Tag Archive for: foot pain

Plantar Fasciitis

How to Survive Flip-Flop Season Without Wrecking Your Feet

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Flip-flop season is here – which means sunshine, beach days, and pool time. But it can also mean extra foot pain. And every summer around this time, we see an influx of people dealing with aching arches and stabbing heel pain – most commonly known as “plantar fasciitis”

What is Plantar Fasciitis?

Quite simply, it’s inflammation of your plantar fascia – the tissue that makes up the arch (bottom) of your foot. Your plantar fascia runs from the base of your heel, down the length of your foot, and into your toes. It’s responsible for both the mobility and stability of your foot, enabling you to propel yourself during walking and running. When you land on your foot, your arch falls or flattens – this is called pronation. In response, your foot then stiffens or supinates, providing the power to push off. If any part of this mechanism is not functioning properly, your plantar fascia can become stressed and overworked, leading to what we call “plantar fasciitis”.

How Do Flip-Flops Contribute?

Footwear can either “protect” your arch or cause it to overwork. Technically, if your foot mechanics are sound and the arch of your foot is strong and mobile, footwear should have a negligible impact on your plantar fascia. However, due to prolonged sitting and limited barefoot walking, the bottoms of our feet are not as conditioned as they should be. This is the real problem – not so much what you put on your feet. If you’re used to wearing supportive and cushioned shoes and then suddenly switch to flatter, less supportive flip-flops, it can shock your foot. And if you’re already prone to plantar fasciitis, it will flare up easily and quickly.

What Can You Do?

The good news is you don’t have to give up your favorite summer footwear entirely – you just need to be smart about how you wear them and how you care for your feet. Here are five simple tips and strategies to help you get through flip-flop season without completely wrecking your feet.

1. Choose Supportive Styles

Not all flip-flops are created equal. Those flat, flimsy styles you can pick up at the drugstore for five bucks? Probably not doing your feet any favors. They offer little to no support, and if your foot mechanics aren’t perfect, you’re asking a lot of your plantar fascia every time you take a step. A better choice is a flip-flop that gives you a bit of arch support and structure. Look for ones with a cushioned sole, some contouring through the arch, and even a slight heel cup to help stabilize your foot and keep it from sliding around. The right pair makes a big difference – a key factor for enjoying flip-flops pain-free.

2. Save Them for Short Distances

Even the most supportive flip-flop has its limits. They’re not designed for long walks, hours of standing, or sightseeing on vacation. Think of them like you would a slipper – something you wear for convenience or comfort in short bursts, not as your all-day shoe. If you’re going out for a full day of walking, or standing at an outdoor event, it’s better to switch to something more structured that supports your foot and ankle. Use your flip-flops strategically – around the house, to and from the pool, or for short errands. Giving your feet the right support when it matters most can go a long way in keeping them pain-free.

3. Strengthen Your Feet (and Your Core)

One of the best ways to prevent plantar fasciitis – or keep it from coming back – is to strengthen the muscles that support your arch and stabilize your entire lower body. Most people don’t think about exercising their feet, but they absolutely should. Working on things like toe strength, arch activation, ankle mobility, and balance helps condition your feet so they can handle different surfaces and demands. But don’t stop at your feet – your core matters too. The way your pelvis and deep abdominal muscles function has a direct impact on how forces move through your body when you walk. A weak or poorly functioning core can lead to poor movement patterns that put extra stress on your feet. Strengthening both your feet and your core can transform the way you move – and reduce the load on your plantar fascia dramatically.

4. Stretch and Massage Regularly

One of the most underrated things you can do to prevent or treat plantar fasciitis is to stretch and massage your feet on a regular basis. Tight calves, stiff ankles, and tension through the soles of your feet can all contribute to pain and inflammation. A few minutes of daily stretching – focusing on your calves and toes – combined with massage using your hands, a lacrosse ball, or a mobility tool, can make a huge difference. This kind of soft tissue work helps relieve tension, improves circulation, and keeps your plantar fascia mobile and healthy. 

5. Don’t Ignore Persistent Pain – Treat It Early

If you’re already feeling pain in your heel or arch that just won’t go away, don’t wait around hoping it gets better on its own. Plantar fasciitis becomes harder to treat the longer it sticks around, and it can quickly go from annoying to chronic. When that happens, exercise and stretching might not be enough to get you out of pain – and that’s where regenerative therapy comes in. Shockwave therapy (EPAT) is a non-invasive treatment that uses high-energy sound waves to stimulate blood flow and break up tight, inflamed tissue. It helps jumpstart healing in a way that rest and stretching can’t. EMTT (Extracorporeal Magnetotransduction Therapy) takes this even further. It uses pulsed magnetic fields to penetrate deeper into tissues and promote healing at the cellular level. Together, shockwave and EMTT are incredibly effective at reducing pain, accelerating recovery, and allowing you to tolerate the exercises and movement you need to fully resolve your plantar fascitis.

Bottom Line

Flip-flops don’t have to be the enemy. But if you’re not taking care of your feet, wearing them can easily lead to pain and frustration. By choosing the right styles, wearing them in moderation, and taking the time to strengthen and care for your feet – you can enjoy them all summer long without paying the price. And if foot pain does creep in, don’t ignore it. Get the right help early. Treatments like shockwave and EMTT, combined with expert-guided movement and strengthening, could be exactly what you need to survive flip-flop season pain-free – and keep your feet happy long after summer ends.

Plantar Fasciitis

Enjoy Flip-Flop Season: Strategies to Prevent and Treat Foot Pain

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Flip-flop season is officially here – but unfortunately – that also means we are about to see an influx of foot pain – otherwise known as “plantar fasciitis”.

Here’s a question someone asked me just the other day… “I’ve been wearing my flip-flops for the past week and notice that the pain in my arch and heel has acted up. Is there anything I can do? Or do I need to just not wear flip-flops anymore?”
While wearing more supportive shoes would certainly help, staying on top of your plantar fasciitis and/or preventing it altogether means flip-flops don’t have to be an issue, and you can continue enjoying them all season long.

First – What is Plantar Fasciitis?

Quite simply, it’s inflammation of your plantar fascia—the tissue that makes up the arch (bottom) of your foot. Your plantar fascia runs from the base of your heel, down the length of your foot, and into your toes. It’s responsible for both the mobility and stability of your foot, enabling you to propel yourself during walking and running. When you land on your foot, your arch falls or flattens—this is called pronation. In response, your foot then stiffens or supinates, providing the power to push off. If any part of this mechanism is not functioning properly, your plantar fascia can become stressed and overworked, leading to what we call “plantar fasciitis”.

How Do Flip-Flops Contribute?

Footwear can either “protect” your arch or cause it to overwork. Technically, if your foot mechanics are sound and the arch of your foot is strong and mobile, footwear should have a negligible impact on your plantar fascia. However, due to prolonged sitting and limited barefoot walking, the bottoms of our feet are not as conditioned as they should be. This is the real problem—not so much what you put on your feet. If you’re used to wearing supportive and cushioned shoes and then suddenly switch to flatter, less supportive flip-flops, it can shock your foot. And if you’re already prone to plantar fasciitis, it will flare up easily and quickly.

What Can You Do?

The best way to prevent and treat plantar fasciitis is to not neglect your feet. Consistent mobility exercises for your toes and ankles are key, as is conditioning for the strength and stability of your arch. Balance exercises, toe exercises, and plyometric (jumping) exercises are all important. Additionally, make it a point to walk around without shoes as often as possible. Incorporating pelvic floor and core training exercises is also beneficial because the function of your deep core has an impact on your foot mechanics.

When Your Pain is Too Severe

If your plantar fasciitis is too painful, jumping into exercises may not help and could even aggravate it more. One effective treatment modality for particularly painful cases is something called Shockwave Therapy (Extracorporeal Pulse Activation Technology or EPAT). During a shockwave treatment, high-pressure sound waves are delivered directly to the affected tissue, bringing blood flow and accelerated healing to the injured and inflamed area (in this case, your plantar fascia and surrounding muscles). The treatment is non-invasive and penetrates deeply. Pain reduction can be seen in as little as one shockwave session, but research shows it to be most effective after a minimum of six. Shockwave therapy can significantly reduce pain and swelling from plantar fasciitis in the short term, allowing you to tolerate the exercises required to keep your plantar fasciitis at bay in the long term.

When addressed correctly, plantar fasciitis doesn’t have to be chronic, and it doesn’t have to dictate your footwear selection. If you’ve tried various treatments already for your plantar fasciitis without success, consider working with an expert who can accurately identify where your plantar fasciitis is coming from. They can also help you decide if incorporating something like shockwave therapy – in addition to the necessary exercises – is what’s needed to finally resolve your plantar fasciitis and get back to enjoying your flip-flops again.

Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Pain expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch – or inquire further about Shockwave Therapy – CLICK HERE.

plantar fasciitis

Best Treatments for Persistent Plantar Fasciitis – According to Science

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Ever had nagging foot and heel pain that’s so bad it feels like you’re walking around on glass? Yep – that’s called plantar fasciitis – and it impacts over 2 million individuals in the United States every year. 

Plantar fasciitis occurs when you have inflammation of your plantar fascia – the tissue that makes up the arch (bottom) of your foot.

Your plantar fascia is responsible for both the mobility and stability of your foot so that you can propel yourself during walking and running. When you suffer from plantar fasciitis – it’s not only annoying and painful – but can be quite debilitating. It keeps runners from running, walkers from walking, and eventually will cause problems up the kinetic chain (think knees and hips) when left untreated. Typical treatments for plantar fasciitis include everything from rest, ice, cortisone shots, orthotics, braces, exercise, and stretching. 

But which treatments are best? 

Depending on who you ask – you’ll get a lot of different answers – so let’s see what the science and research says. 

Cortisone Shots:

While there is plenty of evidence to support the use of cortisone shots for reducing pain and inflammation – it’s important to consider the consequences of how cortisone works. When you’ve got damaged, painful tissue from overuse or overstretching – such as what can occur with plantar fasciitis. The cells in your tissue respond by releasing certain factors designed to recruit blood vessels, stem cells, and healing factors. The inrush of these fluids causes temporary swelling and pain, but it also stimulates the laying down of new collagen. Collagen, a naturally occurring protein in your body that helps tissue to heal and become strong again. Cortisone works by shutting down this cellular process. Which is great because it stops the swelling and pain from occurring. But by doing so – it inhibits your body’s natural healing process.

This can result in weakened tissue that stays in a weakened state. Leaving you susceptible to repeated and sometimes permanent damage over time, especially if you keep getting cortisone shots. So while cortisone injections may appear to be the miracle quick-fix you’re looking for – it’s crucial you consider the long-term consequences that inhibited tissue healing could cause.

Regenerative Shockwave Therapy:

Unlike cortisone shots, this therapy aids in the tissue-healing process instead of inhibiting it. And there is good research and evidence to support its use with plantar fasciitis specifically. While it’s been successfully used in Europe for decades, it didn’t surface in the United States until around the year 2000. Shockwave Therapy uses acoustic sound waves to stimulate the same natural healing process described above. This can be especially useful in tissue that has already experienced damage. What I like about Shockwave Therapy – is that it’s completely non-invasive – compared to something like platelet-rich plasma (PRP) injections (another popular treatment for plantar fasciitis). With injections, there is always a risk of infection. You don’t have to worry about that with Shockwave Therapy. That, combined with promising evidence for significant pain reduction in as few as six sessions, makes this a wise treatment choice for plantar fasciitis.

Stretching and Strengthening Exercises:

For most musculoskeletal injuries (plantar fasciitis included) the research overwhelmingly supports the use of stretching and strengthening as an effective and long-lasting means of treatment. So why does this approach fail so often? And make us quick to resort to injections, surgery and other types of medical procedures to resolve musculoskeletal-related pain? The biggest problem I see is not with the stretches and exercises themselves, but with exercise prescription. That’s why you can’t just go to Google or YouTube and look for “the best exercises for plantar fasciitis”. Finding great and appropriate exercises isn’t the issue.

The problem is that you won’t know when and how to perform them – and you risk making your plantar fasciitis worse or resorting too quickly to a more invasive treatment option because you think the exercises just didn’t work. With plantar fasciitis specifically, the type of stretching and exercise you choose has to match the stage of tissue healing. You have to load the tissue just enough to cause the appropriate amount of tissue damage that will elicit remodeling of tissue fibers – but not so much that you elicit an inflammatory cycle, which will disrupt the remodeling process. The only way plantar fasciitis truly heals is through remodeling the damaged tissue. And this requires a perfectly prescribed stretching and exercise protocol – which can take up to 7-9 months to work.

So be cautious of the quick fixes, work with an expert, and be patient in this process – because stretching and strengthening really do work when done correctly for Plantar Fasciitis.

In the battle against plantar fasciitis, a prescribed combination of stretching and strengthening exercises, along with non-invasive passive modalities that work to enhance your body’s natural healing process tend to be the most effective. Stay away from ice, rest, and other invasive procedures that disrupt healing or interfere with tissue remodeling.  If your plantar fasciitis is chronic, understand that there’s still hope, but it may take some time. My advice is to talk with an expert who is up to date on the latest research, and who has a good understanding of tissue healing and remodeling.

Because ultimately – the best treatment for plantar fasciitis must involve a combination of these two things. 

Local to Portsmouth, NH? Discover how regenerative shockwave therapy can help! CLICK HERE to learn more and start your journey of pain relief.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media group. To get in touch, or to inquire further about Shockwave Treatment, CLICK HERE to talk to one of our specialists or call 603-605-0402

Plantar Fasciitis

Don’t let Plantar Fasciitis Ruin Flip Flop Season

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Good weather is on its way and if you haven’t already broken out your flip flops – it’s only a matter of time before you do. The only unfortunate thing about flip flop season is the coinciding rise in plantar fasciitis that typically comes with it.

Someone I was speaking with the other day recently asked:

“Now that I’m wearing flip flops again, my plantar fasciitis is acting up. Is there anything I can do? Or do I need to stop wearing flip flops altogether?”

This is a great question.

While yes, wearing more supportive shoes would certainly help. Ideally, if you can stay on top of your plantar fasciitis and/or prevent it all together, flip flops don’t have to be an issue at all and you can continue enjoying them all season long.

First – what is plantar fasciitis?

Quite simply, it’s inflammation of your plantar fascia – the tissue that makes up the arch (bottom) of your foot. Your plantar fascia runs from the base of your heel, down the length of your foot, and into your toes. It’s responsible for both the mobility and stability of your foot so that you can propel yourself during walking and running. When you land on your foot your arch falls or flattens – this is called pronation.

The response to this action is that your foot then stiffens or supinates. This is where your foot gets the power to push off. If any part of this mechanism is not functioning properly, your plantar fascia can become stressed and overworked. This leads to inflammation/plantar fasciitis.

What causes your plantar fascia to become inflamed?

Basically, it can be anything that impacts or disrupts the natural mechanics of your foot to pronate and supinate. Most commonly, poor mobility in either your ankle or 1st toe is the culprit. Even tight hips and weak glutes can cause problems all the way down to your foot. Anything that impacts the way your foot hits the ground has an opportunity to influence the level of force and energy transmitted through your plantar fascia when you walk.

When the natural pronation/supination mechanism is disrupted, your plantar fascia will attempt to compensate. If this goes on uncorrected, your plantar fascia eventually becomes angry and irritated – resulting in a very painful case of plantar fasciitis.

So what do flip flops have to do with this?

Footwear can either “protect” your arch, or cause it to overwork. If your foot mechanics are sound and the arch of your foot is strong and mobile, footwear should have a negligible impact on your plantar fascia. But because of how much we sit, and how little we walk around barefoot, the bottoms of our feet are simply not as conditioned as they should be.

This is really the problem – not so much what you put on your feet. If you’re accustomed to wearing supportive and cushioned shoes all the time, and then suddenly switch to flatter, less supportive flip flops, it’s going to be a shock to your foot. And if you’re prone to plantar fasciitis already, it will flare up easily and quickly.

What can you do?

The best thing you can do to prevent and treat plantar fasciitis is to not neglect your feet. Performing consistent mobility exercises for your toes and ankles is key, as well as conditioning for the strength and stability of your arch.

Balance exercises, toe exercises, and plyometric (jumping) exercises are all important. Also, making it a point to walk around without shoes as often as you can. Along with all of this, it’s a good idea to incorporate pelvic floor and core training exercises. The function of your pelvis can have a significant impact on your foot mechanics.

But what if your plantar fasciitis is too painful?

If this is the case, jumping into exercises may not help, and could even aggravate your plantar fasciitis.

But one treatment modality that is known to be effective for particularly painful cases is something called Shockwave Therapy (Extracorporeal Pulse Activation Technology or EPAT).

During a shockwave treatment, high pressure sound waves are delivered directly to the affected tissue to bring blood flow and accelerated healing to the injured and inflamed area (in this case your plantar fascia and surrounding muscles).

The treatment is non-invasive and gets very deep. Pain reduction can be seen in as little as one shockwave session, but the research shows the most effectiveness after six.

Shockwave therapy can help to significantly reduce your pain – and even swelling – from plantar fasciitis in the short-term. It will allow you to tolerate the exercises required to keep your plantar fasciitis gone for the long-term.

When addressed correctly, plantar fasciitis doesn’t have to be chronic and it doesn’t have to dictate your footwear selection.

Are you local to Portsmouth, NH?

CLICK HERE to learn more about our Shockwave Therapy treatment – one of my specialists will reach out to you and see if you would be a good fit.

If you’ve already tried a lot of different treatments for your plantar fasciitis and they haven’t helped – consider working with an expert. They can incorporate something like shockwave therapy. This combined with the exercises you need will make a difference and get you back to enjoying your flip flops again.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, email her at [email protected].

Plantar Fasciitis

Are Flip flops Aggravating Your Plantar Fasciitis?

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Now that summer is here – it’s flip flop and sandal season for many. Unfortunately, this also typically results in a rise in foot pain and plantar fasciitis cases. One of my readers recently wrote to me and asked about this.

Here’s what Jennifer wanted to know:

“Now that I’m wearing flip flops again, I noticed that my plantar fasciitis is acting up. Is there anything I can do? Do I need to stop wearing flip flops?”

This is a great question Jennifer. In order to answer your question, let’s look at a few reasons why plantar fasciitis occurs in the first place. Ideally, if you can stay on top of your plantar fasciitis and/or prevent it all together, flip flops won’t even be an issue.

First – what is plantar fasciitis? 

It’s inflammation of your plantar fascia – the tissue that makes up the arch (bottom) of your foot. Your plantar fascial runs from the base of your heel, down the length of your foot, and into your toes. It’s responsible for both the mobility and stability of your foot so that you can propel yourself during walking and running. When you land on your foot your arch falls or flattens – this is called pronation. The response to this action is that your foot then stiffens or supinates – this is where your foot gets the power to push off. If any part of this mechanism is not functioning properly, your plantar fascia can become stressed and overworked – leading to inflammation/plantar fasciitis.

What causes your plantar fascia to become overworked?

Basically anything that impacts or disrupts the natural mechanics of your foot to pronate and supinate. Most commonly, poor mobility in either your ankle or 1st toe is the culprit – but even tight hips and weak glutes can cause problems all the way down to your foot. Anything that impacts the way your foot hits the ground has an opportunity to influence the level of force and energy transmitted through your foot and arch when you walk, which in turn impacts the natural pronation/supination mechanism. When disrupted, your plantar fascia will attempt to compensate for the pronation/supination mechanism. If this continues to happen, your plantar fascia eventually becomes angry and irritated – resulting in plantar fasciitis. 

Flip flops, or any other shoe for that matter, can either “protect” your arch, or cause it to overwork. Technically speaking, if your foot mechanics are sound and the arch of your foot is strong and mobile, footwear should have a negligible impact on your plantar fascia. Sadly, this is rarely the case for many people. Because of how much we sit, and how little we walk around barefoot, the bottoms of our feet are simply not as conditioned as they could be. This is really the problem – not so much what you put on your feet. If you’re accustomed to wearing supportive and cushioned shoes all the time, and then suddenly switch to flatter, less supportive flip flops in the summer, it’s going to be a shock to your foot. And if you’re prone to plantar fasciitis, it’s going to flare up during flip flop season.

The best thing you can do to prevent and treat plantar fasciitis is to not neglect your feet.

Performing consistent mobility exercises for your toes and ankles is key, as well as conditioning for the strength and stability of your arch. Balance exercises, toe exercises, and plyometric (jumping) exercises are all important, as well as making it a point to walk around without shoes as often as you can. If you’ve already got an ongoing problem with your foot, then I wouldn’t recommend haphazardly incorporating these exercises into your routine without guidance. Talk to an expert who can help you. Plantar fasciitis, when addressed correctly, is very treatable, and you could be back to enjoying flip flops in no time.

Are you local to Portsmouth, NH and looking for help with foot pan?

CLICK HERE to request a discovery call with our Client Success Team to see if we would be a good fit for you!

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, or request a free copy of one of her guides to back, neck, knee, or shoulder pain, email her at [email protected].

Back_Pain_Specialists_Portsmouth_NH

Where is your pain REALLY coming from?

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Don’t assume that where your pain is… is where the problem is!

This is a very common assumption and one that that we’ve been seeing a lot lately. If you watched our most recent Happy Hour on Facebook Live, then you know the story of the young guy who came to us looking for help with his heel pain. I checked out his heel, foot, and leg, but didn’t find any issues that would be causing the pain that he had been experiencing for four years.

I had planned on addressing the heel specifically before examining his back, but when he mentioned that he also felt a lot of tightness from his back into his leg, I decided to check it out. We did a test on his back and when he stood up, he immediately told me that his heel felt better! I was just as surprised as he was.  He was able to walk with less pain and his movement felt better overall. But when he started stretching his calf to his heel again, the pain came right back.

All that stretching he’d been doing day after day – to the area that he thought was the problem – may have actually been doing him more harm than good!

Now, it’s pretty clear that this young client doesn’t have a foot problem – where is pain actually was.  He has a back problem. And that’s something we can work through and fix! But if he never saw a specialist physical therapist like myself, he probably would’ve continued to believe that there was just something irreversibly wrong with his heel, and maybe even limited certain areas of his life, like football and sports, because of that.

Why should this matter to you?

You might not have heel pain or even noticeable back issues, but maybe you have pesky knee pain, a hip that hitches when you walk, or an achy ankle. Maybe you just feel muscle tension that never seems to go away, or weakness performing certain tasks.  These could all be indicators of a problem in your back!  Or somewhere else that just hasn’t been looked at yet, because it doesn’t match the main area of your pain.

If you’ve tried a lot of things and it’s not going away, it’s an indicator that your haven’t found the real source of your problem yet. Especially if you’ve gone to a doctor for pain in another part of your body and they’ve told you that there’s “nothing wrong.” Or maybe you’ve been stretching, massaging, and foam rolling religiously every day – only for it to keep coming back like a vicious cycle.  You might think that by doing this, you’re helping your problem and keeping it from getting worse – and you might be – but you certainly aren’t doing anything to actually address the problem and you aren’t any closer to a real solution. That’s why physical therapists are so important to have as part of your healthcare team – we’re trained to examine and treat the whole person – not just the foot/knee/hip/heel.

Getting Help

We know not everyone is ready to commit to regular physical therapy appointments, and that’s why we offer free Discovery Sessions out of our practice in Portsmouth, NH! All you have to do is fill out this brief form here and we’ll contact you. Discovery Sessions are a great opportunity to talk with a specialist about creating the best plan to get you healthy and feeling your best – without any obligation or commitment.

Feel free to reach out anytime, and be sure to like our Facebook page to stay up to date on Friday Happy Hour videos in the weeks to come!