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Plantar Fasciitis vs. Heel Spurs

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

Plantar Fasciitis vs. Heel SpursPlantar fasciitis and heel spurs are two different but closely connected conditions that lead to chronic or intermittent pain in your feet and heels.

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.

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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.

Plantar fasciitis and heel spurs

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.

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The Worst Shoes for Plantar Fasciitis

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

IWorst Shoes for Plantar Fasciitist’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!).

Orthotic heel pain discount kits

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!

2. Flats

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 for plantar fasciitis

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.

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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 for plantar fasciitis

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!

Plantar Fasciitis Ebook

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Does Strength Training Help or Hurt Plantar Fasciitis?

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

Strength Training Plantar fasciitisMost 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?

Crossfit with 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?

High Impact Exercise & Heel Pain

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!

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Is Plantar Fasciitis a Disability?

The answer to this question depends a lot on context. A disability can be medical–an injury or a limitation that affects how you live your life. Or a disability can be a legal classification that determines whether or not you’re able to receive different benefits (like Social Security disability benefits, or Veterans Administration benefits).

Plantar fasciitis can be both a medical disability and a legally-protected disability that may qualify you for medical treatment, insurance coverage, or disability benefits, depending on a few different factors. In this post, we’ll explore what qualifies plantar fasciitis as a legal disability, how plantar fasciitis disabilities are classified, and whether plantar fasciitis qualifies for VA disability.

What Qualifies Plantar Fasciitis as a Disability?

In the United States, the Americans with Disabilities Act (or ADA) defines the word “disability” in a legal sense, as a mental or physical condition that “Substantially limits one or more major life activity. This includes people who have a record of such an impairment, even if they do not currently have a disability. It also includes individuals who do not have a disability but are regarded as having a disability.”

Whether or not your plantar fasciitis qualifies as a disability in the legal sense or not, your pain and suffering are real. Heel pain and plantar fasciitis can be extremely debilitating, making it difficult to walk, or participate in daily activities. Talk to your doctor about whether you may be eligible to get a Handicapped Parking Permit

Plantar Fasciitis can be considered a legal disability that qualifies you for Social Security disability benefits in the US under these conditions:

  • You have severe plantar fasciitis that makes it difficult or impossible for you to work — and you can show that your particular job is difficult or impossible to perform with plantar fasciitis
  • You can document that your plantar fasciitis has significantly interfered with or prevented you from working your work for at least a year–or would prevent you from working for at least a year.
  • Your plantar fasciitis has been officially diagnosed and documented by a licensed doctor
  • If you’re over age 50, your claim for benefits may be approved more quickly

If you believe that your plantar fasciitis may be considered a legal disability, you should talk to your doctor, then apply for disability benefits with the Social Security disability office. It’s important for you to keep records of all your doctor’s visits, work you’ve had to miss, or any other records that show how much plantar fasciitis has impacted your life. It’s also important to understand that the process of obtaining benefits can take some time, and some paperwork!

In countries outside of the US that use socialized medicine, obtaining disability may be less difficult, and you may qualify for benefits whether or not you are working. In the UK, the disability must be present (or seem likely to continue) for 9 months instead of one year. To find out whether or not you qualify for disability benefits outside of the United States, start by contacting your local branch of government to get the ball rolling.

How Is Plantar Fasciitis Classified as a Disability?

Disability Heel Pain

There isn’t a straightforward path for classifying plantar fasciitis as a disability in the Social Security’s Blue book, which is a list of conditions and impairments that might qualify you for benefits.

Depending on your unique situation and the location of any heel spurs, you may be able to get SSA benefits under Section 1.02, Dysfunction of a Joint.

However, most people with plantar fasciitis end up qualifying for benefits under Social Security’s “RFC” (residual functional capacity) clause, an assessment that determines how severe your pain is, and how much it interferes with your ability to work.

In an RFC assessment, disability claims employees will perform an assessment to look at your limitations, your doctor’s documentation of which treatments you have tried, how long you’ve been suffering from plantar fasciitis, how the pain affects your daily life, and any medications you’re using. Keep in mind that, in general, the claims assessment is mostly a process of reading through documents. Some claims fail because a doctor didn’t fully and completely describe pain levels and intensity, or document just how much the condition impacts your life on a daily basis. Make sure you communicate with your doctor about this process, and how important thorough documentation is for your case.

Does Plantar Fasciitis Qualify for VA Disability?

VA disability assistance helps veterans who have served the United States recoup medical expenses for injuries they’ve sustained during military service or because of military service.

Many vets suffer from painful heels and feet from plantar fasciitis, which can make walking, moving, or living life difficult. The VA may also approve claims for depression caused by the pain from chronic plantar fasciitis, foot deformities that lead to collapse of the arch, sciatica, or back and knee problems that are related to plantar fasciitis.

Depending on how severe your pain and disability from plantar fasciitis is, the VA benefit will rank your condition on a scale from 10-100 (with 100 being the most severe and eligible for the most benefits).

Similar to the SSA, a VA disability claim for plantar fasciitis will need to be submitted to the VA and evaluated, so the more you and your doctor can document your condition, treatments, and your pain level the better your chances of receiving appropriate benefits.

The pain from plantar fasciitis can be truly debilitating–and disabling–especially when the condition is chronic. Whether or not your unique situation qualifies for disability benefits with the SSA or VA, you deserve support and relief from family, friends, and other plantar fasciitis sufferers. And if you do decide to pursue disability benefits for your condition, remember to document your pain and your treatment process as thoroughly as possible, work together with your health provider to help him or her understand the types of details you need to documented, and follow the claims submission and review steps outlined by the SSA or the VA to get the financial help you need.

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Osteopathic Manipulative Treatment (OMT) for Plantar Fasciitis

Osteopathic manipulative treatmentOsteopathic Manipulative Treatment (OMT for short) is a treatment for Plantar Fasciitis that involves manipulating the bones and connective tissues in the foot to help them align properly, bear weight more effectively, and work correctly in tandem with the arch of your foot.

This noninvasive treatment is usually performed by an osteopath, a doctor who specializes in holistic (whole-body) medicine and musculoskeletal problems. Osteopathic doctors typically emphasize noninvasive treatment options and proper alignment as the basis for healing.

What is OMT, what are the pros and cons of this type of treatment, how much does it cost, and where can you find a provider for this treatment?

What is OMT?

OMT, or Osteopathic Manipulative Treatment is a type of physical therapy for Plantar Fasciitis that helps realign the bones and soft tissues in the foot.

Unlike some treatments, OMT takes a whole-body, holistic approach to healing. In other words, while your osteopath will gently manipulate your foot bones and tissues, he or she will also look at the alignment of your ankles, legs, and hips.

Robert Truax, DO, says. “For [pain from plantar fasciitis] the evaluation and treatment both begin with the hips. I evaluate the lower back and pelvic areas because the foot lands where the hips tell it to. If there is tightness or restriction in the hips, the foot lands incorrectly, setting up abnormal stress loads that can result in pain.”

During each treatment session, your doctor will apply gentle pressure, targeted stretches, some elements of massage, and other exercises to encourage the bones, muscles, and ligaments to align properly. You can also expect to be given “homework” in the form of additional exercises and stretches, rest and icing, taping, and wearing orthotic insoles to help stabilize gait, support the arch, and align the posture properly.

Pros and Cons of Osteopathic Manipulative Treatment

While OMT isn’t backed by a lot of evidence, the pros outweigh the cons for many people with plantar fasciitis:

Pros of Osteopathic Manipulative Treatment

Osteopathic Manipulative Treatment

In general, OMT has very few risks, and uses many different techniques that are supported by solid evidence (like stretching and orthotics!)

Noninvasive and Painless

OMT doesn’t involve incisions, surgical instruments, or expensive equipment. The experience is painless and totally noninvasive.

Relatively Inexpensive

While costs of OMT can vary depending on your provider and whether the treatment is covered by insurance, most people end up paying somewhere in the neighborhood of $100 per session, a small cost in comparison with many treatments. Some osteopathic doctors offer discounts for booking several sessions at once.

Significant Anecdotal Evidence, and Proven Techniques

While OMT doesn’t have the distinction of many scientific studies or clinical trials, it does incorporate a lot of proven conservative treatments for plantar fasciitis, including stretching, icing, massage, and the use of orthotics.

OMT also has plenty of anecdotal evidence to back it up, from people who have had success with an osteopathic doctor. If you’re considering OMT, it can be helpful to talk to real people who have had this type of treatment.

Whole-Body Focus

Plantar fasciitis usually develops as a result of multiple factors and multiple body systems (like excess body weight combined with improper gait, combined with overuse in exercise). It only makes sense that a whole-body approach to plantar fasciitis that takes into account gait, alignment, posture, and musculoskeletal health along with biomechanics in the foot, ankle, hips, and legs would be very helpful in healing.

Cons of Osteopathic Manipulative Treatment

Osteopathic Manipulative Treatment (OMT) for plantar fasciitis

OMT doesn’t have a lot of evidence to back it up, which is the primary con. You should also take care that your provider uses non-thrusting techniques, which have the potential to damage bones and tissues.

Minimal Clinical Evidence

A review of OMT-related studies conducted by Warwick Medical School showed that more evidence, and higher-quality studies are needed to make any definite conclusions about osteopathic manipulative treatment.

However, this doesn’t mean this treatment is ineffective–it just means OMT hasn’t been proven effective. It just means that you should proceed with caution before investing a lot of money or time into this procedure. Given the minimal risks and side effects from OMT, many people feel that this treatment is worth a try–and many have had significant success!

Caution with Thrusting Techniques

Thrust techniques aren’t usually part of plantar fasciitis treatments; however, these more abrupt, forceful movements can carry a higher risk of trauma or complications, so talk to your osteopath before your treatment to ask about what techniques will be used, and whether your OMT will be low or high velocity, and thrusting or non-thrusting.

Where Can I Get OMT?

You’ll need to find a DO, or doctor of osteopathy to get OMT treatment. You can find a DO in your area on osteopathic.org. Make sure to ask the osteopath you choose whether or not they offer this treatment, since some practitioners may not offer certain treatments.

In case you’re wondering, an osteopath has completed four years of medical school, and many have additional medical training. Your osteopath will be able to help you with OMT, and is also fully authorized to prescribe and perform other medical interventions and prescribe medications.

Is OMT right for you? For many people with heel pain from plantar fasciitis, the answer is a resounding yes. And while this modality doesn’t have a lot of high quality studies or evidence backing it up, that just makes it extra important to do your research, know what to expect, and proceed with caution while continuing proven conservative treatments for plantar fasciitis like orthotics, stretching, icing, and rest.

Plantar Fasciitis Ebook

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