9 Mistakes That Can Make Plantar Fasciitis Worse

Plantar fasciitis can be painful. So the last thing you want is to make it worse. The problem is, what you do — from your diet to your everyday habits — can inadvertently aggravate this inflammatory foot issue.

Here, Nelya Lobkova, DPM, a New York City-based podiatrist at Step Up Footcare, shares the most common mistakes that may flare up your foot pain and explains how to prevent or at least help relieve plantar fasciitis.

A lack of H2O affects just about every system and part of your body, and your plantar fascia is no different.

"Dehydration can lead to diminishing the lubricant fluid around tendons and ligaments that prevent overuse injuries," Dr. Lobkova says. This translates to potential micro-tearing and scarring of the plantar fascia, she says.

‌Fix it:‌ "Drinking six to eight ounces of water every few hours is a good trend to follow to prevent dehydration," Dr. Lobkova says. But you may need more H2O if you're active and perspiring a lot. "Sweating creates a loss of water in the body that needs to be replenished," she says.

While calf-stretching is a stellar way to get some relief from plantar fascia pain, improper technique can trigger more discomfort. Case in point: bouncing.

"The act of bouncing while stretching the calf puts extra weight on the Achilles tendon and the heel bone," Dr. Lobkova says. "This can aggravate plantar fasciitis because it adds a weighted strain on the inflamed fascia."

‌Fix it:‌ "Instead of bouncing, try to hold a calf or Achilles stretch for 10 seconds," Dr. Lobkova says.

Another good stretch is a heel rise, she says. Here's how to do it:

1. Stand barefoot on the affected leg on a stair or box with a rolled-up towel resting beneath the toes of the sore foot and the heel extending over the edge of the stair or box.
2. Let the unaffected leg hang free, bent slightly at the knee.
3. Slowly raise and lower the affected heel to a count of three seconds up, two seconds at the top and three seconds down.
4. Once you can comfortably complete 12 repetitions, try holding dumbbells or wearing a backpack stuffed with books to add weight. Perform 12 repetitions of the exercise three times a day.

You might think walking barefoot is NBD, but if you're struggling with plantar fasciitis, going shoeless can sabotage your foot health.

"Ambulating barefoot on hardwood or tile flooring, which has minimum shock absorption, could lead to multiple foot and ankle issues," Dr. Lobkova says. That's because your heel is the area of the foot that takes on the most body weight.

"Thus, barefoot walking at home increases the likelihood of developing plantar fasciitis, inflammation and tearing of the insertion of the fascia at the heel bone," she explains.

‌Fix it:‌ Stick to shoes. "Instead of walking barefoot (even at home), consider a cushioned sneaker or slide to provide adequate shock absorption," Dr. Lobkova says.

Your high-impact workouts can be harming your heels.

"High-impact exercise, like running, places three times the body weight on our feet, including the heel," Dr. Loblova says. "The increase in weight on the heel can lead to or worsen plantar fasciitis by increasing inflammation in the plantar fascia."

‌Fix it:‌ "I advise trying low-impact exercise such as yoga or Pilates if you're experiencing plantar fasciitis," Dr. Lobkova says. Another option is riding a stationary bike.

Plus, with low-impact movements such as downward dog, you get the added benefit of stretching and lengthening the hamstring and calf tendon, she says.

Because plantar fasciitis is an inflammatory condition, noshing on foods known to cause inflammation is a bad idea.

"Inflammatory foods, such as foods with refined sugars and starches, trans fat and processed meats can lead to an inflammatory process in the gut," Dr. Lobkova says. "The result is your body working twice as hard to digest food and transfer it into usable energy."

Now you might be wondering, ‌how does this affect my feet?‌ Dr. Lobkova puts it like this: "In these situations, the body becomes too busy to act on reducing inflammation in other areas, such as the plantar fascia."

‌Fix it:‌ Pile your plate with fruits, vegetables and healthy fats like omega-3 fatty acids, which can help reduce systemic inflammation, per the Academy of Nutrition and Dietetics.

In addition, anti-inflammatory supplements can also help moderate the inflammatory process involved in plantar fasciitis, Dr. Lobkova says. Specifically, she recommends turmeric supplements (containing curcumin). Try taking one 400- to 600-milligram capsule twice a day for about a month, she says. But always consult with your doctor beforehand.

Bad news for flats and flip-flop fans: These flimsy shoes shouldn't be worn if you suffer from plantar fasciitis or heel pain.

Most flat shoes have zero heel drop (meaning your heel and toes are level), offer minimal stability in the sole or cushioning under the heel and put maximum stress on the heel bone, Dr. Lobkova explains. "All these factors could exacerbate pre-existing plantar fasciitis," she says.

‌Fix it:‌ Upgrade your flip-flops. Look for ones that have some elevation in the heel (like a slight platform or wedge), arch support and localized heel cushions, Dr. Lobkova says.

Everyone has an old pair of beloved sneakers that fit like slippers. But, ironically, these worn-in shoes are working against you and promoting foot pain.

Old sneakers usually show signs of wear and tear in the outsole, midsole or even insole. "But all three of these shoe components contribute to the stability and support of the shoe," Dr. Lobkova says. Here, she breaks down what happens when each part gets beat up with time:

• ‌If the insole is worn down‌, it's possible to develop a blister or plantar fibroma from abnormal friction causing irritation of the bottom of the foot against the shoe.
• ‌If the midsole is worn down‌, the stability and cushioning under the heel is compromised, which can cause excessive stretching of the plantar fascia.
• ‌If the outsole is worn down‌, there's a loss of traction, further compromising the stability of the shoe, which can also cause extreme stretching of the plantar fascia.

‌Fix it:‌ Kick those old kicks to the curb. "I advise getting new walking shoes and running sneakers at least every year," Dr. Lobkova says.

But if you're very physically active, you may even consider buying new sneakers more often than that. Just keep an eye on your shoes: While the deterioration of a shoe is not always apparent, the first sign of wear typically occurs on the lateral side of the heel (outside of the shoe), which correlates to where the heel strikes the ground, she says.

While having one pair of sneakers for the gym and everyday life is convenient, it's not the best strategy when it comes to preventing plantar fasciitis pain.

For starters, "working out in the same shoes you wear outside the gym contributes to wear and tear of the shoe," Dr. Lobkova says. And, as we know, a worn-out shoe can be bad for your feet.

"In addition, many casual sneakers are usually flat (zero heel to toe drop) and flimsy (not supportive)," she says. This lack of shoe support and cushion becomes even more problematic when you're working out and likely putting more stress on your feet.

‌Fix it:‌ Ideally, you should have two separate sets of sneakers: one for casual, everyday use and another for the gym (we know this can be costly).

But no matter what activity you wear them for, your sneakers should have sufficient support. Dr. Lobkovas suggests that people with plantar fasciitis should aim to buy sneakers with:

• Extra rigidity in the sole and cushioning in the midfoot to prevent impact on the heel and associated pain
• A thick midsole or rocker bottom to redistribute plantar pressures
• A firm heel counter (the back part of the heel surrounding the Achilles insertion) to minimize abnormal stretching of the plantar fascia and diminish pain and inflammation in the heel and arch of the foot

"Over-the-counter orthotics can provide temporary relief for plantar fascia in the form of cushioning under the heel," Dr. Lobkova says. But there's a right and a wrong way to wear them, and if you're doing the latter, you could be worsening your foot pain.

"A common mistake is placing the orthotics over the insoles in the shoes," Dr. Lobkova says. But this adds bulk and causes crowding in the shoe. In other words, it just makes things more uncomfortable.

‌Fix it:‌ "The orthotic should replace the insole in the shoe or sneaker," Dr. Lobkova says. That means you must remove the regular insole before placing the orthotic inside. And if it doesn't fit, then it's not the right type of orthotic for that shoe, she adds.

You can also opt for custom orthotics, which are insoles designed especially for you to keep your foot in an optimal position while walking to eliminate the mechanical forces that cause plantar fasciitis, Dr. Lobkova says.

Custom orthotics offer a lot of bonuses because you can make them to adapt to different conditions that worsen plantar fasciitis, she says. For example, your podiatrist can design your insole with a "hole in the heel" to offset a heel spur or add special cushioning to counteract loss of the fat pad under the heel bone.

What's more, "custom orthotics could also be made thinner to accommodate casual and dress shoes as well as sneakers," Dr. Lobkova says.