In this article, we will discuss using a walking boot for plantar fasciitis and whether or not it is necessary for recovery. The goal is to answer the question: "do you need a walking boot for plantar fasciitis?"
Plantar fasciitis is a common condition in runners (affecting around 10-19% of runners) that affects the heel and bottom of the foot, causing pain and inflammation. This condition is caused by inflammation of the plantar fascia, a band of tissue that connects the heel bone to the toes.
The pain associated with plantar fasciitis can range from mild to severe, making it difficult for runners to walk or stand for prolonged periods.
One treatment option occasionally recommended for plantar fasciitis is using a walking boot.
A walking boot is a type of brace worn on the foot and ankle to provide support and stability to unload the plantar fascia and allow it to heal.
Definition of plantar fasciitis
The plantar fascia is a shock absorber and supports the foot's arch. When the plantar fascia becomes overworked, it can be inflamed and cause pain and discomfort.
Plantar fasciitis is a progressive condition; the pain usually starts with a mild ache and worsens over time if not addressed appropriately.
Symptoms of plantar fasciitis
The pain associated with plantar fasciitis can range from mild to severe and can be sharp or dull. A burning or aching sensation can also accompany it. In some cases, the pain may be severe enough to make it difficult to walk or stand for long periods.
Common symptoms include:
- Pain in the heel or bottom of the foot, especially when standing or walking
- Pain that is worst in the morning and after periods of rest
- Pain that improves with activity but returns after prolonged standing or walking
- Stiffness in the foot, especially in the heel
- Swelling in the heel or bottom of the foot
The use of a walking boot for plantar fasciitis
Using a walking boot to treat plantar fasciitis is controversial, and there isn't a lot of research to back it up one way or another.
The theory behind using a walking boot is to take the stress off the plantar fascia and allow it to rest, allowing your plantar fascia to heal.
Explanation of a walking boot
A walking boot is a medical device worn on the foot and ankle to provide support and stability.
Walking boots are typically used for short-term pain relief and can be used for conditions such as plantar fasciitis, stress fractures, ankle sprains, and recovery after foot or ankle surgery.
A walking boot is made up of a hard plastic or composite shell that encases the foot and ankle. The shell is lined with padding for added comfort and support. The boot also has a built-in air bladder or foam padding to help control swelling and allow for a better fit. In addition, some walking boots have a rocker sole that helps reduce heel pressure and promote natural foot movement. Finally, the boot is fastened with straps or laces to ensure a snug and secure fit.
It's important to note that walking boots are not intended for long-term use, it's typically recommended for short-term pain relief and protection.
Its use should be in conjunction with other physical therapy and exercises to help strengthen the muscles and tendons in the foot and ankle.
Pros of using a walking boot for plantar fasciitis
Using a walking boot for plantar fasciitis can provide several benefits. Some of the pros of using a walking boot for plantar fasciitis include:
- Pain relief: A walking boot can help to reduce the stress on the plantar fascia, which can alleviate pain and inflammation. The boot also provides support and stability to the heel and bottom of the foot, which can help to relieve pain when standing or walking.
- Protection from further injury: A walking boot can help to protect the foot from further damage by providing support and stability. This can be especially beneficial for individuals with an active lifestyle or a job requiring prolonged standing or walking.
- Reduced swelling: Many walking boots have built-in air bladder or foam padding. This limits the motion in the foot, decreasing stress through it, and ultimately reduces inflammation and promotes healing.
- Improved function: A walking boot can help to improve function by reducing pain. Someone with severe plantar fasciitis that needs to be on their feet all day can do so in a walking boot.
- Can be used in conjunction with other treatments: A walking boot should be used with other treatments such as rest, ice, stretching exercises, and physical therapy to help speed up recovery.
Cons of using a walking boot for plantar fasciitis
While a walking boot can provide several benefits for individuals with plantar fasciitis, there are also potential downsides. Some of the cons of using a walking boot for plantar fasciitis include the following:
- Prolonged recovery: A walking boot takes away any stress from your foot. This means the ankle and foot muscles are not working while you are in the boot, causing them to weaken. When it is time to get out of the boot, a foot and ankle strengthening program is recommended to recover the strength lost in the boot.
- Inconvenience: Walking boots can be bulky and heavy, making them difficult to move around in. This can be especially challenging for individuals with a job requiring prolonged standing or walking.
- Cost: Walking boots can be expensive. Typically they range from $40-$70 per boot.
- Risk of complications: While it is rare, there is a risk of developing skin irritation, blisters, or other complications from prolonged use of the walking boot.
Determining if a walking boot is necessary
Determining whether or not a walking boot is necessary for plantar fasciitis can be a complex decision. The decision to use a walking boot should be based on a variety of factors, including the severity of pain, stage of recovery, occupation or lifestyle, other medical conditions, and the patient's preference. It's essential to consult with a healthcare professional to determine the best course of treatment for plantar fasciitis.
Factors that influence the decision to use a walking boot
Several factors influence the decision to use a walking boot for plantar fasciitis. These include:
- The severity of pain: The severity of pain is one of the essential factors in determining whether or not a walking boot is necessary. A walking boot may be recommended if the pain is severe and not improving with other treatments.
- Stage of recovery: The stage of recovery is also vital in determining whether or not a walking boot is necessary. A walking boot may be unnecessary if an individual is in the early stages of recovery. It should be used as a last resort after other treatment options have been exhausted.
- Occupation or lifestyle: An individual's occupation or lifestyle can also influence the decision to use a walking boot. For example, suppose an individual has a job that requires prolonged standing or walking. In that case, a walking boot may be recommended to help alleviate pain and protect the foot from further injury.
- Your preference: Your preference is also significant when deciding whether to use a walking boot. Some patients may prefer to use a walking boot, while others may prefer alternative treatments.
Treatments for Plantar Fasciitis
Different approaches can be taken when it comes to treating plantar fasciitis. One way to categorize these treatments is by their focus: immediate relief, addressing the underlying cause, and as last resort options. Understanding these different categories can help individuals to make informed decisions about their treatment plan.
You can check out mine if you are looking for a plantar fasciitis treatment plan designed by a Doctor of Physical Therapy.
Immediate Relief:
Heel pads: Heel pads are a tool that can provide immediate relief from your plantar fasciitis. They work to alleviate pressure on the sensitive heel. While many who suffer from plantar fasciitis see less pain in the short term, heel pads don't have great long-term effects.
Taping: Anti-pronation taping can also provide immediate pain reduction. It aims to unload the plantar fascia by lifting the arch. You can check out this video to learn how to tape yourself. It is easier to have someone else tape you but completely doable by yourself.
Shoe Inserts: Over-the-counter or custom-fabricated foot inserts can support the foot's arch and cushion the heel. Research has shown foot inserts can reduce pain and improve function, particularly for those who respond to tapping.
I want to add custom foot inserts are expensive. If you do not have custom inserts, don't have to go out and buy a pair. The inserts you get from the shelf are just as effective as custom-made ones.
Factors you will want to consider are the rigidity of the insert, your arch height, the heel cup design, and the length of the orthotic.
Please read this article I wrote up here on choosing the best insert for your shoe.
Night Splints: Wearing night splints has proven to be an effective method for pain relief from your plantar fasciitis, especially for those with pain during their first steps in the morning.
The hardest thing about night splints is they are uncomfortable to wear. They make what's called posterior and anterior night splints. Landorf and Menz found anterior night splints were more comfortable, with fewer reports of sleep disturbance. In addition, studies have shown relief when using night splints.
Ice: Ice for plantar fasciitis has effectively reduces pain associated with plantar fasciitis by numbing the area and reducing inflammation.
A study showed that one of the best treatments for reducing plantar fasciitis symptoms was applying cold therapy for 20 minutes before bed. This was proven to be better than in the morning. Ice in the morning helped decrease the pain experienced upon the first steps in the morning.
It is non-invasive, safe, affordable, and quick to apply, making it a convenient option for those with busy schedules.
Applying ice for 15-20 minutes up to 3-4 times daily to the bottom of the foot, particularly the heel and arch where the plantar fascia ligament is located, is recommended.
Applying ice therapy includes using an ice pack, a frozen water bottle, or an ice bath.
Heat: Heat is good when treating plantar fasciitis. Applying heat to the foot arch can relax the plantar fascia and decrease pain caused by tension. This alone can make a huge difference in reducing plantar fasciitis symptoms.
Heat therapy also increases blood flow to the area, which is crucial for healing. When your blood vessels get bigger (vasodilation), more nutrients, oxygen, and healing cells can rush to the injured spot. In addition, the increased circulation can help flush out waste materials.
Fixing Your Plantar Fasciitis
Stretching: Research has proven a tight plantar fascia, and tight calf muscles put you at risk for plantar fasciitis. So why not stretch them? Plantar fascia and gastroc/soleus-specific stretching have been proven to relieve plantar fasciitis.
I've found stretching the plantar fascia particularly helpful for those with high arches. Some telltale signs of a high arch are you are a "loud stepper" when you are barefoot, have calluses on the outside of your feet, or have wear on the outside of your shoes.
Foot Intrinsic Strengthening: In 2014, a study by Latey et al. found a link between weak foot intrinsic muscles and plantar fascia pain. Therefore it would make sense to strengthen the foot intrinsics.
Intrinsic foot strengthening makes sense when you think about it from an anatomical standpoint. The plantar fascia and the intrinsic foot muscles help make up the foot's arch. Plantar fasciitis can be caused by too much flattening of the arch, irritating the heel from excess tension. By strengthening and activating the arch's intrinsic foot muscles, we can cause less flattening. Leading to less stress at the heel, ultimately getting you out of pain.
Hip Strengthening: Your hips play a huge role in the stability of your legs, particularly your knees and feet. We will focus on how the hips affect your feet. After all, this is an article about plantar fasciitis.
Strengthening the hips can help lift the arch and activate your foot's intrinsic muscles. If you're skeptical, go ahead and take off your shoes and socks and stand up. Note how far your arches are off the ground. Now, while standing, I want you to contract your glute muscles and look back down at your feet. You should notice your arches are now lifted higher off the ground.
With this exercise, someone with flat feet will notice more of a change, but strong and active glutes are just as important for someone with high arches. High arches don't get you out of hip strengthening, sorry.
Last Resort Plantar Fasciitis Treatments
Walking Boot: A walking boot is traditionally designed as a "last resort" treatment for plantar fasciitis. Someone who has tried immediate relief along with two months of targeted exercises should consider using a walking boot. As we discussed, another thing to consider is how active the person is throughout the day. Someone active may see a more significant benefit.
Injections: Injections come in the form of either corticosteroid injections or PRP injections and are another treatment option for stubborn plantar fasciitis. They are considered a last resort treatment.
Corticosteroid injections for plantar fasciitis aims to get you immediate pain relief (basically numb the area) while you can perform exercises to fix the root of the problem with little to no pain. The downside is they can weaken the structures in that area. The goal of these injections is to get you immediate pain relief (basically numb the area) while you can perform exercises to fix the root of the problem with little to no pain.
PRP injections for plantar fasciitis aim to use the power of your bodies own stem cells to accelerate the healing process. The downside of these injections is it is expensive as it is not covered by insurance.
Conclusion
In summary, whether or not a walking boot is necessary for plantar fasciitis will depend on the individual case. A walking boot can provide several benefits, such as pain relief, protection from further injury, reduced swelling, and improved function.
However, there are also potential downsides to using a walking boot, such as prolonged recovery, inconvenience, and cost.
The decision to use a walking boot should be based on various factors, including the severity of pain, stage of recovery, occupation or lifestyle, other medical conditions, and the patient's preference. It's important to consult with a healthcare professional to determine the best course of treatment.
It's also important to note that a walking boot should not be used as the sole treatment for plantar fasciitis. Instead, it should be used in conjunction with other treatments such as stretching exercises and targetted strengthening to help strengthen the muscles and tendons in the foot and ankle. It's also important to follow the guidance of the healthcare professional regarding the duration of use and the appropriate level of support and stability needed.
Consult with a doctor or physical therapist
Consulting with a doctor or physical therapist is crucial when determining the best treatment for plantar fasciitis. They have the experience and expertise to evaluate the individual case and make recommendations based on the patient's specific needs and condition. They can also help determine whether a walking boot is necessary and, if so, which type of boot and what level of support and stability is appropriate.
A doctor or physical therapist can also provide an accurate diagnosis, which is essential for effective treatment. In addition, they can rule out other conditions that may be causing the pain and inflammation in the heel and bottom of the foot.
They can provide guidance on properly using a walking boot, monitor the recovery progress, and adjust treatment accordingly.
