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The Consequences of Leaving Plantar Fasciitis Untreated

By Noelle Ihli, medically reviewed by Dr. Kimberly Langdon, M.D.

First, the good news: 90% of plantar fasciitis cases can be successfully resolved with simple, conservative treatments.

What’s the bad news? The longer plantar fasciitis goes unaddressed, the longer the healing process takes and the more potential complications that may arise. Not allowing your arch enough rest time after a foot injury, working a job that requires a lot of time on your feet, participating in high-impact activities without proper footwear or support, and failing to follow through with at-home treatments after symptoms develop are the most common ways plantar fasciitis persists and gets worse.

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Risks of Untreated Plantar Fasciitis

Symptoms of plantar fasciitis and heel pain usually develop gradually, although some cases can develop more quickly (for instance, after a foot injury). If heel pain and other symptoms of plantar fasciitis (like redness, inflammation, and swelling in the feet) are left untreated, other more serious complications can arise:

Plantar Tears

Over time, if plantar fasciitis is left untreated, the inflammation and stress to the plantar fascia can result in small tears in the fascia (sometimes called “micro-injuries”). You may not be aware of the exact moment that each small small tear appears, however you will notice your pain level gradually worsen. If these tears are left unaddressed, they may grow in size and number, and make the plantar fascia more vulnerable to rupture and debilitation.

Plantar Rupture

Plantar rupture can happen if plantar fasciitis is not addressed, but an individual continues to participate in activities that place a great deal of impact on the plantar fascia. These activities might include jogging, sports, or even standing for long periods of time in ill-fitting footwear.

Symptoms of plantar fascia rupture usually include a loud popping sound, followed by intense pain, bruising, and swelling in the foot. Putting weight on the affected foot will be very painful. If you suspect plantar rupture, you should seek medical help immediately. You will likely be required to wear a boot or crutches for a period of time after a ruptured plantar fascia.

Research also shows that steroid injections, a common treatment for pain relief of chronic plantar fasciitis, are a significant risk factor for plantar rupture, because of the way that the steroids interfere with collagen synthesis in the foot.

Plantar Fibromatosis

Plantar fibromatosis is a condition in which benign, slow-growing nodules form along the plantar fascia. The nodules often grow slowly and undetected, followed by sudden, rapid growth. As time passes and the nodules grow, walking may become uncomfortable or painful.

Plantar Fasciitis Pain Spots

While many cases of plantar fibromatosis are believed to be triggered by genetics, there is is a correlation between individuals with plantar fasciitis and individuals with plantar fibromatosis. Some researchers believe that plantar fibromatosis can be triggered by a tear in the fascia that is left untreated.

Heel Spurs

Heel spurs are one of the most common consequences of leaving plantar fasciitis untreated. In an attempt to protect the arch of your foot and mitigate damage, your body sends an army of cells to the site of the problem, which begins depositing calcium. Over time, these deposits can build up into sharp protrusions that dig into the fatty pad of the heel and cause a great deal of pain with each step.

Heel Spurs Medical Illustration

Heel spurs can build up over several months’ time without causing pain. In other words, allowing plantar fasciitis to go untreated may mean that a secondary problem brews unnoticed–until the sharp pain reappears.

Complicated Decisions About Surgery and Medical Interventions

Left untreated, plantar fasciitis can become chronic and make surgery more likely. While surgery can be a successful last resort for cases of chronic plantar fasciitis that don’t respond to conservative treatments like orthotics, rest, and icing, it’s important to remember that surgery can often be avoided through prompt and consistent treatment when heel pain arises.

Help avoid complicated (and expensive) decisions about surgery and other medical interventions by taking symptoms of plantar fasciitis seriously!

Hip, Knee, and Back Pain from Plantar Fasciitis

Over time, untreated plantar fasciitis and heel pain can lead to unexpected hip, back, and knee pain. The arches of the feet work in tandem with the tendons, ligaments, and muscles throughout the lower body. When the plantar fascia is compromised, other muscles, ligaments, and tendons must work harder to compensate. This cascade of overuse can eventually lead to pain outside the arch.

Plantar fasciitis can also lead to abnormal gait patterns while walking or standing, leading to repetitive stress injuries as the hips, knees, and backs are repeatedly required to move in abnormal ways.

Listen to the Warning Signs of Plantar Fasciitis

Recognizing the symptoms of plantar fasciitis and treating this condition early is the best way to avoid secondary problems and complications. Think of the pain from developing plantar fasciitis as a warning, encouraging you to address the problem at hand before more damage occurs. Stretching, icing, and using special orthotic inserts are all effective ways to curb the damage from plantar fasciitis and begin healing.

 

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This article was originally published on May 17, 2020, and updated on January 31, 2020.

What is the Fat Pad Squeeze Test?

Fat pad squeeze testThe fat pad squeeze test is a diagnostic tool your doctor may use to rule out stress fractures and bursitis before ordering imaging scans, or making a diagnosis of plantar fasciitis.

Keep reading to learn what you should expect from a calcaneus squeeze test, when your doctor may use this test, and whether you can do this test at home.

What to Expect From a Calcaneus Squeeze Test

A calcaneus squeeze test is a very simple diagnostic tool, that can be performed in just a few seconds in your doctor’s office.

During the fat pad squeeze test, you will lie down on your stomach, with your knees flexed so that the doctor can easily examine your heels.

Your doctor will then squeeze the fat pad of your heel, using three different motions to compress the back, sides, and middle of the heel. Depending on the location and severity of pain during the squeeze test, your doctor can rule out stress fractures and bursitis of the heel, or confirm a diagnosis of plantar fasciitis.

What Your Doctor Can Learn from a Fat Pad Squeeze Test

A fat pad squeeze test can be helpful in two different ways: The test can help confirm your doctor’s diagnosis of plantar fasciitis, bursitis of the heel, or stress fracture in the heel depending on where you feel pain during the test. Or the test can help rule out one or more of these diagnoses. Sometimes initial symptoms of heel pain can present similarly, and the heel squeeze test can hone in on a more precise locus of pain and help your doctor decide whether further imagining is needed.

Plantar Fasciitis or Heel Fracture: Tenderness or discomfort when the doctor presses down on the middle of your heel indicates potential plantar fasciitis. More intense pain indicates a possible heel fracture.

Retrocalcaneal Bursitis: Pain when the doctor presses down on the back of the heel indicates likely inflamed bursa at the back of the heel, or retrocalcaneal bursitis.

Heel Fracture: Sharp pain that results from squeezing the sides of the heel is a warning sign of a heel fracture.

When Your Doctor Might Use the Heel Pain Squeeze Test

Your doctor may decide to perform a heel pain squeeze test any time you are experiencing severe heel pain that makes it difficult to walk or go about your daily activities. Fat pad squeeze tests can be especially helpful in confirming or ruling out stress fractures, in cases where a case of plantar fasciitis does not seem to be improving with conservative care.

If you have any of the following symptoms, that seem to indicate a possible stress fracture or retrocalcaneal bursitis, your doctor may want to do a fat pad squeeze test:

  • Pain that gets worse the longer you are on your feet
  • Pain that is extremely sensitive to the touch, on the back, sides, or middle of the heel
  • Pain that improves somewhat with a long period of rest
  • Pain that gets worse when you stand on tiptoe or flex your feet downward (this can indicate bursitis)

Can You Do the Fat Pad Squeeze Test At Home?

While the fat pad squeeze test might sound simple, you shouldn’t try it yourself at home. For one thing, it will be difficult (without an extensive knowledge of the ligaments, bones, and tendons in the foot) to know precisely where to squeeze during each movement.

And just as importantly, without training to help you know how hard to squeeze, it’s possible that you may inflict further damage or pain on an already tender area! If your heel is extremely tender to the touch, can’t support any weight, and gets worse (instead of improving slightly) with stretching and movement throughout the day, it’s time to schedule a doctor’s appointment. You may have a stress fracture or bursitis, instead of plantar fasciitis.

Do I Need to Get a Heel Pain Test?

If your symptoms are consistent with mild to moderate plantar fasciitis, you likely don’t need a heel pain test. The overwhelming percentage (90%) of plantar fasciitis cases can be resolved simply with conservative care, at home within about 3-6 months. Get plenty of rest, ice your feet to manage pain and inflammation, stretch your feet to help improve mobility and strength in the plantar fascia, and wear orthotic inserts to realign and support the damaged fascia.

If, however, your symptoms are severe or inconsistent with mild to moderate plantar fasciitis (for example, extreme tenderness to the touch), you should make an appointment with your doctor, who may decide to perform a heel pain test.

Are Crocs and Clogs Good or Bad for Plantar Fasciitis?

Crocs for plantar fasciitisThere’s no question that clogs and Crocs are amazing. We love the way they slide right on without laces and straps, softly cradle our tired feet, and take us everywhere from the beach to the grocery store.

But we all know that the things we love aren’t always good for us. And many people have questions about whether Crocs and clogs are actually good for plantar fasciitis.

Don’t worry — we won’t tell you to toss your favorite pair of Crocs or clogs. But there are a few things you should know!

Are Clogs Good for Plantar Fasciitis?

Clogs have been around for a very long time–and with good reason! Wooden clogs were worn by the Dutch while they farmed long hours on their feet, and people around the world have adopted them since–including people who suffer from plantar fasciitis!

It’s important to remember that not all clogs are created equal. Some can be a lifesaver for painful heels, while others can actually make your plantar fasciitis worse.

Benefits of Clogs for Plantar Fasciitis

You can find a staggering array of different clogs — from lightweight trendy slippers to orthopedic clogs made especially for professionals who spend a lot of time on their feet.

The right pair of clogs can offer easy-on, easy-off casual footwear that cradles and cushions sore heels, doesn’t compress your toes while you walk, and supports your damaged arch.

Clogs designed for working professionals or orthopedic support are ideal for individuals with plantar fasciitis. Choose clogs with a thick, cushioned sole, clear arch support, and a comfortable fit that leaves you plenty of room in the toe box but doesn’t slide around while you walk.

Drawbacks of Clogs for Plantar Fasciitis

Most of the drawbacks of wearing clogs for plantar fasciitis come from choosing the wrong type of clog or wearing a shoe that doesn’t fit properly. Ill-fitting or cheaply made shoes can place additional strain on your damaged arch, or cause additional wear to an already damaged heel pad.

Avoid clogs with a hard, thin sole and opt for a cushioned, thick sole with clear arch support. You’ll also want to make sure your clogs fit properly and don’t cause your foot to slide around too much while you walk (another hallmark of cheaper fashion clogs). A comfortably loose fit in the toe box is ideal, but your heel should be cupped securely, resting below the ball of the foot when you stand in the shoe.

Are Crocs Good for Plantar Fasciitis?

Crocs, which were originally made as non-slip, waterproof shoes for boating, have quickly become a popular choice for plantar fasciitis sufferers.

Benefits of Crocs for Plantar Fasciitis

Like clogs, Crocs come in a wide number of colors, styles, and brands! Some crocs are now made especially for individuals with heel pain, while others are meant to be worn as a casual, colorful waterproof shoe.

The right pair of crocs can help protect your feet, cushion your heel, and support your arch in situations that you might otherwise go barefoot (like the beach, pool, in the yard, or on a boat).

Crocs are typically extremely lightweight, breathable, and promote circulation which can be an advantage over clogs, especially in the summertime — or for individuals with diabetes. And like clogs, Crocs have lots of room in the toe box to promote a natural, healthy gait that doesn’t compress the toes.

Potential Drawbacks of Crocs for Plantar Fasciitis

Crocs weren’t meant to be running shoes, or even walking shoes for long distances. Don’t wear them while you walk or stand for long periods of time. Instead, opt for running shoes with orthotic inserts, which will offer better arch support and cushioning.

You’ll also want to be wary of “fashion crocs,” which are typically thinner, less cushioned, don’t have much in the way of arch support, and are less structurally stable while you walk.

Make sure you choose a pair of Crocs that has a supportive heel cup, arch support, and a thick, cushioned sole (instead of thinner plastic that may bend or distort as you walk).

How to Make Your Fashion Crocs or Clogs Better for Plantar Fasciitis

Have a pair of trendy Crocs or clogs you love — that aren’t exactly compatible with your plantar fasciitis because of a hard, thin sole or lack of arch support? There’s no need to toss your favorite pair of shoes.

Just add arch support and heel cushioning with Heel Seat Wraps. These lightweight, comfortable wraps can be worn all by themselves, or with almost any pair of shoes (including open toed sandals!) to help align and support a compromised arch, and soothe a damaged heel pad.

If you have plantar fasciitis, clogs and Crocs can make long hours on your feet more bearable and comfortable–as long as they have the proper arch support, cushioning, and fit! But even if your favorite pair of crocs or clogs lack arch support or cushioning, there’s still hope. Just add a pair of Heel Seat Wraps, so you can continue to wear the shoes you love without worrying about making your heel pain worse!

Pros and Cons of Custom Orthotics for Plantar Fasciitis

Custom Orthotics Whether you’ve been newly diagnosed with plantar fasciitis or have been struggling with heel pain for months, chances are you have wondered whether or not you need custom orthotics.

Let’s take a look at the pros and cons of custom shoe inserts that can help you make your decision!

Will Custom Orthotics Help Plantar Fasciitis?

A quality pair of custom orthotics can make a big difference in improving your plantar fasciitis, by supporting your arch and cushioning a sensitive, deteriorating heel pad. That’s why orthotics are one of the top-recommended conservative treatments for plantar fasciitis!

Unfortunately, just one set of custom orthotics can cost upwards of $200. Is the price worth it? Keep reading to learn more about the benefits, drawbacks, and alternatives to custom orthotics!

Benefits of Custom Orthotics

In the past, custom orthotics had to be created by a podiatrist. However, now it’s quite a bit easier to get a pair of custom orthotics without even leaving your home.

Several companies will send you a footprint imprint kit, along with a short questionnaire online, to determine where you’re feeling pain, the exact width and length of your foot, and any other particular needs you may have (e.g., correcting overpronation).

Within less than a month, you’ll get a pair of custom orthotics.

Drawbacks of Custom Orthotics

While custom orthotics can make a big difference in heel pain, there are a few drawbacks that you should know about before you decide to buy!

High Prices

One of the biggest drawbacks to custom orthotics is the high prices. For just one pair, your starting price is about $230 on the low end. While this isn’t nearly as high as many medical interventions, it is one of the highest priced conservative treatments for plantar fasciitis.

Accessibility

Because of the high prices of custom orthotics, they aren’t exactly accessible for people with a tight budget. And because of the turnaround time needed to ship you a kit, take your foot imprint, send the imprint back, plus time for creating the orthotics themselves, it’ll be about a month before they arrive at your door — which can feel like a long time if you’re suffering.

Minimal Evidence to Justify Custom Inserts

While there’s a good deal of evidence to show that orthotics can improve plantar fasciitis, there’s not much evidence to show that custom orthotic inserts do a superior job. In fact, a recent landmark meta-analysis of 20 studies shows that custom orthotics and prefabricated orthotic inserts perform pretty much identically.

So, Are Custom Orthotics Worth It?

Custom orthotics can be a lifesaver for some people, especially if you have several different foot issues you’re trying to beat. However, for most people, the benefits of high-quality non-custom orthotics, like Heel Seats are identical to custom orthotics (the main difference being that higher price tag!).

Still can’t decide? Test out a pair of 5-star, non-custom orthotics that come with a money-back guarantee (like Heel That Pain!). If you still wonder what you might be missing with a pair of custom orthotics, test drive a brand that offers a money-back guarantee (several do!). That way, you can make sure you love your custom orthotics before you get stuck with the cost. And at the end of the day, you’ll be able to rest assured that you have the best fit for your foot–and your wallet!

Alternatives to Custom Shoe Inserts

If you aren’t ready to drop more than $200 on a pair of custom orthotics, the good news is that you have some fantastic alternatives. Clinically proven orthotic inserts like Heel Seats cost about as much as lunch out on the town, which means that you can afford to outfit every pair of shoes in your closet for less than one pair of custom orthotics.

If you spend most of your summer in sandals, there’s also alternatives that can be worn with bare feet, such as Heel Seat Wraps, which lift and align the arch like an orthotic insert, but can be worn with open-toed shoes and sandals.

Have you tried custom orthotics? Tell us in the comments below — we love hearing from you!

How to Find a Foot Doctor Near Me

How to Find a Foot DoctorIf you’re suffering from chronic or severe symptoms of plantar fasciitis, the question, “How do I find a heel pain doctor near me?” is at the very top of your list.

And while that question might seem easy enough to answer in the information age, it can be surprisingly difficult to know where you should start in your search for an amazing plantar fasciitis doctor near you. Save yourself time and frustration with these helpful tips!

Tips for Finding a Plantar Fasciitis Doctor Near Me

Finding the right plantar fasciitis doctor near you is one of the most important steps you’ll take toward healing, particularly if your symptoms are severe or have not responded to conservative heel pain care.

Use these handy resources to quickly find the right podiatrist near you:

Talk to Your General Practitioner

While your GP might not be the right fit for specialized podiatric care, here or she is very likely to be connected with doctors in many different specialties, and be familiar with the experiences that other patients who have been referred to that doctor have fared!

Search the APMA

The APMA (American Podiatric Medical Association) allows you to search for a podiatrist near you, using either a zip code search or a mile radius search (since the podiatrist closest to you might have a different zip code). Using this tool also allows you to find out whether your potential podiatrist has been board certified in different specialties (like surgery), which may be important to you.

Use the APMA Search Tool to Find a Foot Doctor Near You

Check Out Your Insurance Provider Network Online

If your insurance network is choosy, and you want to make sure that the foot doctor you choose is going to be fully covered, you may want to check your provider’s online network. Most providers offer a searchable database of in-network doctors that can be narrowed by speciality and location.

Use RateMDs.com (and Cross-Reference with Google!)

The right bedside manner, and positive outcomes from other patients are (understandably!) important factors from patients. RateMds.com allows you to read reviews from patients in your area, and can help you find a doctor with high reviews. More than 2 million providers can be found on this site alone. Make sure to cross-reference your findings with Google reviews, especially when there are only a few experiences shared on RateMds.com.

Use Local Social Media

While Facebook and Instagram aren’t much help in finding a plantar fasciitis doctor, local forms of social media, like Nextdoor.com can connect you with people in your neighborhood and district. The site allows you to post questions, asking for recommendations about which podiatrist in the area comes highly recommended, or to search other people’s questions about finding a foot doctor.

What Kind of Foot Doctor Should I Look For?

In general, if you have chronic or severe plantar fasciitis, you’ll want to start by meeting with a podiatrist. He or she can help you explore many different medical treatments for your condition, and in many cases may be certified to perform surgery, should you decide on that option.

If you are pretty sure, based on your medical history and research, that you are headed toward a surgical procedure, you may want to look for an orthopedic surgeon, who will typically have additional surgical expertise — but may be more difficult to make an appointment with. Depending on your condition and the success of more conservative medical interventions, a podiatrist may refer you to an orthopedic surgeon.

Will I Need a Referral for a Plantar Fasciitis Doctor?

It can be confusing to know whether or not you need a referral for a specialist like a plantar fasciitis doctor.

For the most part, you do not need a referral to make an appointment with a podiatrist. However, you should still check with your insurance provider, since some carriers have more complex rules about coverage for specialized medical care.

Getting a referral can also be helpful in other ways. If you have had a good relationship with your family doctor or general practitioner, he or she will often be willing to send an introductory letter to the podiatrist they recommend, along with a patient history (including injuries, treatments you have already tried, and medications you may be taking).

How did you find your foot doctor? Share your experience and tips in the comments below!

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