How to prevent plantar fasciitis on the Camino

[Nivala]

Hey
I am panicking a little bit and I hope I can get some help and reassurance from you guys.
I’ve walked the Camino in 2019 and got diagnosed with plantar fasciitis when I got home.
I’ve trained the past two months with going on hikes from 8-21km, mostly on the weekends.

Around Easter I noticed pain under my heel when I did a trigger point massage. It wasn’t a full blown plantar fasciitis with stiff feet and pain in walking and standing (yet). I stopped hiking for a while and did all the things I did when I had plantar fasciitis: warming up the feet in the morning before getting out of bed, ice treatment, stretching, trigger point massages, voltaren in the evening and no jumping. And it healed within a few days.

Now I have the same thing again. And I’m supposed to go on the Camino in less than two weeks. I’m supposed to walk in my new hiking boots, but I’m not sure how much I can walk now. I also read on the internet that you should have a shoe with a lot of cushioning if you hike with plantar fasciitis, like Hoka bondi or clifton. So now I’m not sure if I should buy them instead. And if I bring Hoka shoes and my hiking boots, I put more weight on my backpack which is more pressure on my feet.

I’m also very frustrated that there are a lot of contradicting advice out there about plantar fasciitis. Some say you should have soles/shoes with arch support and don’t go barefoot and some say you shouldn’t because it makes your feet weaker and you should go barefoot as much as you can to strengthen your feet.

I feel very anxious about my upcoming pilgrimage. I have already planned on walking shorter distances or stopping for a few days, but I’m afraid that I will injure myself so severely that I can’t continue.

Any advice?

 

[Robo]

I feel your pain. Quite literally!

Indeed there is so much advice out there. But we have to remember that we are all different, and our conditions and treatments will differ.

I can only relate what worked for me........as I developed Plantar Fasciitis prior to my last Camino, that finished 2 weeks ago.

I should point out, that I walked 1,200 kms pain free.

1. I stopped training when the pain commenced.
2. I sought professional medical advice (my doctor and a podiatrist)
3. I had custom orthotics made that give great arch support. Not the off the shelf ones that you shape by warming them with a hair dryer. But 'made for you' orthotics.
4. I 'bullied' my doctor into referring me for cortisone injections in both Plantar Fascia. and both Achilles. (I had that too) The 'bullying' was required as the condition was still quite mild, but would worsen quickly once I started my Camino. So it was more a 'preventative' measure. I know from previous experience that the cortisone helps, but can wear off in 5-6 weeks. So I had all 4 shots in the days prior to departing.
5. I stretched. Dozens of times a day. Just a simple calf stretch for 20 secs. But 'really' stretched them. If I felt my plantar or achilles (they are joined) tightening at any time, I'd stretch some more.
6. I used Voltaren Gel morning and night.
7. I used highly cushioned shoes. Hoka Stinson. All the other Hoka felt too 'thin' for me.
8. I planned on walking under 25 kms / day. In fact my average was 19 kms.
9. I walked slowly, with lots of breaks. (av speed during the day incl breaks was 3.3 kph, max walking speed was about 4 kph)
10. (Added after @EricJR comment below). I use 2 hiking poles at all times, and use them to take a lot of weight of my feet/joints.

In the past I've had to resort to icing. This time I didn't need to.
In the past I was taking anti inflammatories and pain killers all the way. This time I didn't need to.

Prior to leaving I focussed on getting my body weight down, rather than training.
And getting my pack weight as light as possible.
Every kg makes a huge difference.

Good luck....

PS.
I think walking around barefoot for 2 years at home during Covid may have caused my problem.
I now wear crocs that have at least some arch support. and no more pain.

PPS.
I don't think you need the boots. My previous 3 Caminos I wore boots.
This time my feet loved the trail runners......

 

[EricJR]

Thumbs up for Rob's advice to consider regular calf stretches. This provided the most noticeable single benefit for me, in terms of my arch / sole / Achilles tendon problems - I didn't stretch anything very hard, but for a good 30 seconds, twice at a time, in the morning and at 3-4 stops per day.

Other suggestions:

1. Shoes seem to be very personal, but this year I took Merell ventillator's with much more rigid soles, and that was far better for me than last year's squishy-soled trail runners. The latter flexed a lot on hard ground, which I think put too much strain on my feet. I will probably try Hokas at some point.
2. I used one hiking stick, with a horizonal handle - I only use it for stability and to take weight on downward slopes, and I think it helps prevent strain (also it's great on slippery ground).
3. Avoid consecutive long-distance days, which may cause problems to build up.

 

[Robo]

Thumbs up for Rob's advice to consider regular calf stretches. This provided the most noticeable single benefit for me, in terms of my arch / sole / Achilles tendon problems - I didn't stretch anything very hard, but for a good 30 seconds, twice at a time, in the morning and at 3-4 stops per day.

Other suggestions:

1. Shoes seem to be very personal, but this year I took Merell ventillator's with much more rigid soles, and that was far better for me than last year's squishy-soled trail runners. The latter flexed a lot on hard ground, which I think put too much strain on my feet. I will probably try Hokas at some point.
2. I used one hiking stick, with a horizonal handle - I only use it for stability and to take weight on downward slopes, and I think it helps prevent strain (also it's great on slippery ground).
3. Avoid consecutive long-distance days, which may cause problems to build up.

Good point on the hiking poles. I used two. Always. Up, down, flat.
I'll add it to my list above!

 

[Grousedoctor]

I’m going to join in on reinforcing what @Robo and @EricJR said above. My experience was almost identical to that which Robo described.

I walked the CP a year ago and developed plantar fasciitis very quickly. Ever step of my Camino was painful to the point where walking took a great effort just to complete each stage (but I did). Having been on numerous other Camino routes, I wasn’t sure why this time I was having foot problems. My conclusion was that the plantar fasciitis was brought on by my choice of shoes for this Camino. Because I had been doing a significant amount of running in them, I chose to take my more minimalist running shoes for this trek. That was a real mistake. The shoe did not have enough support and within a couple of days, the foot/heal pain began. Luckily, I had brought with me my Teva hiking sandals which I switched to, but the damage was already done. Even with my change of shoes, walking hurt!

I know that you only have two weeks until your Camino so certain prescriptive advice won’t do you much good. Nonetheless, here’s what I did along with a few suggestions.

1. I went to see a podiatrist and was clearly given the diagnosis of plantar fasciitis.
2. Both feet were given cortisone injections which gave me some immediate relief and might be something you could get if you can get in to see a specialist.
3. His advice was to stress my feet as little as possible. For training purposes, I switched to riding my Peloton. Very little foot pressure on the bike which allowed me to rest but to also maintain my conditioning. You might think about how you could continue training now but minimizing the strain on your feet.
4. Custom orthotics were ordered (unfortunately they took about a month to receive). These well cushioned inserts made all the difference. Since you leave soon, look into a good quality insole like Superfeet which I had worn on previous Caminos.

As said above, shoe choice is very individual and depends on your feet. At this point, I would choose a shoe recommended for people with the plantar fasciitis condition. I would also get the best over the counter insoles that I could. See a podiatrist. Cortisone injections may help you. Change your training routines for now giving your feet a rest. Then, in the beginning of your Camino, determine your daily distance based on how your feet feel rather than on an arbitrary destination. You might also want to consider using a backpack transfer service in the beginning to reduce the weight issue until you see how your feet feel. Very best of luck. Buen Camino!

P.S. As a footnote, my plantar fasciitis condition is now under control. I continue to wear my custom orthotics, but I no longer have any foot pain or discomfort.

 

[Robo]

4. Custom orthotics were ordered (unfortunately they took about a month to receive). These well cushioned inserts made all the difference. Since you leave soon, look into a good quality insole like Superfeet which I had worn on previous Caminos.

@Nivala I got custom made orthotics within a week. So it might be worth checking around and asking podiatrists what the lead time is before seeing a specific podiatrist.

 

[TMcA]

Good advice given already. I'd just add that I always wear house shoes. Always. My house shoes are off-the-shelf Haflinger clogs with an insert for additional arch support. I have similar inserts for all my hiking boots.

 

[JoroAtanasof]

Hey
I am panicking a little bit and I hope I can get some help and reassurance from you guys.
I’ve walked the Camino in 2019 and got diagnosed with plantar fasciitis when I got home.
I’ve trained the past two months with going on hikes from 8-21km, mostly on the weekends.

Around Easter I noticed pain under my heel when I did a trigger point massage. It wasn’t a full blown plantar fasciitis with stiff feet and pain in walking and standing (yet). I stopped hiking for a while and did all the things I did when I had plantar fasciitis: warming up the feet in the morning before getting out of bed, ice treatment, stretching, trigger point massages, voltaren in the evening and no jumping. And it healed within a few days.

Now I have the same thing again. And I’m supposed to go on the Camino in less than two weeks. I’m supposed to walk in my new hiking boots, but I’m not sure how much I can walk now. I also read on the internet that you should have a shoe with a lot of cushioning if you hike with plantar fasciitis, like Hoka bondi or clifton. So now I’m not sure if I should buy them instead. And if I bring Hoka shoes and my hiking boots, I put more weight on my backpack which is more pressure on my feet.

I’m also very frustrated that there are a lot of contradicting advice out there about plantar fasciitis. Some say you should have soles/shoes with arch support and don’t go barefoot and some say you shouldn’t because it makes your feet weaker and you should go barefoot as much as you can to strengthen your feet.

I feel very anxious about my upcoming pilgrimage. I have already planned on walking shorter distances or stopping for a few days, but I’m afraid that I will injure myself so severely that I can’t continue.

Any advice?

I can only speak about my experiance , in order to prevent PF i was using massage ball every morning and right after finishing every stage during Camino .
I have weak spot on my right leg in the PF area but nothing sevire thougt .
Also this year i was using non zero drop trail runners (Topo athlethic 5 mm drop ) and i didnt had any pain . Another point is the streching .

500 SMALL MASSAGE BALL - BLACK

500 SMALL MASSAGE BALL - BLACK null This ball is designed for self-massaging after sports. It allows you to give your muscles and trigger points a deep massage.

www.decathlon.co.uk

 

[Kitsambler]

I developed PF the second year of Le Puy route, and it was due to inadequate arch support (self-inflicted wounds hurt the most: I had MacGuivered some Dr Scholls inserts into squishy pancakes). Got custom orthotics , which worked well. Also got Superfeet Green (more than one pair of boots), which are nearly the same as the custom orthotics and also work great.

 

[DwainS]

I’ve started my walk in SJPP on May 18. I’ve had it since then. I’am 6 days out of Santiago. Bought heel cushions in Santo Domingo. Sore right now as I just walked into Tricastela. Just do these stretches I seen on you tube and rub my sore heel on ball and I’am good to go for next day. Doesn’t get sore the next day till later on in the walk. Then I repeat my routine. I’am not saying this is for everyone but works for me. Developed this problem about a month before I started my walk.

 

[debbyg]

Just completed my camino, also suffer from plantar fasciitis regularly, used Superfeet pink inserts in boots, performed calf stretches and used KT tape every day - no issues during my trip.

 

[motero99]

I am walking the Camino Fortunes right now. Started in Lisbon and just finished a 20 mile day, Tui to Redondela. QI got plantar fasciitis over year ago and had to postpone 2022 Camino. Tried PT and Cortisone shots but they did not completely heal the plantar fasciitis. In April I finally got orthotics. The first set were hard plastic with pads. They did nothing for me. Went to an athletic based lab and got cork orthotics. They are cushioned and do the job. Also got 2 Cortisone shots before I I left. Am using Hola Speed Gots in wide. Plantar fasciitis is greatly reduced. Hola Doors Gots in wide are not as wide as other brands . The high arch of the orthotics can't my foot which results in compression of the little toe and blisters on the little toe. My kids joined me in Porto. Had them bring original Speed Goat inserts. Now I change inserts during the day and Plantar Fasciitis is not giving me problems and blisters are under control.

 

[DTCamino]

I agree with the posts here. For my plantar fasciitis: Hoka Challengers, Superfeet green inserts (2 pairs, swapped daily), stretches, and voltaren(you can 2% in Spain over the counter). My podiatrist and physical therapist approved all, I had custom inserts made but the Superfeet green are just as good, the studies support good aftermarket insoles are as good as the custom. I also used a massage ball (Rubz) to loosen the fascia.

 

[jfgough]

Hi
I had what i thought was PF for over a year. When i finally went to a podiatrist she told me that my arches were fine, but the fat pad on my affected heel was gone. Im a 65 yo male with plenty of wear and tear so this may not relate to your problem.
The doctor told to 1) stop wearing hiking boots/shoes for walking on hard surfaces 2) buy heel cushions for my regular shoes and 3) try Hokas for road walking and hiking.
I bought Hoka Bondi 8s for my regular walking routine and Hoka Stimson ATR 6 for hiking. This immediately stopped the heel pain and improved my quality of life.
Im not promoting Hokas, but using well cushioned shoes with a substantial heel like hokas really helps me. I was wearing very nice Altras before, but they were zero drop heels.
I hope you find your solution, i know how discouraging this can be.
Im heading out in late August to walk the CF with my Hokas.
Buen Camino

 

[motero99]

I forgot to add I am taking a Meloxicam 15 Mg tab everyday as soon as I finish walking.

 

[Nivala]

I just want to thank you all guys for your support. I had several people saying that I shouldn’t go on the Camino and that was very discouraging.
But I bought the Hoka Bondi 8 Wide yesterday and they definitely feel like walking on clouds. I also continued stretching and massaging and my feet definitely feel much better today. I will start with shorter distances than I had planned to and I might hop over stages to reach Santiago in time, but I am very determined to walk it.
I also started reading everything is figureoutable by Marie Forleo and I just like the mindset she shares. I want to be positive about this experience instead of worrying all day long.

 

[henrythedog]

The advice above is good. I suffered with PF several years ago and it brought one of my caminos to a halt.

In addition: pay lots of attention to your calves. Stretching and massage is important as everything attaches to your Achilles and thence to your fascia (spelling?)

 

[peregrina2000]

In addition: pay lots of attention to your calves. Stretching and massage is important as everything attaches to your Achilles and thence to your fascia (spelling?)

Such good advice. Another vote for frequent stretching, to add to the opinions of Robo, Eric, Debby, and others.

Achilles is one perennial problem area, especially if you’re on a camino with a lot of asphalt.

After having a camino ended by a hamstring pull a few years ago, I now have an iron clad policy that at the first sign of muscle pain, no matter where that muscle is, I stop walking and do some stretching. I then incorporate those particular stretches into my daily pre- and post- camino routine. I had a few lower back twinges this year on the Lana, started doing a lot of stretching right there on the camino, and made sure to stretch every morning and every night. The one day I forgot I was reminded by a bit more pain, but a 20 minute stretching stop and not forgetting at night or in the morning got me back to a pain-free walk.

Last year, on my first day on the Torres out of Salamanca, I had a 15 km start on asphalt, and sure enough, I started with some shin pain. But it disappeared, I think because of my stretching.

Icing is also not a bad idea.

I think the worst thing to do is to just suck it up and walk through it, hoping things will get better.

 

[Colette Z]

Hey
I am panicking a little bit and I hope I can get some help and reassurance from you guys.
I’ve walked the Camino in 2019 and got diagnosed with plantar fasciitis when I got home.
I’ve trained the past two months with going on hikes from 8-21km, mostly on the weekends.

Around Easter I noticed pain under my heel when I did a trigger point massage. It wasn’t a full blown plantar fasciitis with stiff feet and pain in walking and standing (yet). I stopped hiking for a while and did all the things I did when I had plantar fasciitis: warming up the feet in the morning before getting out of bed, ice treatment, stretching, trigger point massages, voltaren in the evening and no jumping. And it healed within a few days.

Now I have the same thing again. And I’m supposed to go on the Camino in less than two weeks. I’m supposed to walk in my new hiking boots, but I’m not sure how much I can walk now. I also read on the internet that you should have a shoe with a lot of cushioning if you hike with plantar fasciitis, like Hoka bondi or clifton. So now I’m not sure if I should buy them instead. And if I bring Hoka shoes and my hiking boots, I put more weight on my backpack which is more pressure on my feet.

I’m also very frustrated that there are a lot of contradicting advice out there about plantar fasciitis. Some say you should have soles/shoes with arch support and don’t go barefoot and some say you shouldn’t because it makes your feet weaker and you should go barefoot as much as you can to strengthen your feet.

I feel very anxious about my upcoming pilgrimage. I have already planned on walking shorter distances or stopping for a few days, but I’m afraid that I will injure myself so severely that I can’t continue.

Any advice?

I’ve been in Hoka Bondi since suffering a very bad PF on my Camino del Norte in 2018. My podiatrist and all her staff are in Bondis. Many hospital staff wear Hokas. For me Clifton’s are too flat vs Bondis that are a 5 mm drop at heel and much more cushioned..

 

[dick bird]

¨Treatment​

Most people who have plantar fasciitis recover in several months with conservative treatment, such as icing the painful area, stretching, and modifying or avoiding activities that cause pain.¨

This is the website that provides this advice which is reassuring except for the last bit. They also advise you see a medical practitioner, as they point out and a lot of posters on this thread have pointed out, everyone´s feet are different.

Plantar fasciitis - Diagnosis and treatment - Mayo Clinic

www.mayoclinic.org

 

[soleil]

I've only got one Camino to my name so far, but I live in a warm climate so I've been barefoot most of my life. It's finally taking its toll now that I'm in my mid 50s.

MRI revealed mild PF and some tendonitis, as well as some arthritis in my foot. Dr Scholls arch supports help but the solid gold is my Hokas. I had to give up flip flops but the Hoka recovery flips I just bought seem to work fine (and will be my after hike choice on the Coastal next year). I wear Clifton 8s for work and at the gym (because there is no natural elevation, so I set the treadmill for inclines!) They're pricey for sure, but pain has an even bigger cost.

I'm also finding that since finishing the English in May, the more I walk the less it hurts...so I do 5k a day every day now.

 

[Joannel]

I developed PF on the Frances in May. I rested for 6 days and was treated by a physio in Leon. Treatment was massage, TENS machine strapping for 3 days, hourly stretches for 3 days, followed by 3 times daily stretching. 6 days after the physio visit I had no foot pain, and went on to complete my Camino.
Gruen Camino

 

[Suzanne H]

I developed enough pain on my last camino that I stopped a few weeks into it (after walking short day, then taking several weeks off to rest…) because I didn’t want to hurt myself for the future. I knew my ankles were giving me problems, but the heel pain suggested PF too. Fast forward to now… I also have pain in the heels (but none in the arch) and I’m working with my therapist on ankle and hip weaknesses. I do not have PF, even though I have SOME of the symptoms.

Not all foot pain comes from plantar fasciitis.

You’re right. The info on the web is contradicting and every body responds differently to stressors. This is why there is no perfect shoe — we all have different needs. My physical therapist is doing miracles for me right now. I’d recommend speaking to one before you go if you can.

What is typically consistent for long distance walkers is the need to ensure our calves aren’t too tight, our ankles are strong and move freely, the arches in our feet aren’t collapsing (or rolling), and our core/hips/back can support us during a long walk. Sorry, that’s an oversimplification. But, a realistic summary! Walking 20k a day IS a stressor.

You’ve mentioned the contradicting info about having arch support vs being barefoot often to strengthen the foot…. Ive been there too! Bottom line: if you’re in pain, you’ll need supportive shoes until your body is strong enough to transition to barefoot style shoes. And more-so if you are carrying a backpack. Barefoot shoes feel great if your body and feet are healthy and strong and you’ve trained in them for months. If you are looking for a new shoe now, maybe try on a Brooks shoe. Although Hokas and Altras get a lot of attention on this forum (and I own several!), Brooks are a favorite of podiatrists and physical therapists for those working on foot issues.

Consider learning taping techniques. Voltarin gel is a good pain reliever. So sorry you’re having this pain and I hope you’re able to have a good Camino in spite of it.

 

[Nivala]

Hey! I just wanted to give an update.
Unfortunately the Hoka shoes didn’t work out. I had so much pain in my left foot from the end of the first day and on the second day I had to take the bus back to Puente de la Reina to buy new shoes.
It went well until week three… In corrion de Los Condes I saw a medical doctor at the health center and I have been diagnosed with PF in my left foot. I can’t walk more than 5-10 km per day. So I will only try to get from Léon to Sarria and then take the bus to Léon.
I just try to make the best out of it!

 

[henrythedog]

Hey! I just wanted to give an update.
Unfortunately the Hoka shoes didn’t work out. I had so much pain in my left foot from the end of the first day and on the second day I had to take the bus back to Puente de la Reina to buy new shoes.
It went well until week three… In corrion de Los Condes I saw a medical doctor at the health center and I have been diagnosed with PF in my left foot. I can’t walk more than 5-10 km per day. So I will only try to get from Léon to Sarria and then take the bus to Léon.
I just try to make the best out of it!

Do the best you can; but take it easy. In my painful experience, there’s no quick fix.