Plantar Fasciitis Natural Healing
Over a decade ago, I had a conversation that left a lasting impression on me. Daniel Howell, PhD is a Professor of Biology at Liberty University, who teaches human anatomy and physiology, and had performed biomedical research at both Duke University Medical Center and McGill University in Montreal. Our conversation was about how plantar fasciitis is so widespread and how his research indicated simple barefoot living could be key to relievin the pain naturally.
Now, more than ten years later, it’s remarkable how his message continues to resonate. What he described back then — the connection between shoes, restricted foot function, and chronic heel pain — is being confirmed in more and more research today (see research section at the bottom of this post). Studies now show stronger feet and healthier arches from barefoot and minimalist practices, while mainstream podiatry is still catching up. And since speaking with Dr. Howell, I’ve also learned about the fascia throughout the body — how it stores tension and trauma. That makes what he was saying back then about the plantar fascia make even more sense now.
Why is Plantar Fasciitis So Common?
Plantar fasciitis is one of the most common foot injuries experienced by Americans. It’s been estimated that up to 30 million people may be afflicted with plantar fasciitis in the United States alone, and these people account for up to 40% of the visits to podiatrists.
A cursory search online will provide you with a litany of websites – many quite reputable – that parrot pretty much the same. Plantar fasciitis is described as “microtears in the plantar fascia [that] lead to collagen degeneration” reads one website and the condition is caused by “prolonged running, jumping, standing, or walking,” “gait abnormalities,” “obesity,” and “poorly fitting footwear.” Preventative measures include losing weight and wearing footwear that is “well cushioned” with “ample arch support.”
After perusing several websites with pretty much the same information one could be left feeling as if they truly know what plantar fasciitis is, what causes it, and perhaps the best course of treatment. And yet, next year, over one million people will see a doctor because of plantar fasciitis, just as last year. And many of those cases are recurring.
As is typical, when it comes to Americans and their feet, many people – including doctors and podiatrists – simply cannot imagine the possibility that their foot woes may be due to their shoes. Not a poor choice of shoes, but to SHOES. Nor can they conceive that the best thing they could do for their aching feet is simply to take off their shoes and just walk around barefoot a little. That advice is not given on any of the most popular medical websites I reviewed on plantar fasciitis.
Fortunately there are podiatrists who are willing to question the status quo on plantar fasciitis. Drs. Harvey Lemont and Ray McClanahan, for instance. Lemont’s research suggests that plantar fasciitis is almost universally a misdiagnosis. He and his former student, Dr. McClanahan, seem convinced by his research that the majority of cases of plantar fasciitis are actually plantar fasciosis.
The Difference Between Plantar Fasciitis & Plantar Fasciosis
It’s a seemingly small change in the name, but it’s a major change in how you think about the cause and treatment of the pain. Fasciitis refers to inflammation, whereas fasciosis refers to necrosis, or death in the tissue. How you approach treating inflammation versus necrosis will be markedly different. Recent reviews, including a 2014 analysis in BMJ Open Sport & Exercise Medicine, confirm that most chronic heel pain cases show degenerative tissue changes/tissue death in the plantar fascia (fasciosis), not inflammation (fasciitis) — though short-term, acute pain may still involve some inflammation. So, if most people have plantar fasciosis instead of plantar fasciitis, what is the cause and cure for this condition?
What Causes Plantar Fasciosis?
Dr. McClanahan speculates that the primary cause is the shoes we wear, specifically shoes with arch supports, elevated heels, toe springs, and narrow toe boxes. Unfortunately, virtually every shoe on the market has these features, especially “athletic shoes.” How exactly these features cause plantar fasciosis is described beautifully in this video with Dr. McClanahan, but the short version goes like this: elevated heels, toe springs, narrow toe boxes, and arch supports immobilize the foot into an unnatural position such that the posterior tibial artery is pinched and blood flow to the plantar fascia is severely reduced. Over time, this results in death of the tissue (plantar fasciosis) and the pain associated with plantar fasciitis.
Other risk factors have also been identified in recent research: tight calf muscles (gastrocnemius and soleus) significantly increase strain on the plantar fascia, which is why calf stretching and mobility work are now widely recommended. Modern studies (see research section at the bottom of this post) also show that heel spurs — once thought to be a major cause — are usually incidental and not responsible for pain.
What Can You Do To Prevent or Treat Plantar Fasciosis?
The absurdly simple answer is… take off your shoes and walk. Unfortunately, many people are just unwilling to do that due to social pressure. In that case, try to find shoes without toe springs, arch supports, elevated heels, and narrow toe boxes, such as moccasins, Vibram Fivefingers, or other minimalist shoes on the market.
Be careful, though: as the minimalist shoe concept has ballooned in recent years, many shoes advertised as “minimalist” are far from it in truth. Try to find shoes without the features mentioned above. Or better yet, kick off your shoes and walk around barefoot as much possible.
The barefoot approach now has more published science behind it. A 2019 study in Frontiers in Sports and Active Living showed that wearing minimalist shoes increased the size and strength of intrinsic foot muscles, improving natural arch function. Stronger feet mean better resilience against plantar fascia pain.
By contrast, standard medical guidelines (like the 2020 update from the American College of Foot & Ankle Surgeons) still recommend a long list of conservative treatments: stretching the calf and plantar fascia, physical therapy, night splints, orthotics, shockwave therapy, or even platelet-rich plasma injections. Surgery is considered a last resort. The average recovery timeline given in mainstream medicine is 6–18 months. Mentioning this is important, because it shows just how long people struggle under the traditional model — compared to the potential relief from restoring natural foot function.
I believe that getting out of your shoes is not only the cure for plantar fasciitis but is the ultimate key to healthy feet. A shoe is a cast that immobilizes your foot. I am convinced that exercising your feet by walking barefoot is the single best thing you can do for the health of your feet. Not sitting barefoot. Not barefoot running. Walking barefoot.
Walking barefoot allows the muscles in your feet to come alive, stretches your tendons and ligament, strengthens your bones, and exposes the skin of your feet to air and sunshine, enhancing their natural antibiotic potential. Shoes, on the other hand, cause atrophy of foot muscles, weaker tendons, ligaments, and bones, and suffocate your feet in a microbial hotbed. And, as we’ve seen, shoes can pinch off the blood flow to your plantar fascia.
The Takeaway
For both plantar fasciitis and plantar fasciosis, walking barefoot in nature and around your house will help, if not, eliminate the pain entirely and correct the issue.
If you’re currently dealing with heel pain, a gentle transition may help: wear cushioned shoes in the morning hours when pain is usually worst, but kick them off and ease into barefoot walking later in the day. Combine this with simple calf stretches, fascia stretches, and foot-strengthening exercises to restore blood flow and tissue health.
The Research
2019 — Ridge
Walking in Minimalist Shoes Is Effective for Strengthening Foot Muscles
BYU clinical trial reported that walking in minimalist shoes was just as effective as specific foot-strengthening exercises in increasing both muscle size and strength over eight weeks.
2021 — Curtis
Daily activity in minimal footwear increases foot strength
Scientific Reports showed that participants who switched to daily activity in minimal footwear experienced an average 57.4% increase in foot strength within six months.
2023 — Xu
International Journal of Sports Medicine found that studies involving minimalist shoe interventions (minimum of 2 weeks with a control group) showed intrinsic foot muscle strength increases of 9–57% and muscle size increases of 7–10.6%.
2024 — García-Arrabé
A study comparing barefoot running to wearing advanced footwear found that barefoot runners—especially those running barefoot for two years—showed increased muscle thickness and cross-sectional area in intrinsic foot muscles.
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