Plantar Fasciitis Taping (February 2018)

Plantar fasciitis (PF) causes pain in the heel and bottom of foot that compels people to curtail their activities. Too often it becomes chronic: it gets better, the hopeful individual resumes some of their activities, and then it gets worse. Around and around they go. I’ve known people who have completely abandoned their cherished running routine because of their persistent fasciitis. 

If you announce in a crowd that you have plantar fasciitis, people will come out of nowhere to tell you how to treat it because it is such a common condition. Rolling your foot on a tennis ball and making a frozen roller with water in a plastic bottle are the top recommendations. If you have plantar fasciitis, you undoubtedly have heard of these and other ways to treat it. Our experience is that these strategies rarely cure the problem. We believe that the only way to fix your persistent PF is by taping it the way that physical therapists and trainers do. We waited until the condition was completely gone, then began the stretching recommendations to further prevent recurrence.

Taping is hard to learn, tedious to do, and may require being taped 24/7 for weeks. We’ve handed more than one person the taping instructions for what we consider the cure, offered to show them how to do it, and they’ve declined. It’s an onerous task that they don’t want to take on.

Because of copyright issues, we can’t reproduce the pages from our taping book  “Illustrated Guide to Taping Techniques”  by Austin, et al. It is currently out of print but copies are sometimes available. There is a newer edition that we haven’t seen that presumably has the PF taping information: "An Illustrated Guide to Taping Techniques Principles and Practices” by Hewetson, et al. Also, check online for “plantar fasciitis taping techniques” to see what free instruction is currently available. We are happy to loan our book to you if our paths regularly cross.

A Portland podiatrist maintains that it isn’t actually plantar fasciitis but plantar fasciosis. Our best guess is that both are true: that it starts as fasciitis and evolves to fasciosis over a period of years. You can read that discussion by following this link. Dr McClanahan also has excellent videos accessible from his website on PF and other topics.

Consider making an appointment with a physical therapist, sports trainer, or other professional who is experienced with taping techniques. You can see how it is done, ask questions, and learn how it should feel, which will make your do-it-yourself project easier.

The “How & Why” of Taping According to Bill
The general concept is that chronic plantar fasciitis persists because of recurrent micro trauma to the plantar fascia.  Every time you take a step, the plantar fascia is stretched, which causes further harm to the already damaged tissues.  Tape provides external support to the arch of the foot, not by pressing up into the arch like an orthotic does, but by connecting the ends of the arch together. Using tape to link the 2 ends of the arch limits the amount that the arch can stretch and flatten, thereby limiting the tugging on the plantar fascia (see diagram below).

The trick with taping is to get the tension just right. When walking, you should feel firm support from the tape but not discomfort.  You should be able to walk comfortably with it taped.  You adjust the tension by increasing or decreasing the amount of dorsiflexion (toes pointing towards shin) of the foot during taping.  

To increase the tension when applying the tape, increase the plantar flexion (toes point away from shin); to decrease the tension, increase the dorsiflexion. Don’t change the tension by wrapping more or less loosely but by changing the foot flexion.  The tape should be applied with slight snugness but no real tension. A good place to start is with the foot in neutral position—the position of the foot when relaxed.
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Plantar Flexion

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When you walk on the taped foot, there should be no pain and blood circulation to the toes must be normal. Don’t be surprised if you have to redo it several times to get the tension right the first few times you try it.  It will get easier.  Also, it’s a lot easier to have someone else do the taping, but it is possible do it yourself.

The foot should be taped whenever you walk on it.  Always!  For me, this meant I had to leave it taped all night since I always get up at night.  If you don’t, then you could take the tape off before you go to bed and reapply it before you stand on it in the morning.  Fresh tape should be applied after showering since the water will allow the tape to stretch or become dislodged.

Keep taping for at least a couple of weeks. You want the fasciitis to be completely healed before you stop.  If you stop taping and you start to feel the fasciitis again, immediately resume the taping.  I would do normal walking activities while taped but not significant exercise that might over stretch the plantar fascia (hiking, running, weight lifting while standing - but seated is OK).

One problem to watch for is skin irritation or breakdown from the tape.  Use white athletic tape (not something stretchy) but the sticker it is, the harder it is on your skin.  Cheaper tape tends to be less sticky so try tape from some less specialized store and not something you get at a pharmacy or a high quality sporting shop.  If skin irritation becomes a big problem, try leaving it on more than 1 day since peeling it off is what really damages the skin, but be aware if you’re losing too much support.  There are also sprays like Tough Skin that can help protect the skin from damage. And of course, if you are allergic to latex, only use latex-free tape.

Once the PF injury has healed, ease back into your activities.  When things are going well, start a good stretching program for your plantar fascia to prevent a recurrence.  You will find many suggestions for stretching online. Don’t do that while it’s healing, only afterwards.

And a reminder about blood circulation.  After taping always check to be sure the circulation to the toes is normal.  You can do this by gently squeezing the blood out of a toe with your fingers and when you release the pressure, it should immediately go from white to red as it refills with blood.  The circulation should always be normal, both at rest and with activity.

This is a huge commitment, but I fiddled around for a couple of years with recurrent fasciitis and taping finally took care of it—for good.