A basic version of this tutorial was first published in 2003 when I originally observed that many stubborn cases of plantar fasciitis could be cured by “power icing,” and I wanted to get that idea out into the world. The tutorial underwent a major upgrade in July of 2006, becoming what I still believe to be the best available single source of information on the subject. Numerous minor improvements have been made since then, and this record of changes was started on August 26, 2007. A particularly large number of improvements were made in the fall of 2012 while preparing to record the audiobook version.
A key feature of PainScience.com tutorials is that they I actively update them as new science and information becomes available, and the most recent version is always automatically available to customers. Unlike regular books, and even ebooks — which can be obsolete by the time they are published, and can go years between editions — this document is updated at least once every three months and often much more. I also log updates, making it easy for readers to see what’s changed. This tutorial has gotten 61 major and minor updates since I started logging carefully in late 2009 (plus countless more minor tweaks and touch-ups).
Science update (Apr 14 '16, section #4.21) — Significant revision in light of (finally!) good new evidence about natural running and injury prevention. See section #4.21, Should you run naked? On faddish running styles and running shoes (or the lack thereof).
Good news update (Mar 17 '16, section #4.18) — Another good news update: ESWT is starting to look more promising. The section has been revised to be much more positive. See section #4.18, Fancy ultrasound: Extracorporeal Shockwave Therapy (ESWT).
New advice (Feb 26 '16, section #4.13) — Not only a new section but new good news! First version added Feb 2, substantial edit and expansion Feb 26. See section #4.13, Strengthening is a strong option.
Update (Jan 4 '16, section #4.7) — Careful and thorough editing/update of NSAID recommendations, especially with regards to safety. See section #4.7, Ibuprofen and friends: non-steroidal anti-inflammatory drugs (NSAIDs), especially Voltaren® Gel.
Science update (Jul 9 '15, section #4.10) — Some good news changed to bad news: a discouraging follow-up study on arch-specific stretching. See section #4.10, Know your stretches.
Upgraded (May 16 '15, section #3.2) — Many editorial and referencing improvements. See section #3.2, Ultrasound and plantar fascia thickness.
New section (Sep 23 '14, section #4.26) — A short new section, finally, on PRP injections. It’s brief, but links to a main, free article covering the topic in some detail. See section #4.26, Regenerative medicine? Platelet-rich plasma injections.
Major edit (Jul 9 '14, section #2.9) — Modernized. I continue to hone my understanding of pain weirdness science and its implications. See section #2.9, Pain is weird: the surprisingly fallible role of the brain in all this.
Minor addition (May 24 '14, section #4.11) — Brief review of calf-stretching gadgets See section #4.11, Conventional standing calf stretches (bent knee and straight knee).
Upgraded (Apr 1 '14, section #3.3) — Much more information about the (minor) significance of bone spurs. They may not matter a lot, but it’s good, useful, evidence-based context. See section #3.3, Using other diagnostic technologies.
Major update (Jan 1 '14) — The first complete professional editing of this book has now been completed. Although the difference will not be obvious to most readers, several hundred improvements and corrections were made, and it is definitely a smoother read.
Minor update (Dec 11 '13, section #2.3) — Added a fun science item about the amazing ankle mobility of the Twa people of Africa. See section #2.3, Probably my calves are too tight!
New recommendation (Jul 11 '13, section #3.3) — Now recommending a specific type of MRI to scan for bone swelling. Thanks to reader R Russell for the suggestion. See section #3.3, Using other diagnostic technologies.
Minor update (Jun 4 '13, section #4.20) — Added a terrific quote from a famous podiatrist about inconsistency in orthotics prescriptions. See section #4.20, Arch support, heel cups and orthotics.
Minor update (Mar 29 '13, section #4.7) — Upgraded risk and safety information about Voltaren Gel. See section #4.7, Ibuprofen and friends: non-steroidal anti-inflammatory drugs (NSAIDs), especially Voltaren® Gel.
Product upgrade (Feb 4 '13) — Audiobook version now available.
Improved (Jan 11 '13, section #4.27) — Expanded and edited. Reflexology and acupuncture added. See section #4.27, Don’t bother with ….
improved (Jan 11 '13, section #4.25) — A little more and better advice. See section #4.25, Some tips on beating the morning pain.
Minor update (Dec 7 '12, section #2.4) — More detail in my personal story of truly structural foot problem. See section #2.4, So what if you are a flat-footed, tight-calved pronator?
Expanded (Nov 29 '12, section #4.14) — Added much more detailed self-help information for trigger points. See section #4.14, Trigger point massage for your feet, shins & calves.
Major upgrade (Nov 26 '12, section #4.14) — Rewritten, modernized, expanded. See section #4.14, Trigger point massage for your feet, shins & calves.
Minor update (Nov 24 '12, section #4.16) — Some customizing of “brain wrangling” for plantar fasciitis. See section #4.16, Brain wrangling: what to do about sensitization.
Science update (Nov 20 '12, section #4.21) — Weak but interesting new evidence on natural running and injury prevention. See section #4.21, Should you run naked? On faddish running styles and running shoes (or the lack thereof).
Rewritten (Nov 9 '12, section #4.15) — Bigger, better, more positive discussion of this option. See section #4.15, Friction massage the plantar fascia.
Major update (Oct 28 '12, section #4.23) — A “minor” science item really changed the tone of this section. The point is still the same — avoid heels — but now it’s a more interesting point. See section #4.23, Beware of high heels.
Science update (Oct 25 '12, section #2) — Unimportant but interesting science update about the forces required for arch muscles to activate for support. See section #2, Nature of the Beast: What is plantar fasciitis?
New section (Oct 17 '12, section #4.1) — New standard section I’m introducing to most of the tutorials to “manage expectations.” Too many readers assume there’s going to be a specific miracle treatment plan. See section #4.1, So what’s the plan?
Rewritten (Oct 15 '12, section #4.8) — Completely revised to reflect new science and new understanding of the interaction of ice with “inflammation.” See section #4.8, Icing: more is better?
New science (Oct 12 '12, section #3.2) — Same content, more science support. See section #3.2, Ultrasound and plantar fascia thickness.
New section (Oct 10 '12, section #5) — No notes. Just a new section. See section #5, Now what?: An action-oriented round-up of my recommendations.
Science update (Oct 7 '12, section #4.10) — References pretty much completely renovated and upgraded — and generally good news for once. See section #4.10, Know your stretches.
New section (Oct 7 '12, section #4.7) — No notes. Just a new section. See section #4.7, Ibuprofen and friends: non-steroidal anti-inflammatory drugs (NSAIDs), especially Voltaren® Gel.
Like new (Oct 6 '12, section #4) — Major upgrade, with a much more detailed introduction to this part of the book, and long and useful list of summarized treatment options. See section #4, Treatment: What can you do about plantar fasciitis?
Minor update (Oct 5 '12, section #3.2) — Slightly expanded and clarified. Added a note about feeling a thickened plantar fasciitis with your fingers. See section #3.2, Ultrasound and plantar fascia thickness.
Minor update (Oct 5 '12, section #3.1) — Several minor clarifications and improvements. See section #3.1, Several conditions that might get confused with plantar fasciitis.
New section (Sep 29 '12, section #4.16) — No notes. Just a new section. See section #4.16, Brain wrangling: what to do about sensitization.
New section (Sep 28 '12, section #2.9) — No notes. Just a new section. See section #2.9, Pain is weird: the surprisingly fallible role of the brain in all this.
New section (Sep 25 '12, section #2.7) — No notes. Just a new section. See section #2.7, Where’s the fire? The inflammation myth.
Edited (Sep 25 '12, section #2.6) — Revision in preparation for audiobook production, with a focus on modernizing information about trigger points. See section #2.6, How trigger points can hurt like plantar fasciitis.
Edited (Sep 25 '12, section #2.5) — Revision in preparation for audiobook production, with a focus on modernizing information about trigger points. See section #2.5, The general importance of muscle in plantar fasciitis.
Rewritten (Sep 18 '12, section #2.2) — Merged information on arches and pronation, rewrote for clarity, and added a couple nice new supporting quotes. See section #2.2, Maybe it’s my pronation? Or flat feet?
Edited (Sep 18 '12, section #2.1) — Longer and clearer than before. In particular, I came up with a much better way of explaining the fragility of “bony” spurs. See section #2.1, Getting to the root of plantar fasciitis: could it be bone spurs?
Science update (Jul 4 '12, section #4.20) — Added good new evidence that customization of orthotics isn’t very accurate. See section #4.20, Arch support, heel cups and orthotics.
New section (May 11 '12, section #2.8) — Inspired by something surprising that I learned writing the new surgery section, this is a brief description of another major possible explanation for persistent symptoms. See section #2.8, Plantar fasciitis in the bone?
New section (May 10 '12, section #4.4) — Substantive new section of about 1400 words, with several footnotes and new references. See section #4.4, Surgical options for plantar fasciitis: so many!
More expert opinion (May 5 '12, section #4.5) — Added a particularly strong anti-steroids opinion to the section. See section #4.5, Steroid injections are promising but problematic.
Minor update (Dec 21 '11, section #4.24) — Added some more detail to exercise description, and a whimsical ankle coordination challenge. See section #4.24, Mobilize your lower leg musculature.
Minor update (Dec 13 '11, section #4.2) — Addressed some common fears about the threat of getting out of shape while resting. See section #4.2, The art of rest: the challenge and the opportunity for patients who have supposedly “tried everything”.
Minor update (Sep 28 '11, section #4.22) — Added reference to Kong et al, about the effect of shoe wear. See section #4.22, More about reducing impact, especially with Oesh shoes.
New section. (Aug 26 '11, section #4.22) — Now officially endorsing Oesh shoes for reducing impact. See section #4.22, More about reducing impact, especially with Oesh shoes.
Minor update (Aug 22 '11, section #4.23) — Added a reference about high heels and knee pain. See section #4.23, Beware of high heels.
Minor update (Jul 29 '11, section #1.1) — Added a reference about the poor overall quality of online information about common injuries. See Starman et al. See section #1.1, The plantar fasciitis misinformation explosion.
Major update (Jun 21 '11) — Major improvements to the table of contents, and the display of information about updates like this one. Sections now have numbers for easier reference and bookmarking. The structure of the document has really been cleaned up in general, making it significantly easier for me to update the tutorial — which will translate into more good content for readers.
New section (Mar 20 '11, section #4.21) — Finally, long overdue, a new section on this topic (for all the running injury tutorials, in fact). See section #4.21, Should you run naked? On faddish running styles and running shoes (or the lack thereof).
Minor update (Jan 18 '11, section #4.20) — Added a reference to a large, interesting study that showed that custom orthotics failed to reduce injury rates in marines. See section #4.20, Arch support, heel cups and orthotics.
Improved (Sep 30 '10, section #2) — Beefed up with better explanations and science about how plantar fasciitis involves more “degeneration” of your foot than inflammation. See section #2, Nature of the Beast: What is plantar fasciitis?
New cover (Aug 6 '10) — At last! This e-book finally has a “cover.”
Expanded (Jul 16 '10, section #4.5) — Added a substantial chunk of content about a promising experimental treatment protocol. Unproven but interesting. See section #4.5, Steroid injections are promising but problematic.
Minor Update (Dec 30 '09, section #4.27) — Some new comments on Graston Technique in response to a reader’s questions. See section #4.27, Don’t bother with ….
Minor update (Dec 30 '09, section #4.10) — Added an answer to a reader question, “Are soft night splints good enough?” See section #4.10, Know your stretches.
New section (Dec 30 '09, section #4.5) — No notes. Just a new section. See section #4.5, Steroid injections are promising but problematic.
Older updates — Listed in a separate document, for anyone who cares to take a look.