Active Release Technique, or ART for short, is a treatment that was initially developed to treat soft-tissue injuries in athletes as quickly as possible.
Since then, ART has gained popularity with doctors and patients to treat microtraumas, tears, and painful scar tissue in a wide variety of injuries — including plantar fasciitis.
In this article we’ll cover how ART therapy works, how this therapy differs from other soft-tissue treatment methods, potential risks and benefits, how much Active Release Technique costs, and whether ART is effective for plantar fasciitis.
What Is Active Release Technique (ART)?
Active Release Technique (ART) is a patented treatment method that targets injuries to soft tissues in the body (like tendons, ligaments, and nerves). The soft tissues of the body (including the plantar fascia) are vulnerable to injuries like tears, bruising, or pulls, as well as chronic deterioration and microtraumas (small tears that accumulate over time).
Scar tissue and adhesions can build up as a result of these injuries and traumas, which places extra strain on tendons, limits range of mobility, and entraps nerves at the injury site. This scar tissue can lead to significant pain and become a big roadblock to healing, especially in areas of the body that don’t naturally get a lot of blood flow (like the heel and arch!).
ART is performed by a trained medical provider, who uses unique movements and manipulations to help break up painful scar tissue, facilitate blood flow to the injured area, and promote healing.
How is ART Different from Other Soft-Tissue Treatments?
While ART might sound very similar to Graston or deep tissue massage at first glance, Active Release Technight is unique in a few different ways. It can be helpful to compare and contrast these common soft-tissue treatments:
ART vs. Graston
Both of these therapies work to break up adhesions and scar tissue while improving circulation. In Graston, a therapist uses instruments instead of the hands to manipulate tissues. These two treatment methods are often used hand in hand.
ART vs. Deep Tissue Massage
Both of these therapies combine pressure with a series of movements. However, unlike deep tissue massage, the movements in Active Release Therapy do a better job of lengthening and applying tension to scar tissue, which helps break that scar tissue up more effectively. ART and deep tissue massage are sometimes used together in therapy sessions.
How Effective Is Active Release Therapy for Plantar Fasciitis?
As of now, there aren’t peer-reviewed studies that can offer conclusive evidence about the effectiveness of Active Release Technique. However, the feedback from patients and providers is encouraging, and the principles of ART are aligned with tried-and-true treatment methods.
The arch of your foot and heel are avascular. That means these areas get very little blood circulation naturally. When the arch is injured, strained, or overused the body has a more difficult time sending blood cells to the injury, which are crucial for delivering oxygen, nutrients, and collagen to rebuild the damage. That’s one of the biggest reasons why injuries like plantar fasciitis are slower to heal than say, a cut on your arm.
It’s also the reason why ART’s specialized movements to improve circulation and deliver needed blood supply to the plantar fascia and heel are effective. Each of the movements targets a specific muscle, ligament, or tendon in the foot (there’s more than 100, including the flexor digitorum brevis, abductor hallucis, and the flexor digiti minimi brevis!) and deeply works the tissue using principles of friction, lengthening, and pressure to increase circulation and break up stubborn scar tissue.
Potential Risks and Benefits of Active Release Technique
As with any treatment, ART has unique benefits to offer, along with a few risks that can be summed up as follows:
Potential Benefits of ART
- Helps improve circulation and blood flow to the avascular plantar fascia
- Targeted movements break up scar tissue and adhesions
- Improved blood flow delivers oxygen and nutrients that may speed up healing time
- Improves the flexibility of the foot and range of motion
- Relatively inexpensive compared to many medical interventions
Potential Risks of ART
- The procedure can be moderately painful because of the targeted, intense pressure of the movements that aim to break up scar tissue and adhesions
- Outcomes haven’t been well documented in studies — but that’s because the studies haven’t been done. (There is promising anecdotal evidence from providers and patients).
- While ART can be very successful in reducing pain and improving mobility, it isn’t a cure. ART should be done in tandem with lifestyle changes that address why heel pain and plantar fasciitis formed in the first place (like overuse, repetitive stress, or gait imbalance).
What to Expect During an ART Session
Expect your ART session to be part evaluation, part treatment. Your provider will first determine the health, strength, and flexibility of your fascia, ankle, toes, and surrounding muscles and ligaments.
After this evaluation, your provider will use his or her hands to apply pressure, friction, and lengthening techniques to the fascia and surrounding tissues. You will likely be an active participant in your treatment session, moving and standing in different ways to maximally lengthen muscles and ligaments. Keep in mind that these movements can be painful, particularly for individuals who have low pain tolerance; however, most people find that they can tolerate the procedure, and that relief from symptoms occurs within just one to four sessions.
Can I Do ART for Heel Pain at Home?
The movements in ART are extremely specific and deeply work the muscles, tendons, and ligaments in the foot. Without specialized training, trying to apply the necessary pressure and friction to the foot could result in injury.
While there are many easy massage techniques that you can do at home to help improve blood flow, circulation, and break up scar tissue, it’s best to leave Active Release Technique to trained physicians.
Finding an Active Release Technique Provider
If you’re interested in trying ART, there are several different types of providers that offer this therapy. Physical therapists, massage therapists, chiropractors, and doctors are often trained in Active Release Technique.
You can find a certified ART provider in your area by using the directory on the ART website. More than 10,000 providers have been trained worldwide, so chances are high that you have one or several providers nearby!
Cost of Active Release Technique
The cost of ART will depend on your provider, and your insurance coverage. If the therapy is covered by your insurance (and many insurance providers do cover ART if they cover physical therapy), you may only be responsible for a co-pay.
However, even if you are uninsured or your insurance does not cover physical therapy, Active Release Technique is still generally more affordable than many other treatments. Expect to pay similar rates as a chiropractic session or massage visit. You may be able to get a discount for booking several ART sessions upfront (most people need between one and four sessions).
Supplementing Active Release Therapy
While ART is a promising treatment for cases of stubborn or chronic plantar fasciitis, it’s not a miracle cure or a stand-alone treatment. By taking steps to treat the underlying cause of your plantar fasciitis (the reason the condition developed), you can help make sure your arch and heel stay healthy!
Make sure to maintain tried and true conservative treatments that address common causes of plantar fasciitis (like inflexibility and muscle weakness, overuse, and strain to the arch) by regularly stretching and strengthening your arch and surrounding tissues, resting and icing your feet often, and supporting and realigning your arch to a proper height with quality orthotic inserts.
As it turns out, turmeric (more specifically its active compound, curcumin) is more than just a delicious seasoning for your favorite Indian takeout dish.
This fragrant yellow spice, a close relative of ginger, is also renowned for its anti-inflammatory properties, antioxidant effect, weight management support, and pain relief.
Wondering if supplementing with turmeric can help improve your heel pain or plantar fasciitis in a natural way? We have your answers!
Is Turmeric (Curcumin) Good for Plantar Fasciitis?
Turmeric (curcumin) shows a surprising number of health benefits that may improve heel pain from plantar fasciitis:
One of the most compelling benefits of using turmeric for plantar fasciitis is its pain relief properties. One study conducted by the Cytokine Research Laboratory found that the curcumin in turmeric was a more effective anti-inflammatory than aspirin and ibuprofen, and has pain-relief properties on par with phenylbutazone and hydrocortisone.
This is fantastic news for people with chronic plantar fasciitis who are concerned about the negative side effects (like liver damage and ulcers) that can arise with long-term or heavy use of NSAIDs.
Curcumin is also renowned for its antioxidant properties — which can make a big difference in how quickly your body heals from damage to the plantar fascia!
The cells in your body create “free radicals” as part of their normal metabolic cycle. And when inflammation is present in the body, free radical production goes up. Without antioxidants (which neutralize free radicals), these harmful free radicals have the potential to further damage the cells and organs in the body. Adding antioxidants like curcumin to your diet while you recover from an injury can help your body heal.
When the plantar fascia becomes damaged through overuse or injury, the body sends a flood of proteins and cells to the injured area to do damage control. This immune response shows up as inflammation, swelling, and redness in the heels and arch of the foot.
A review of clinical research by Thorne Research showed that curcumin has significant anti-inflammatory properties that can improve injuries like muscle strain, sprains, and plantar fasciitis. One study conducted by the Universiti Kebangsaan Malaysia Medical Centre found that when mice were given curcumin for one month, several markers of inflammation (like paw thickness) decreased significantly.
Weight gain can put extra strain on the arch of the foot, increasing your risk of developing plantar fasciitis. Turmeric has been shown to help individuals maintain a healthy body weight by slowing the growth of fat cells, helping the body metabolize fat more easily, and preventing the formation of adipose tissue.
One study conducted by Velleja Research showed that after supplementing with curcumin, participants lowered their BMI by 2%-6%.
Using Turmeric for Inflammation
While there isn’t a standardized dose of turmeric to help improve your plantar fasciitis, many studies have concluded that, even at high doses, turmeric is safe for consumption. The most common mild side effect that you may notice is gastrointestinal discomfort, which can be avoided if you add turmeric to your diet slowly (instead of a high dose all at once!)
In general, it’s a good idea to take the most natural (organic and minimally processed) form of turmeric/curcumin that you can find, to help your body most easily absorb it.
The most common ways to use turmeric/curcumin include the following:
You can make turmeric paste by mixing ¼ cup turmeric powder with ½ cup water, then heating on low until a thick paste is formed. This mixture can be kept in your fridge for several weeks. This paste can be eaten in turmeric milk (recipe below) or applied topically by mixing with coconut oil or olive oil spreading across the heel and arch of the foot. Massage this paste into the skin, wrap with plastic wrap, and leave on for an hour.
Turmeric Milk or Turmeric Tea
Add a piece of raw turmeric root (½ inch to 1 inch) or a teaspoon of turmeric paste to a cup of milk in a saucepan. Heat slowly to simmer, but do not boil. Any kind of milk (almond milk, coconut milk, cow’s milk) will work! For turmeric tea, repeat this same process with water. If you like, add a little bit of butter and maple syrup!
Curcumin can also be taken in concentrated form through capsules. Make sure you consult with a doctor on the right dosage for you before you begin taking curcumin capsules, since this method of taking turmeric is the most potent, and your doctor will have helpful insight into your unique health history.
Curcumin can also be taken as a food-grade essential oil, either topically or by mouth. If you don’t like the taste of turmeric milk, this can be a good way to take turmeric in a concentrated form!
Keep in mind that, like other anti-inflammatories, turmeric is a blood thinner and should not be taken during pregnancy or before surgeries and medical procedures. Turmeric can also change how some medications interact with your body (like anti-depressants). When in doubt, talk to your doctor!
Treatments to Try in Addition to Turmeric
Keep in mind that while turmeric shows a lot of potential for lowering the inflammation and pain in your heels or feet, it won’t treat the underlying cause of your heel pain.
If you do decide to supplement with turmeric, make sure you use it alongside these proven remedies to banish your heel pain for good!
While inflammation certainly does play a role in plantar fasciitis and heel pain, most podiatrists believe that deterioration of the arch (including flattening, small tears, and micro-injuries) is the most common underlying cause of plantar fasciitis. By lifting, cushioning, and re-aligning the arch of your foot with high-quality orthotic inserts, you can help your damaged arch heal.
For fast pain relief that calms redness and swelling, ice your feet regularly. The cold from icing numbs pain receptors, and is just the ticket after a long day on your feet.
Rest is absolutely vital to addressing the cause of plantar fasciitis, since this condition is often a result of overuse. Take a break from high impact sports (like soccer or jogging), give your feet plenty of breaks from long periods of standing at work, and allow your arch time to recuperate and repair itself.
Tight, inflexible muscles and tendons in the feet and legs can put you on a fast track to plantar fasciitis. Stretching the feet, heels, ankles, and calves can improve your strength and flexibility, as well as breaking up adhesions and improving circulation in the feet. While it might sound simple, stretching for a few minutes every day can make a significant difference in your pain!
Have you tried supplementing with turmeric? We’d love to hear about your experience in the comments below!
Knowing the difference between the two, and also how they’re related to one another, can help you determine which one you’re suffering from, set a course for treatment, and reduce symptoms of pain and discomfort.
Knowledge is power when it comes to managing, treating and beating your heel and foot pain.
Keep reading below to arm yourself with knowledge and get back on your feet–comfortably!
What’s the Difference Between Heel Spurs and Plantar Fasciitis?
The main difference between plantar fasciitis and heel spurs lies in the source of the pain. Pain from plantar fasciitis is typically felt in the arch of the foot and the heel due to damage or overuse of the plantar fascia. Heel spurs, or tiny jagged calcium deposits on the heel bone, develop in response to the trauma to the plantar fascia and are localized to the heel.
Causes of Heel Spurs vs. Plantar Fasciitis
Think of heel spurs and plantar fasciitis as a one-two punch. Plantar fasciitis is caused by stress and damage to the plantar fascia ligament, the area between the ball of your foot and the heel on the underside of your foot. This stress can be caused by carrying extra weight, wearing worn or unsupportive footwear, trauma to the foot, or spending an excessive amount of time on your feet.
Heel spurs develop as a secondary result of plantar fasciitis. When the plantar fascia ligament is damaged, the body creates what’s known as heel spurs–small, sharp calcium deposits on the heel bone–in an attempt to support the damaged fascia. Unfortunately, if left untreated, heel spurs can further damage and erode the fatty pad that supports your heel and do permanent damage to your foot.
Symptoms of Heel Spurs vs. Plantar Fasciitis
The simplest way to describe heel spurs is a stabbing sensation in your heel(s)–which makes sense, because that’s exactly what happens. The sharp calcium deposits building up on your heel bone are literally stabbing into the fatty pad of your heel. You’ll likely notice that the pain is worst first thing in the morning, and can come and go throughout the day.
Plantar fasciitis on the other hand encompasses a broader range of symptoms localized in the foot and heel area. Symptoms of plantar fasciitis may be present for some time before you feel the stabbing sensation of heel spurs, since untreated plantar fasciitis and a strained or damaged fascia are the primary causes of heel spurs.
Symptoms of plantar fasciitis include redness, swelling and inflammation in the heel and fascia (the area between the ball of your foot and your heel). You’ll likely experience sharp pain that’s worse in the morning and may get better as the fascia are stretched throughout the day. An aching, burning pain in the heel is the hallmark of plantar fasciitis.
Treatments for Heel Spurs vs. Plantar Fasciitis
Treating plantar fasciitis (which can lead to heel spurs if left untreated) quickly is key to avoiding additional damage. Give your feet rest breaks during the day if you’re spending a lot of time on your feet, and dial down the exercise routine if necessary. It’s also important to ice your feet to reduce inflammation (these Ice Pack Therapy Slippers strap onto the foot and stay in place with velcro, giving you targeted relief for inflammation).
For both plantar fasciitis and heel spurs, it’s critical to wear shoes that have a thick cushioned sole and aren’t worn out at the heel. It’s also important to maintain a healthy weight to avoid adding additional strain to the plantar fascia and heel. One of the best ways you can treat both plantar fasciitis and heel spurs is to use affordable orthotic inserts. They’re effective in greatly reducing or eliminating pain for 90 percent of customers, they only cost about the same amount as a lunch out on the town, and are a great alternative to costly, heavy orthotic shoes or more drastic (and typically unnecessary) surgery. Heel spurs and plantar fasciitis can sound intimidating–and feel even worse. But with a few ounces of prevention and consistent, proven remedies, you’ll be feeling better in no time.
It’s a jungle out there when it comes to shoes and plantar fasciitis. Lurking in your favorite pair of shoes could be an arch-killer.
Is your closet safe? Which shoes do the most harm to your feet when it comes to plantar fasciitis?
We’re looking at you first, cheetah-print stilettos!
1. Stiletto Heels or Ultra-High Heels
Hillary Brenner, a spokesperson for the American Podiatric Medical Association, says, “Heels are getting higher and higher. We podiatrists like to call it shoe-icide.” And shoe-icide is right! Stiletto heels and other ultra-high heels are one of the worst types of shoe you can wear if you have plantar fasciitis (and put you at risk for developing the condition if you don’t have it yet!).
Ultra high heels raise the arch of your foot to an unnatural angle, destabilizing it and putting an intense amount of strain your plantar fascia, making them some of the worst shoes for your feet. Not to mention, you’re always one short step away from an ankle sprain or break!
Hold the front door: If stiletto heels are enemy #1, then shouldn’t flats be one of the best shoes you can wear for plantar fasciitis? Not so fast. Flats create the opposite problem for your feet, offering little to no support for the arches of your feet, meaning that your plantar fascia isn’t able to distribute your weight and the impact of movement nearly as well. Without proper support, your arch can be further strained and flattened because of flats. Bad news for plantar fasciitis!
3. Flip Flops
Flip flops are another top culprit for bad shoes for plantar fasciitis. Flip flops typically have flat, skinny soles that absorb very little impact–leaving your arch to stand alone in supporting your weight and the strain of physical activity. Flip flops also have zero support for your heel, meaning it’s possible for your foot to suddenly shift if you encounter an unexpected obstacle, straining your plantar fascia or other muscles and ligaments in your foot.
4. Bare Feet
While initially it might seem that au-naturale is best, walking in bare feet can take a serious toll on your arch and is terrible for plantar fasciitis. Why? Because without proper support, your feet are left alone to absorb the full impact of physical activity. And when the plantar fascia is already strained because of plantar fasciitis, going barefoot can be one of the fastest ways to exacerbate the condition.
5. Old Shoes
Have a favorite pair of shoes that you’ve owned forever? Take heed! Old, worn down shoes can make plantar fasciitis worse, since the sole is often very worn down through use. Thick, cushioned shoes are one of the most important qualities in a pair of shoes that improves plantar fasciitis. Worn, old soles don’t provide much support and can lead to irregularities in gait, strain to the arch, and an uneven distribution of impact from physical activity–all of which make plantar fasciitis worse!
6. Brand New Shoes
New shoes can be just as hard on plantar fasciitis as old shoes, particularly leather shoes that may have a very stiff or tight heel, since this can cause your heel bone to rub against the heel of the shoe, causing additional pain and discomfort and impacting your gait as well. Instead of subjecting your feet to the obligatory “breaking in process” with new shoes, fill two sturdy zip bags with water, place them inside your shoes, and then put them in the freezer overnight. The water will expand when it freezes, stretching out tight shoes without hurting your feet in the process.
What Shoes CAN I Wear?
Are heavy, expensive orthotics your only option when it comes to wearing shoes that will help–not hurt–your plantar fasciitis? Thankfully, the answer is no. While you should still avoid high heels when possible (or wear them for a very short time), a pair of flats or other unsupportive footwear can be turned into a plantar-fasciitis-busting machine with a pair of slip-in orthotics made especially for plantar fasciitis.
Love going barefoot? There’s hope there too. Wear heel wraps, so your feet have the support they need while your toes get the freedom they need!
Most people who take part in strength training programs like Crossfit or BodyPump are typically very dedicated to health and fitness.
And while high-impact strength training can have incredible cardiovascular and muscle-building benefits, they can be extremely hard on the joints, fascia, and ligaments in the hands, arms, legs, and feet.
If you love staying fit with strength training — but wonder if you should worry about heel or arch pain, keep reading!
Plantar Fasciitis and Strength Training
While it’s true that strength training can put a lot of strain and impact on different muscle groups, ligaments and fascia (including the plantar fascia in the foot!) a lot of the outcome depends on your unique body, the exercises you participate in, and how well you care for your body when you’re not strength training (e.g., through proper warmup and cool down, good nutrition, and adequate rest between workouts).
While there are plenty of athletes who do suffer from plantar fasciitis as a result of strength training, there’s also some evidence that strength training programs can actually help improve plantar fasciitis, like this report from the Scandinavian Journal of Medicine and Science in Sports. The study followed participants who wore orthotic inserts and performed mild stretching daily, versus participants who wore orthotic inserts and engaged in high-load strength training daily. At the end of the study, the participants who engaged in strength training reported better function and pain levels.
Can Programs Like Crossfit Cause Plantar Fasciitis?
There’s no straightforward answer here: Many individuals who regularly enjoy Crossfit or BodyPump will maintain healthy arches and pain-free heels. Depending on the type of program and the types of exercises, some people may even enjoy protection from and improvement of heel pain or arch pain!
However, most types of strength training can still pose some risk of plantar fasciitis and heel pain. Specific high-impact exercises or routines that place a lot of strain and force on the arch of the foot through running, jumping, and lifting weights, strength training can be risk factors for heel pain.
Remember: Any high-impact activity, including jogging, basketball, or even standing in place for long periods of time can increase your risk for plantar fasciitis. The important thing is to take heel pain seriously, treat it quickly with effective remedies, and approach strength training in such a way that your heels and arches stay healthy!
Strength Training Safely for Plantar Fasciitis
If you love strength training, there are plenty of ways you can enjoy your passion safely–even if you have plantar fasciitis! This strength training protocol, originally developed by Dr. Rathleff, can be incorporated into your routine to help protect against plantar fasciitis or improve existing heel pain.
If you do notice heel pain while strength training, listen to your body. Take a break from the specific exercises or activities that aggravate the pain, and use the simple, inexpensive treatments below to give your arches extra support and cushioning.
If you’re taking a group fitness class like Crossfit, let your instructor know what’s going on. He or she can help you make modifications for very high-impact exercises that do not include a lot of jumping or strain on the heels, arches, or feet.
Are There Any Exercises I Should Avoid?
Again, the answer to this question depends a great deal on the health and strength of your feet and heels. If you’re new to strength training, acclimate to working out slowly, and allow yourself a couple days of rest between workouts to avoid degeneration and micro-injuries that may cause pain and lead to plantar fasciitis.
If you are experiencing heel pain while you strength train, you may want to avoid plyometric exercises (where both of your feet leave the ground) until you’re fully recovered. These exercises can include full-jacks and hal- jacks, long jumps, squat jumps, froggy jumps, jumping side lunges, jogging in place or running sprints across the room, and jumping rope.
In general, if your symptoms are mild, it’s okay to continue lifting weights, participating in low-impact exercises, and continuing exercises that strengthen the legs, feet, and ankles. Make sure you support your plantar fascia with orthotic inserts and use the treatments below to manage and treat your heel pain. When in doubt, see a doctor, especially if your pain is severe and you suspect you may have sustained a fracture or tear.
Treating Heel Pain from Strength Training
For most people, rest is a good first-line defense against heel pain from strength training. If particular activities seem to make your heel pain worse, avoid them until you feel better, then continue paying attention to how your body feels as you run, jump, or lift weights.
Icing, NSAIDs like Ibuprofen, and Tylenol can help bring down inflammation and manage pain flare-ups while taping and compression socks can help reduce swelling and improve blood flow while you exercise. Remember to warm up and cool down properly with stretches that strengthen and improve flexibility in your arch, calves, toes, and ankles.
To help your arch absorb extra impact and weight while you strength train, slip Heel Seats (an orthotic insert proven twice as effective as Dr. Scholls) into your favorite pair of supportive athletic shoes.
As you listen to your body, respond to heel pain quickly, and approach strength training safely, you can enjoy all the health benefits you set out for–including healthy feet, heels, and arches!