of your foot and plantar fasciitis.

Care, I'd love to see you.