In this Q & A, Meghan Kelly, MD, Assistant Professor of Orthopedics at the Icahn School of Medicine at Mount Sinai, provides at-home stretching tips that treat heel pain in more than 90 percent of plantar fasciitis patients and advises on how to prevent developing the painful condition.

How do I make my heel stop hurting?

To immediately deal with the pain associated with plantar fasciitis, you can use ibuprofen (ex. Advil) or naproxen (Aleve).  In addition, rolling a frozen water bottle under the arch of your foot can also relieve the pain.

What can I do to treat plantar fasciitis?

The way to treat about 95 percent of plantar fasciitis cases is by stretching. There are two main stretches which, if done well every day, should make the condition go away in about a month. This method worked for me and every one of my patients.

On the left, Dr. Kelly shows how patients can stretch their plantar fascia and, on the right, she demonstrates an Achilles tendon stretch.

Attend to your plantar fascia.

Plantar fasciitis is an inflammation of the plantar fascia—a thick band of tissue at the bottom of the foot. You can address this inflammation by stretching that tissue. Do this by putting your leg in a “figure four” position with the ankle over the opposite knee. Then, grab your toes and pull them toward your shin and massage the plantar fascia for 5 minutes. You should do this stretch two or three times a day.

Your Achilles tendon is tight. Loosen it.

Almost everyone has a tight Achilles—it’s just the way we’re built—and a tight Achilles tendon can affect the plantar fascia. There are a couple of stretches that can help. The one I like, and that I show my patients, involves standing on a stair or curb with both heels facing out. Hold onto the railing, then move the heel that is painful off the edge of the stair or curb and let it drop. Allow your other foot to relax. Hold this position for five minutes. I know that’s a really long time, but the Achilles tendon is a very large tendon and it takes time to stretch it. Do this twice a day. It doesn’t always feel great at the time, but it really does help.

The hardest part about treating this condition is being diligent about doing these stretches twice a day, every single day. I often recommend taping a reminder on your refrigerator, or some place you can’t avoid seeing.  If your heel hurts after you stretch, that’s normal. That’s when you can ice it and/or take a painkiller.

Should I try to stay off my feet? Do I need to wear special shoes in the house or outside?

You can walk as much as you want with plantar fasciitis. If it starts to hurt, you can stop—but you aren’t damaging anything if you keep walking.

In terms of footwear, the best shoes for plantar fasciitis are ones that fit correctly—both in length and width—and provide arch support. You can also use removable inserts (called orthotics) to “fix” a pair of shoes that does not have the support you need. I recommend trying over-the-counter orthotics first, to see if they help as custom-made ones can be very expensive. If you have really flat feet or very high arches, you can get over-the-counter orthotics that are designed to help with that.

I don’t routinely recommend wearing shoes inside—I’m a big fan of bare feet—but, if you’re having pain from plantar fasciitis, wearing supportive shoes in the house can sometimes help. Try it and see if it works for you.

Should I use a foot brace or splint, or a boot?

There are splints available at your local pharmacy that hold your foot at a right angle while you sleep. This will keep your plantar fascia stretched out overnight, and then, when you get up in the morning, you won’t have heel pain as you step out of bed. Some people swear by this method. The majority, however, tell me that they tried an overnight splint but woke up in the middle of the night to take it off because it was uncomfortable. If you want to try using a splint, that’s fine; it won’t do any damage. But, there are no research studies that prove its effectiveness.

Occasionally, I prescribe a walking boot for plantar fasciitis patients as it can take some pressure off the heel. But that can backfire. If you’re wearing the boot all the time and not doing the stretching exercises, your calf muscles may weaken. That won’t help with the pain. Sometimes, I give patients a walking boot for about a week, just to get them walking until the pain becomes bearable. During that time, I urge them to continue doing their stretches and, as soon as they can, I encourage them to stop using the boot altogether.

All in all, the best—and most effective—treatment for plantar fasciitis is stretching.

What if I’ve tried all this and am still having pain?

If none of this works, you might try formal physical therapy. A physical therapist may be able to help you do your stretches more effectively. Sometimes they have equipment in the physical therapy suite that you don’t have at home and can be beneficial.

If none of that works, there are also some procedures available. Extracorporeal shock wave therapy is a noninvasive method of stretching the plantar fascia that involves applying waves of electricity to the tissue. Another option is the Tenex FAST procedure. With this approach, we poke tiny holes in the plantar fascia with a needle. perform these procedures and those who do will likely only try them if everything else has failed.

How can I prevent plantar fasciitis?

The best way to prevent the condition is to avoid unsupportive shoes and to stretch before and after you exercise. But sometimes you do everything right and still end up with plantar fasciitis. That’s why it’s good to know what stretches can treat it.

Each year, approximately two million patients in the United States are treated for an irritating heel pain caused by a condition with a difficult-to-pronounce name. Plantar fasciitis (pronounced PLAN-taar-fa-shee-AY-tus) is an inflammation of the plantar fascia—a thick band of tissue at the bottom of the foot—which connects your heel bone to your toes and helps support your arch.

This very common condition is the most frequent cause of heel pain and can affect just about anyone, though it’s pretty rare among kids. If left untreated, the pain can last for weeks, months, or even years.

Meghan Kelly, MD, Assistant Professor of Orthopedics at the Icahn School of Medicine at Mount Sinai, explains why we experience this condition and when you should see a doctor.

What does it feel like to have plantar fasciitis?

You will probably feel pain in your heel, though it may also spread to your arch and along the bottom of your foot, all the way across to where your toes begin. Sometimes you’ll experience a slow burn, sometimes it really fires up. It’s usually most tender on the inside of the heel.

The pain usually starts first thing in the morning. You get out of bed, put your foot on the floor, and you feel pain on the bottom of the foot when you try to put your heel down. You may find you want to tiptoe around a little bit until things start to settle. Once your plantar fascia stretches out, it becomes more tolerable to walk on your whole foot.

Plantar fasciitis pain usually comes and goes throughout the day. It might feel better after walking a bit, then painful again if you’ve been sitting then stand up to walk, or if you’ve been on your feet for an extended period. That’s the unusual part about plantar fasciitis. While other conditions, like arthritis and Achilles tendonitis, get progressively worse throughout the day, the pain with plantar fasciitis waxes and wanes.

What causes plantar fasciitis?

This condition can occur for a variety of reasons, but is usually due to a change in the way your foot hits the ground. It can also stem from tightness in your foot and ankle muscles.

Often, people experience plantar fasciitis after a change in activity. Personally, I had that experience a few years ago, when I started wearing a pair of shoes with a really hard insole. Plantar fasciitis can also affect athletes when they change up their exercise routine. Occasionally we don’t know what caused the pain.

I saw a lot of plantar fasciitis as the world began opening back up after the COVID-19 lockdowns of 2020. All of a sudden, people traded in their flip flops and sneakers for hard-bottomed shoes and heels. They started going back to the gym, commuting to the office, and walking around the city after having not done so for more than a year. And, their feet were not happy about it.

How is the condition diagnosed? Is it chronic?

Most of the time, plantar fasciitis is diagnosed by taking a patient’s medical history, going over a list of their symptoms, and pressing on the “magic spot” that really hurts. Typically, for plantar fasciitis patients, that spot is on the bottom of the heel, close to the instep. Sometimes doctors take X-rays to rule out other issues, such as bone spurs or a foot shape that might make you more prone to problems.

Thankfully, if treated completely, plantar fasciitis goes away and does not come back. If it does come back, that means you never really got a hold of the condition the first time around.

Do I need to see a doctor?

There’s a good chance you can address plantar fasciitis on your own. But, if you find the condition is affecting your daily activities, you should consider going to the orthopedist. A doctor can make sure you do have plantar fasciitis, not something else, and can give you some simple stretches to treat it.

As many continue to work from home due to the COVID-19 pandemic, physicians are seeing a rise in orthopedic complaints associated with home offices. Anyone who has worked for extended periods at home knows these can include pain in your shoulder, hip, and lower back, among other nagging complaints.

“The shift of our work spaces from the office to our home introduces the challenge of finding a good working space. This can be especially difficult when also caring for our loved ones while working,” says Shawn G. Anthony, MD, MBA, Assistant Professor of Orthopedics at the Icahn School of Medicine at Mount Sinai.

Many of these pains are preventable with a few simple changes to the home office environment. To optimize your in-home work space and avoid irritating aches, Dr. Anthony provides these four tips.

Find a dedicated home office space

A dedicated space can be a challenge if you live in a New York City apartment or are rooming with others. So, while the ideal home office does not need to be a separate room, it should have basic components like adequate lighting—lighting that is bright white and non-glare producing—, an adjustable chair, and a flat table surface. Most importantly, avoid working in bed or on the couch, as working for extended periods with poor posture causes the most number of injuries.

Create a comfortable work space

Try to position your laptop or desktop monitor at or slightly below eye level—this is where an adjustable chair is helpful—so that your wrists are kept level and your feet are supported or kept flat on the floor. Patients often ask whether a standing desk is better than sitting. If possible, it’s best to combine both throughout the workday as each can cause issues after prolonged periods of time.

Maintain good posture while working

It’s easy to forget good posture and slouch in a chair. When seated, remember to keep your ears positioned over your shoulders and your shoulders positioned over your hips. This will keep your spine in good alignment while sitting for long periods. Your hips and knees should be bent at approximately 90 degrees, and a cushion can be added for lower lumbar support. Try to keep frequently used objects, such as a telephone or computer mouse within reach, as repeatedly stretching to reach for items can cause overuse injuries.

Take breaks and exercise

If you don’t already, introduce 10 minutes of morning and evening stretches to maintain flexibility. Tight muscles from prolonged sitting are the most frequent cause of joint pain due to increased stress across joints. A foam roller is especially helpful to maintain flexibility and to combat tightness in the quads, hamstrings, or iliotibial band—a thick band of tissue that extends laterally from the pelvis to the knee.

Throughout the day, stay hydrated and eat healthy snacks. Be sure to take breaks from sitting in front of your computer by walking around the room during phone calls and setting timers for stand up reminders. Though gyms may be closed, you can stay active by introducing body weight exercises such as wall squats, which are great for your core and quads. Jumping jacks and running in place are good cardio exercises that can be done indoors.

Introducing these simple tips will help stave off injuries and make for a more comfortable work space that does not hamper productivity. If you have any questions or if you are experiencing joint pain, schedule an in-office or virtual visit with a Mount Sinai orthopedist.