Why I Don't Ice or Stretch Plantar Fasciitis and What I Do Instead

Plantar fasciitis is one of the most common things I see. And most of the patients that come to see me have already Googled it. They've tried icing it. They've tried stretching. They've bought the sock that pulls your foot up at night. They've bought the boot. Some have even tried cortisone shots.
But here's the thing. The plantar fascia is a tendon. And tendons don't like to be iced or stretched. That's not how you get them better. You have to treat it based on what it is. It's a connective tissue injury.

I'll tell you something that sounds simple but it works. I tell patients to soak their foot in warm water with Epsom salt. It improves the blood supply to the area and helps it heal.
Most people are told to ice it. I don't agree with that. Ice tightens things. You want to relax the tendon. That's why warm water works better.

The other thing I do not do is give cortisone injections. I know a lot of doctors still do it. But it's not the right solution for this problem. Cortisone weakens tissue over time. You're putting a degenerative agent into a structure that's already strained.
If I have to inject something, I use exosomes. These are regenerative. They tell the body to heal. That's what you want — not to shut inflammation down with steroids, but to guide healing.

We also have to look at the patient's mechanics. Many of these people have either loose ligaments or unstable feet. They need support. I use a device called a TCS. That stands for Tailor–Calcaneal Stabilizer. It's a type of custom orthotic that supports the heel and helps offload the fascia.
Sometimes it's also the shoes. A lot of people are walking around in shoes that are too flat or not supportive enough. I'll ask them what they're wearing and I'll recommend something better. Right now I like the On Cloud Monster because it has a good combination of cushion and support.

If you're dealing with plantar fasciitis, stop stretching it. Stop icing it. Try warm soaks. Get better support. And if it's really not getting better, we have regenerative options that can help without weakening the tissue.
This is a tendon problem, not a muscle problem. Treat it like one.