It was 2015, my daughter had just been born, my son was two years old, and I went to my doctor for two orthopedic issues. The first, which I considered more bothersome, was my shoulder. Carrying around this newborn day and night, doing endless laundry, and doing general household chores, suddenly was all very difficult with this nagging pain in my dominant shoulder. The doctor took some x-rays, printed off some physical therapy exercises from an old book, and sent me home with some exercise bands, and to my surprise, it got better very quickly.

The other issue, that I barely decided to mention, was a slight pain in my left foot, near the heel, that was I was just starting to notice. He treated this the same way as my shoulder, printed off some old physical therapy exercises, and sent me on my way. Unfortunately this issue did not resolve the same way, and would eventually become a major problem in all aspects of my life that involved walking or standing up.

I developed Plantar Fasciitis at the age of 33. It seems to me that people who develop Plantar Fasciitis generally fall in to two camps: an athletic person, possibly a runner, who develops heel pain that limits their sporting activities. The second camp is individuals who maybe aren’t in as great of shape, carry a bit of extra weight, and have pain that really interferes with their normal life. I was definitely in the latter camp. I’ve been overweight to some degree for most of my life, I’m not one to typically enjoys exercise, and the activities that I’m drawn to usually involve sitting (computer, tv, reading, etc).

My son was born in 2013 and he was a bit of a crier. Fussy a lot of the time, rarely content to sit in one place, had a hard time sleeping through the night for a very long time. One place he was almost always happy and content though was in his stroller, on a walk. So that’s what I did, for miles and miles we explored the surrounding neighborhoods, in mediocre worn out shoes, after years of mostly sedentary behavior. This is what most likely lead to my heel pain, along with all the hours of carrying both children, all the extra housework and trips to the store – all par for the course for new parents.

As 2015 came to a close, the pain in my heel transitioned from a slight annoyance, to a real problem. Eventually I got referred to a Podiatrist. This guy had helped my Mom years earlier with the same problem. A cortisone shot, some physical therapy and she had been more or less better for over a decade. The doctor did the same things for me and more. I got a cortisone shot in the office on my first visit. He sold me some fairly inexpensive insoles for my shoes. He prescribed some more detailed at home physical therapy that I performed religiously. The shot actually did take away my pain, for about six weeks. Then unfortunately it returned with a vengeance. I went back to him, this time he sold me expensive custom insoles, prescribed physical therapy from an office nearby, and gave me a second shot. The second shot also relieved the pain, but it lasted less time than the first, and afterwards the pain kept increasing to the point where I was really struggling to do normal activities like going to the store, mowing the lawn, etc.

Physical therapy was interesting, the physical therapist was less interested in me doing stretches and exercises than I expected, and more interested in doing treatments on me. I was very open to this, as all the stretches in the world had not helped me up to that point. He began by warming up my feet with a heating pad, then performing Graston scraping on my foot with a small metal tool. The purpose of this treatment is to break up scar tissue and actually do some controlled damage to the area to increase blood flow and restart the natural healing process. It was during this time my second shot began to wear off, and this process was intensely painful. I was willing to keep doing this in hopes of long term gains, but the aftermath of each session left me hobbling for days, so I turned to Aleve (Naproxen) just to be able to function in my daily life. Soon I was taking these pills day and night, and unfortunately this may have been one reason why this physical therapy ended up not working for me. Non-steroidal anti-inflammatories (like Aleve) do exactly what they promise, limit inflammation – but in the case of a long term, chronic injury – I think they do more harm than good. Especially if you take them 24/7 like I did, there’s never a break to let the inflammation come back and actually heal the injury. I spent a lot of money on probably a dozen sessions of physical therapy, and I actually ended up worse off than I started.

This whole time I had not been purely relying on the wisdom of my podiatrist and physical therapist. I was also scouring the internet for some sort of relief. I tried just about every product you can imagine. Socks, shoes, boots, inserts, creams, toe spreaders, exercise and stretching devices. Some inserts worked better than others for me, some shoes worked better than others for me – but at the end of the day these simply provided me a bit less pain for daily activities, but no closer to being free of this condition. Powerstep inserts seemed to work best out of the dozen or so I tried, even against the custom orthotics that cost me hundreds. Shoes with a very wide toe box seemed to be best for me (I’ve also preferred Asics shoes, but now I needed a 4E Extra Wide to be comfortable, some shoe brands are made with wide toe boxes naturally, Birkenstocks had nice arch supports and plenty of toe room for me). But again, none of these products improved my condition, they just simply allowed me to move with less pain than others.

I visited my podiatrist one last time around the time my physical therapist decided his treatments were not benefitting me. He had ordered an MRI for me, it showed considerable thickening of the plantar fascia, and he was out of expensive suggestions for me to try. He said patients at this stage typically took one of two paths: they would eventually heal up and not come see him again, or be back to schedule a surgery. After many late nights on the internet looking at stories from people who had undergone surgery for this condition, I was definitely not ready to commit to that path. The doctor claimed a very high success rate of the surgery, over 90% of patients had “successful surgeries” – however the definition of success for this surgery is where I had an issue. Undergoing a surgical procedure with some risks just to end up with a mild reduction in my pain is not exactly what I had in mind. If I were to have a surgery, with full anesthesia and months of recovery time, I wanted a pretty high chance of a full cure: no pain, no restrictions, no recurrence. These was not the results I found from patient stories.

I started to investigate some alternative treatments to surgery. PRP (Platelet Rich Plasma) injections, stem cells, dry needling, Extracorporeal Shockwave Therapy (EWST or simply shockwave). They all seemed to work on the same principle: cause some controlled damage to get your body to try and heal the area naturally again (or in the case of stem cells and PRP, directly inject a substance that allows your body to start healing). These therapies were unproven and in some cases quite expensive. My podiatrist offered PRP and stem cell injections, but all but guaranteed my insurance would never cover them, while at the same time claiming the results were mixed at best. I did find another, somewhat less reputable, podiatrist that offered shockwave therapy in my area. His office wasn’t in the nicest part of town, and it seemed a bit rundown and less impressive than my original podiatrist’s office. Perhaps in hindsight, this was a good sign. Not as many repeat customers to fund a nice building in a high rent area. I’ve come to believe that many podiatrists operate the same way that chiropractors do – a great environment, super friendly personality (that many doctors lack), and treatments that make you leave the office feeling a bit better than when you come in.. but ultimately keep you coming back.

This other podiatrist offered shockwave therapy for a pretty low price. Something like $40 per treatment, I don’t exactly remember. I’m sure it would cost more now, like just about everything else. I decided to go for it. He had a machine that I found out with some research cost him a few thousand dollars, and was only available to qualified medical professionals. It had a corded “wand” type tool, about the size of a large flashlight, that was connected to the machine with a cable. He turned it on, set the dials for intensity and frequency, then used the wand on my bare foot. There was some fairly loud clicking noises and a bit of pain where the wand was pressed into my foot. He focused around the area where I had the most pain, varying the depth by pressing against my foot lightly or with more pressure, but also spread out some treatment on the rest of my foot toward the toes, the arch, and even up my leg a bit. The whole thing took only about 10 minutes. The pain during the procedure was fairly mild, in later sessions I even asked him to turn up the intensity thinking it might be more effective. I repeated the procedure five or six times, two weeks apart. I did get quite sore after the procedures, my pain level spiking higher than usual in the two or three days following. I didn’t really mind this, but unfortunately after all of this, I still was no better than I started.

After deciding half a dozen shots of shockwave energy was enough to prove nothing was happening, I returned to the internet for advice. I came across a few real studies that linked magnesium deficiency to plantar fasciitis. I also had been taking PPI medication for GERD & hiatal hernia for many years, which coincidentally often lead to magnesium deficiencies. Magnesium supplements were cheap, so I picked one on Amazon and had it sent to the house. It was a Kirkland brand, and now that I’ve come to know a lot more about supplements, was probably not the best choice for a magnesium deficiency. I started to take one of these pills in the evening, about three months after completing my shockwave treatments. After a week or two, for the first time in over two years, I actually started to get better. For the next three months or so I got a little bit better each day until I plateaued at about 80% better than my low point. This was major. I could do normal walking around things without stressing over painkillers and what would happen the next morning. I still had the same pain, in the same spot, from the same activities, but it was way, way less. Was it the magnesium? Was it a delayed reaction from the shockwave therapy? Was it simply time? I unfortunately do not know the answer. But I do know that I was functional without a boatload of anti-inflammatories for the first time in years.

I stuck to the magnesium supplementation, and enjoyed being able to partake in normal, everyday activities on my feet with just manageable pain levels for about a year. Then I found something else. I came across a guy named Ben Patrick, known online as the “Knees Over Toes Guy”. He had a bit of a different take on physical therapy exercises, novel approaches that were somewhat contrary to conventional physical therapy and athletic training wisdom. His videos have helped me get over some recurring pain in many areas, including my knees, shoulders and feet! Specifically strengthening two little known muscles in the lower legs: the tibialis and soleus.

I started to lift weights around this time in an attempt to ultimately lose a bit of weight. I started to enjoy this process (unlike any cardio I’ve ever done), but fairly quickly ran in to some nagging injuries and pain in my inexperience. That’s what lead me to Ben Patrick’s videos that I mentioned above. His methods helped my knee and shoulder pain from lifting weights, but I also discovered some of his lower leg training methods. The soleus is a muscle below your calf muscle, in the back of your lower leg down closer to where you can feel your Achilles tendon. I started training this muscle with simple calf raises, while seated, using a wedge under my foot, so my ankle was lower than my heel and a dumbbell on my knee. Slow and controlled, focusing on making that soleus muscle do the work. Aim for a weight you can do 30-50 reps (I do both legs at the same time) before the burn gets too strong. This muscle gets strong pretty fast, finding a heavy enough weight can be a bit of a challenge after a while.

The tibialis muscle is a little bit harder to train. This muscle is in the front of your lower leg, along side your shin bones. To make it work you need to extend your toes and then pull them up. You can do this with no equipment by standing with your back against a wall or door, extending your feet out some distance in front of you (the farther, the more difficult), then pulling your toes up while keeping your heels in the same spot. I found this exercise a bit awkward, so I purchased some equipment to make it easier. Initially I just bought some cheap luggage straps that I used to literally strap a dumbbell to the bottom of my feet. Then I sat with my feet hanging several inches off the edge of a bench, and pulled my toes up to perform the exercise. Again slow and controlled, focusing on making that tibialis muscle do the work. Later I purchased a “tib bar” that I could load with plates and use both feet at a time. To be honest in hindsight I think using each foot independently was actually a better exercise. If I could do it again I would purchase something simple like this single leg tib bar. I aim for 9-12 reps, increasing the weight when this becomes too easy – but this exercise, unlike the last, feels fairly challenging and increasing the weight is more difficult.

After a few months of building lower leg strength with these exercises, improving my general health by losing a bit of weight and putting on some muscle by lifting weights, I’d say I’m now 99% cured from plantar fasciitis and have been for a few years. I give zero thought to foot pain when choosing activities, I can walk for many miles at a time, even run if I choose. Barefoot, shoes, doesn’t really matter, I pick footwear based now based on what activity I’ll be doing and the general level of comfort, not out of necessity to avoid pain. My feet can get sore after heavy use, but it’s the normal kind of sore, that goes away after a day or so. I do, very occasionally, get pain in the same area that I did with plantar fasciitis, but it’s quite mild and literally a few minutes per year – just enough to remind me how far I’ve come.

To recap and get links to the purchases I made in my journey, check out my what worked and what didn’t pages.