The plantar fascia is very strong in tensile strength (pulling strength) but not as strong in torsional strength. In other words, anything that causes excessive twisting of the fascia can cause it to become painful. Such twisting can be caused by shoes with weak or absent shanks (the mid portion of the shoe) or an arch the rolls in too much or if the ball of the foot rolls out too much when walking. A tight heel cord is another cause of plantar fasciitis and patients may experience pain after rest or after getting out of bed in the morning.
A foot support that elevates the arch can help remove strain from the plantar fascia. That is what most over the counter shoe inserts do. But remember that the fascia attaches to both the heel and the ball of the foot so both ends of it often need be addressed. A prescription custom molded orthotic may be designed to both elevate the heel and arch, while, at the same time, rotating the front of the foot inward to minimize torsional strain on the plantar fascia. In fact, a custom prescription foot orthotic can be made to do almost anything the prescribing doctor requests that the lab do in the prescription.
Comfort and Custom Foot Orthotics
Prescription custom foot orthotics are the most comfortable orthotics because they are made to fit the contours of the feet. Mass produced OTC orthotics are comfortable if they happen to be close enough to the foot contours. Another way that prefabricated orthotics can be made comfortable is to make them very soft. Soft inserts are easier to sell since they feel good when first tried on. The issue is that an orthotic need achieve a therapeutic objective which requires adequate firmness to achieve that goal. The more accurate the mold of the foot used to make the prescription orthotics, the more comfortable it will be.
If one has heel pain due to plantar fasciitis, do a small experiment. Take a couple of pillows and tape them to the bottoms of your feet, then walk around the block. Initially, the pillows will feel very soft but by the time you get back, the fascia will be more painful since the pillows actually increased the pathologic forces causing the plantar fasciitis. Support always wins the day in the end despite the fact that softness feels good and softness sells.
SIX QUESTIONS TO ASK YOUR DOCTOR ABOUT HEEL PAIN