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Injury Tip Sheet: Plantar Fasciitis

Learn what you need to know to help treat and prevent this common foot injury

Kathy Weber, M.D., M.S.
Daphne R. Scott, PT, Dsc
Chicago, IL

Fast facts

  • Affects over 2 million people each year
  • Occurs mostly in individuals between 40-60 years old
  • Is more likely to effect women than men
  • 10% of cases are running-related

What you need to know

What is plantar fasciitis?

  • Plantar fasciitis is an inflammation of the thick band of tissue, called the plantar fascia, that runs along the bottom of the foot
  • The plantar fascia connects the heel bone to the toes and when it becomes inflamed or swollen can cause severe pain in the heel
  • Can become chronic if the inflammation is left untreated


Signs & symptoms

  • Sharp pain in the heel, typically complains of pain with first steps in the morning or after sitting during the day
  • Pain localized to the bottom of the heel with or after exercise
  • Pain subsides with rest and often improves after muscles in the foot have been stretched
  • Pain develops gradually and often effects only one foot



When should I see a doctor or other professional?

  • You should see a doctor if the pain continues despite rest, stretching, and icing.  Occurs when there is no weight placed on the foot, pain wakes you from sleep, or if the heel pain is in conjunction with fever, redness, or numbness in the foot
  • Doctors may provide additional stretching exercises, cortisone shots to relieve the pain, or splints to wear at night.  Surgery is rarely offered as a treatment



  • Overpronation and/or flat feet can contribute to plantar fasciitis, especially in conjunction with poor footwear
  • Tightness in the calf muscles can lead to inflexibility in the foot
  • Excessive exercise, especially running on hard surfaces, over overtraining


Risk factors

  • People who are overweight or over the age of forty
  • Imbalanced foot mechanics, such as a difference in leg length or inadequate footwear
  • Exercises that place added stress on the tissues in the foot such as long-distance running, ballet, or dance


What you can do


  • Make sure that shoes have adequate arch support and heel cushioning
  • Avoid overtraining and increase workout increments gradually
  • Stretch the arch of the foot and the calf muscles  prior to and after  exercising
  • Ice after stretching and after your workouts


Recommendations for treatment and rehab

  • Icing the foot for 15-20 minutes a few times daily while taking an anti-inflammatory (if appropriate) can add in reducing inflammation and pain.
  • Stretching the arches, calves, and Achilles tendon multiple times during the day to help increase flexibility
  • Wearing a night splint for plantar fasciitis keeps the foot in a position to reduce tightening of the calf muscles and plantar fascia during sleep
  • Minimize irritation to the heel first thing in the morning by putting shoes on before taking the first step when getting out of bed
  • Upon waking, stretch the feet and toes up toward the head to stretch out the calf and foot before stepping


What can I do to stay active?

  • Non-impact activities such as swimming, cycling, circuit strength training are better choices to minimize pain at the heel during recovery
  • Decreasing running mileage and substituting with cross training

For more information on plantar fasciitis and learn the Six S’s of plantar fasciitis, read our Ask the Expert on plantar fasciitis pain.

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A Step-by-Step Guide for a Speedy Marathon Recovery

Learn how to recover fast from long races and skip the weeks of aches and pains

Jenny Hadfield
Co-author of the best selling Marathoning for Mortals and the newly released Running for Mortals.

Post race recovery begins the minute you cross the finish line.  Sure, you’ll recover post-race regardless of what you do, but did you know there is a short window of opportunity to affect the speed at which this happens?  And the faster you recover, the sooner you’ll get back into your running program.  Follow this Step-by-Step Guide post race and you’ll be well on your way to a speedy recovery.

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Getting back into a regular exercise routine is hard work. After all, you have to rebuild your endurance, strength and motivation to hit the gym. Unfortunately, it’s all too easy to make excuses in the face of these challenges. Remember, getting started is the most difficult part – once you’re exercising, you won’t want to stop. Eliminate these common excuses so you can get on your way to a better you:

1. You’re sore

It’s important to know the difference between being sore and being hurt. Discomfort or stabbing pains in your joints or muscles are big no-nos in the exercise world. This is especially true if you feel the ache immediately after a certain movement, such as falling or twisting your ankle. In this case, seek professional medical treatment and don’t exercise until you’re better.

However, if you experience delayed onset muscle soreness, you have no excuse to stop exercising. It’s more than safe to work out, and it’s better for your body to jump back into physical activity. The dull muscle pain usually happens when you work parts of your body that aren’t used to that stimulation. Hitting the gym may actually alleviate that discomfort and help the recovery process, according to Women’s Health.

Additionally, use a personal massager to get your muscles back in working order. You may already know from experience that a massage feels great, but scientific evidence supports this observation, too. A study published in the journal Science Translational Medicine found that 10 minutes of massage on the affected muscles can reduce signs of inflammation, alleviating soreness.

2. You’re sick

While being sick might be an acceptable excuse to take a day off of work, it shouldn’t stop you from working out. According to the Mayo Clinic, you can safely do mild to moderate exercises if all your symptoms are above your neck, such as a headache or runny nose. The New York Times even highlighted research that suggested physical activity can make you feel better overall, though you likely won’t experience any differences in your symptoms. If you decide to work out, be courteous to other exercisers. Cover your mouth when you sneeze or cough, and sanitize any equipment you use at the gym.

That being said, let your body be your guide. If you really feel too sick to work out, stay at home and rest. When you experience a fever, chest pain or a stomach ache, specifically, avoid physical activity to prevent further illness.

Girl blowing her nose in tissue.Don’t let a runny nose stop you from working out.

3. You don’t have time

Being too busy is perhaps the most common excuse to not exercise. To defeat this poor reasoning, you need to employ a little strategy and rethink your priorities. The U.S. Centers for Disease Control and Prevention advised adults need only 75 minutes of vigorous-intensity physical activity each week. Realistically, that means you can jog for less than a half hour, three times per week, and still meet this recommendation.

Think about what you do for 25 minutes each day that could be replaced with exercise. For instance, a 2014 report by Nielsen found that Americans spend between four and six hours each day watching TV. Additionally, U.S. adults spend an average of 3.6 hours per day socializing online, according to Ipsos Open Thinking Exchange. Consider cutting back on these habits to make more time for your health.

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The winter chill can make even looking out the window feel like you’re turning into an icicle, so it takes some serious mental power to exercise outside during the cooler months. However, getting your daily physical activity is essential for staying healthy and avoiding holiday stress. If you want to skip the cost of a gym membership but still work out, use these tips:

Get the right gear

Slipping on ice is a big concern during winter. After all, when you’re walking or running properly, you’re likely not looking at the ground. Even if you do sneak a peek at the sidewalk, you still can’t account for black ice. To avoid getting injured from a fall, wear shoes with non-slip bottoms. You can even buy chains that attach to the bottom of your shoes to create traction and reduce your risk of slipping. Otherwise, just go with a good pair of trail-running shoes.

Of course, it’s also important to dress warm enough for the weather so you don’t develop hypothermia on your morning jog. Opt for layers so you can shed them as you go since you’ll likely warm up once you start exerting energy. Don’t forget to protect areas that are especially susceptible to frostbite such as the ears and fingers.

“Warm ups can increase heart rate, circulation and body temperature.”

Warm up

Prepare for both the low temperatures and your workout with a warm-up routine. According to Sports Medicine Information, aerobic exercises can increase your heart rate, circulation and body temperature, effectively providing extra warmth before you face the winter chill and allowing you to more readily get into a running rhythm. A bit of stretching in combination with cardiovascular exercises can increase your joint range of motion and prevent injury as well. This is especially important in winter, as you may overextend muscles or move awkwardly in an attempt to regain your balance when moving on ice.

Perform a general exercise warm up that targets all parts of your body. For instance, you can prepare your ankles for a workout with the ankle rocker. To do this, stand with your feet shoulder-width apart and slowly rock back and forth from your toes to your heels. Repeat this movement for about 30 seconds. Get your upper body ready for exercise with arm circles. Again, stand with your feet shoulder-width apart, this time extending your arms out to either side of you. Make slow, circular motions from your shoulders, going in each direction for about 30 seconds.

Pick a safe path

You can’t steer clear of every ice patch or pile of snow, but you should at least strategize your running path to avoid as many winter obstacles as possible. For example, while running up and down hills may have been a great way to burn those extra calories in the summer, it can be dangerous in the winter. It’s best to avoid this terrain altogether, advised Jan Ochocki, a coach with the Road Runners Club of America in Minneapolis.

“More falls happen on downhills because you naturally tend to pick up your pace, making it harder to stop when you hit an icy patch,” he told Fitness Magazine.

Additionally, stick to sidewalks instead of the street. Not only are these areas likely clearer than the road, but if you slip and can’t immediately get up, you’d be much safer out of the path of cars.

Don’t forget to unwind with your personal massager after your workout.

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