Barefoot Treatment for Plantar Fasciitis

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Over and over again we hear about the importance of arch support for alleviating plantar fasciitis symptoms. So why do we continue to hear these success stories about going barefoot? Is there any truth to the numerous posts that say being barefoot can cure this otherwise incurable ailment?

Well, we dug through the scientific evidence and found that there may be some truth behind the claims. But how can this be true?

What is Plantar Fasciitis?

plantar fasciitis anatomy
Before we can delve into the potential benefits of going barefoot, it’s important to understand plantar fasciitis. Your plantar fascia is a band of tissue that stretches from your heel to your toes, giving your foot its arched appearance. This tissue is responsible for distributing the pressure your body puts on your feet every time you stand or take a step.

Plantar fasciitis occurs when this tissue becomes inflamed from overuse. This is why many doctors recommend arch supports for people who suffer with plantar fasciitis. The arch support replaces the plantar fasciitis so it doesn’t have to work as hard, thus eliminating its overuse and the symptoms that come with it. So why does going barefoot, the 180 degree opposite of wearing arch supports, work?

Get To Walkin’

Before we talk about going barefoot versus having shoe arch support, let’s review some facts about gait (the way you walk). When you are walking on a normal day, you will first plant your heel, then transfer on to the arch of your foot and ultimately onto your toes. This typical pattern of walking stretches your plantar fasciitis each time you step.

Now imagine how that stretching force on your plantar fasciitis increases when you’re running. It’s easy then to understand why many long-distance runners end up developing plantar fasciitis. Surprisingly, these are the people who benefit most from going barefoot.

What you may not know is that it wasn’t always this way- long-distance runners have historically been barefoot[6]. In fact, the modern running shoe wasn’t popular until the 70s[6]. You may be surprised to learn that humans are the best distance runners in the animal kingdom[7]. Some tribes to this day continue to endurance hunt (also called persistence hunt). We can literally chase an animal long enough to where it physically stops moving.

So how did our ancestors manage this everyday long-distance running without developing plantar fasciitis yet we are constantly plagued with this disease in our modern-day society?

Going Barefoot

The answer is: our ancestors had a different gait. When they ran, they would either land and propel off of their toes (also known as a fore-foot-strike) or they would opt for landing on the middle portion of their foot (also called a mid-foot-strike)[4]. They didn’t land on their heels like almost all runners are taught to do today.

So why can’t you just focus on changing your foot strike pattern and keep your favorite running shoes? Well, running shoes have been designed to promote the heel strike (or rear-foot-strike) gait. You’ll notice that the heel of your shoes is elevated and cushioned, almost making any other gait pattern impossible to maintain. This is why going barefoot is the best option out there.
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Now it is important to realize that not all scientist agree that barefoot running is a cure for plantar fasciitis. There is still research against barefoot running; however, this research is still looking at a heel strike gait, so it doesn’t really apply to your new and improved gait[2]. Also more conservative researchers suggest that barefoot running should be prescribed on an individual basis[5].

For instance, if you have other foot issues, barefoot running may not be for you. A classic example is if you over pronate or supinate your foot- going barefoot could cause you twist your ankle. Also, running with a fore-foot or mid-foot-strike gait can cause shortening of your gastrocnemius, eventually leading to an exacerbation of plantar fasciitis.

To avoid this, you will need to be diligent about stretching after each run. For instance, you can stand facing a wall and place the ball of your foot on the wall allowing your heel to stretch towards the floor. You’ll want to hold a stretch like this for about 10 seconds for every mile you ran. If you are someone who cannot commit to this type of routine, you may want to consider other options.

So how do you go barefoot without subjecting your feet to the rocks, dust, and other non-ideal objects? Luckily, there are now shoes that offer you the option of being barefoot without actually being barefoot. It will take you a while to adjust to the feel of these unusual shoes, but it will happen with time.

When you’re shopping for a new barefoot running shoe, there are a few things that you’ll want to look for. First, make sure that the sole material is thin and flexible. You should be able to bend and twist the entire shoe with minimal effort. Also, there should be no additional padding in the heel. Depending on the terrain you run on, you may want to look for grippers or a waterproof sole. If you will be running on trails or in a wet climate, look for a thin rubber sole on the bottom of your shoe. Make sure any grippers aren’t too thick. You can determine this by putting on the shoe and walking. Can you feel where the grippers are located? If you can, look for another pair.

Next, you’ll need to decide whether you want rounded toes like traditional shoes or whether you want to opt for shoes with a toe separator. There are pros and cons to each, but the easiest way to decide what is best for you is to try them on. Some people want the toe separators but quickly learn that their toes are too short or too long to fit into them optimally. So this rules them out for these users. Personally, if you can wear them comfortably, I recommend the toe separators.

Your plantar fascia acts as a shock absorber. When you’re running on your forefoot, your toes take over this responsibility. Separators allow your toes to stretch and extend the way they need to in order to carry out shock absorption. Again, if the shoes don’t fit you well don’t push it. But if you’re one of the lucky ones that can wear them, don’t be afraid to go for it. Your feet will thank you.

Stopping the Shoes

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Now that you’ve alleviated your problem with running, it’s time to address your need to walk. What is ironic is that walking is really one of the best treatments for plantar fasciitis after it’s under control, yet it’s one of the most condition-aggravating activities out there[1]. So obviously there is still a place for typical athletic shoes and insoles because you can’t walk with a mid- or toe-strike gait without causing your muscles and ligaments damage. However, there are some shoes that you should throw out (or donate) right now if you have plantar fasciitis[8].

For the girls out there, sadly the high heels must go. Even kitten heels have enough of a contorted arch to damage your plantar fascia. Flip flops are also a major no-go. Not only do these shoes neglect to support your arch, they cause you to constantly scrunch your toes. This means that the additional pressure of your muscles contracting is tightening your plantar fascia making it even easier to overstretch and tear as you step. Definitely a lose-lose situation for you and your feet.

Now, I know that many of you runners have your favorite shoes. You’ve broken them in just right to fit the exact curves of your feet. The truth is, you should throw out your athletic shoes every 250-500 miles no matter how good they are[7]. If you have plantar fasciitis, you’ll want to lean more towards 250 as throw-out point. This is because arch supports are made of flexible material that will eventually break down. This is nothing against the shoe, it has to have a sturdy yet comfortable insole. As such, it will break down. But you can keep yourself from breaking down by upgrading your footwear in a timely manner.

Plantar fasciitis can feel like it’s ruining your life if you are an avid runner who can’t go a day without hitting the pavement. But if you’re willing to try something new and go barefoot, you may just be able to keep enjoying the sport that you love without the pain and agony of plantar fasciitis.

References
1. Arthritis Foundation. (2016). Help for heel pain: Fixes for America’s top foot problem- plantar fasciitis. Retrieved rom http://www.arthritis.org/about-arthritis/where-it-hurts/foot-heel-and-toe-pain/treatment/heel-pain-arthritis.php
2. Buchbinder, R. (2004). Plantar Fasciitis. The New England Journal of Medicine, 350, 2159-2166. doi:10.1056/NEJMcp032745
3. Kibler, W. B., Goldberg, C., & Chandler, J. T. (1991). Functional biomechanical deficits in running athletes with plantar fasciitis. The American Journal of Sports Medicine, 19(1), 66-71. doi:10.1177/036354659101900111
4. Lieberman, D. E., Venkadesan, M., Werbel, W. A., Daoud, A. I., D’Andrea, S., Davis, I. S., Mang’Eni, R. O., & Pitsiladis, Y. (2009). Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature, 463, 531-535. doi: 10.1038/nature08723
5. Murphy, K., Curry, E. J., & Matzkin, E. G., (2013). Barefoot Running: Does It Prevent Injuries? Sports Medicine, 43(11), 1131-1138. doi:10.1007/s40279-013-0093-2
6. Sports Injury Clinic Network. (2016). Overpronation. Retrieved from http://www.sportsinjuryclinic.net/sport-injuries/foot-heel-pain/overpronation
7. University of Michigan Health System. (2016). Plantar Fasciitis. Retrieved from http://www.uofmhealth.org/health-library/hw114458#hw114566
8. WebMD. (2016). Slideshow: The Worst Shoes for Your Feet. Retrieved from http://www.webmd.com/pain-management/ss/slideshow-worst-shoes-for-your


About the Author Amanda Powell

Amanda has struggled with plantar fasciitis for many years until she gathered enough knowledge to manage the symptoms and rid herself of all the problems. As there are too few sources for foot health issues, she has decided to help others with her knowledge about this and other foot conditions.

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