Plantar fasciitis is one of the most common forms of heel pain that we see at the Issaquah Foot and Ankle Specialists.

Plantar fasciitis is usually caused or aggravated by biomechanical factors such as the impact of running, walking or even standing. Hard surfaces certainly factor into the cause or onset of plantar fasciitis and also can perpetuate it. It is important to address both mechanical and inflammatory causes of plantar fasciitis. What you wear on your feet plays a big part of this. Some shoes offer better support, while other shoes have better cushioning. Ideally, you want a combination of the two. But some of the newer shoes and sandals go a step further and physically shift pressure away from the heel and also change the dynamics of the gait pattern itself.

Many of us work on hard concrete surfaces. This is obvious when working or shopping in a warehouse like Costco or Sam's Club where the concrete is clearly visible beneath our feet. But often times in an office environment the floors are actually concrete and had a thin layer of carpet over them so really one is still walking and working on a concrete surface. Just standing on your feet in one place will put intense mechanical pressure on the plantar fascia. Having the anti-fatigue mats or foam mats under your feet (such as for a cashier at the grocery store) can offer some relief.

At home it can actually be worse because even though you may not see concrete floors under your feet, it is often hardwood flooring or ceramic tile over concrete. In this situation many of us try to keep our houses clean, so we go barefoot or wear slippers. But in this case the best possible scenario is to wear a supportive sandal as your "house shoe". Examples of this would be brand such as Halflinger or some of the European walking sandals such as Clark or Ecco. Some of the other much lighter sandals such as Crocs also can be effective. In severe situations its best to actually wearing your supportive shoes that may also have additional support such as an over-the-counter insert or a prescription orthotic. The very best possible house shoe or sandal would be the combination of prescription orthotics with MBT sandals or a possibly sketcher shape up (rocker) sandals.

One can even go step further with this. For severe cases you should wear your supportive sandals - right out of bed. And some individuals will even need to wear plastic sandals in the shower.

So for some individuals that means they may want to buy a pair of these "house shoes" and bring them with them when they go to a friend's house. A real estate agent may also want to have a pair of the special sandals or use a shoe cover instead of going barefoot when they're showing houses.

Here is a summary of these recommendations for plantar fasciitis:

• Never go barefoot at home, even if you are a "barefoot person"
• Immediately out of bed in the morning - put on a sandal
• For severe cases you should still wear sandals even in a shower
• The best "house shoe" is either supportive shoe or a very supportive sandal
• For severe cases MBT sandals or Sketcher sandals are very helpful