The deal: Here’s what happens with plantar fasciitis, according to Berkey: “The tissue has had enough,” he says, referring to the tissues of the arch in the foot. “Micro-tears accumulate and a painful tightening occurs. The adhesions tighten as well, and you wake up one morning with a sharp pain in the heel after you take your first step out of bed.”
First aid: Berkey advises rolling out your foot with a frozen water bottle several times a day. “Ice to the point of numbness and then stop,” he says. Any more and you might burn your skin.
Prevention: “We used to always treat this with a night splint,” Boorman says. “But the issue is you’re pushing off over and over again with your foot.” Boorman recommends “plantar flexion” stretches to open up the talus joint, like sitting back on your heels. Berkey has patients focus on the flexibility of the big toe and believes that massaging the arch and foot—self-massage works here as well—will really help prevent arch pain issues if you’re regular about it.
Steve Berkey is a doctor of physical therapy and the director of 90 Revolutions in Falls Church, Va., where 75 percent of his clients are triathletes.
Nate Koch is the director of rehabilitation at Endurance Rehab in Scottsdale, Ariz.
Bryan Hill is a physical therapist and co-owner of Rehab United in San Diego.
Jill Boorman has been practicing physical therapy since 1994 and is currently the clinical manager at Premiere Physical Therapy in Charleston, S.C.