I always tell patients with certain conditions such as Achilles tendonitis and plantar fasciitis that it is going to be a lifetime of maintenance but not a lifetime of pain.  The acute pain is temporary if treated properly and can go away with various treatments.  However, the condition will need to be maintained on a routine basis.  Maintenance consists of three key elements -

(1) manual home stretching

(2) no barefoot walking

(3) good support with a good custom orthotic in the shoes. 

Stretching is essential as the tendons and ligaments get tight. Stretching can be accomplished with physical therapy.  Also, a device called a night splint is oftentimes helpful to wear.  This device stretches out the Achilles tendon and plantar fascia. Typically, it is worn at night, the time when the plantar fascia and Achilles tighten up the most, and when you wake up in the morning after use of this device the soft tissues are all stretched out causing less pain and discomfort.  Finally another form of stretching is manual stretching done at home at least twice a day routinely.

Proper support is the final key element in prevention of surgery.  The gold standard in support and foot control is the use of devices called custom orthotics (inserts) prescribed by a podiatrist.  Foot and ankle support should be maintained even around the house.  If you’re not wearing your orthotics in the house, then you can wear Crocs or something similar with cushion and good shock absorption.

An ounce of prevention is a pound of cure.  These key preventative measures will prevent foot surgery and more invasive procedures.

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