Dear DOCTOR Owen:

My doctor diagnosed me with plantar fasciitis and found a heel spur, which causes me a great deal of pain. I cannot function at work or at home without pain. I have spent a fortune on inserts, shoes, medication, and even physical therapy—to little avail.

My friend told me that she lost weight and her pain went away without any other treatment. I am approximately 70 pounds over my marriage weight, mainly in my belly. Would losing the weight do the same for me?

Spur

Dear “Spur”:

Many of my patients have this condition. In fact, 38% of my first-time patients either are diagnosed with, or have been treated for, plantar fasciitis. At my clinic, we health and diet counselors are able to remit the symptoms 78% of the time with diet and exercise alone. Of course, these cases may not be as bad as yours or they would be referred to a foot doctor. However, the physics of the condition is quite simple, and changing your weight and muscle strength will have profound effects downstream.

Try this simple test:

Stand up.

1. Lean as far forward as you can without losing balance and bend your knees slightly inward. Note the pressure change from the back to the front of your foot. Feel the pressure on the inside of your knees. Also note the slight strain on your hip muscles and in your back.
2. Pick up 20 pounds and hold it in front of your stomach.
3. Repeat Steps 1–3 above.

Multiply the 15 seconds it took you to do these four steps this by minutes, days, and years!

With plantar fasciitis, the poor little ligament at the bottom of your foot, which holds in the muscles under the foot, gets ripped off the bone. The ligament heals, and then gets ripped off again . . . and again. . . and again. The ripped ligament gets pounded when you walk because someone said, “Walking is the best exercise anyone can do.” Voilá! Pain! With the repetitive healings, calcium is deposited in an attempt to prevent more ripping, and looks like a “spur” on an x-ray. Thus, the spur is the consequence of the problem—not the problem.

Most of my patients with plantar fasciitis also have painful knees, hips, and backs. The head bone is connected to the neck bone! The problem is not the foot, but upstream, around your waist. Certainly, losing your belly and the forward center of gravity with it will help. The more weight you lose, the better.

Exercise also helps, but not just working out the foot muscles. In fact, you should almost ignore the foot. Abdominal strengthening will pull your pelvis forward, straighten out your knee angle, and move your center of gravity backward. (Of course, strengthening takes a commitment of time, diligence, effort, and good instruction.) For example:

1. Stand up.
2. Bend your knees in.
3. Pull your pelvis forward.

You can see and feel the difference.

At the full gym in my clinic, patients also exercise their hamstrings, as well as their calf (gastrocnemius) and foot muscles, which all work in concert. I can demonstrate a problem and have exercise professionals work with patients on the spot. Usually, after 12 weeks, most patients are improved or pain-free. Patients are informed about and instructed on exercise logic: “If you have a mechanical disability or liability, don’t go and pound it to death! Exercise smart, not long.”

Obviously, good shoes, postural support, and frequent rest will also help. Remember: You are a “package deal,” not a body part.