TL;DR

If your first few steps in the morning suddenly feel like you’re walking on knives… congrats! You have what I am lovingly calling a sleeping injury.

You know, something that popped up out of the blue in midlife that would have never happened in your 20s before your body needed an engraved invitation to function at a bare minimum?

Welcome to the era where collagen turnover moves at the speed of continental drift and your fascia files a formal HR complaint every time you dare to stand up.

Today, we’re talking specifically about plantar fasciitis (or more accurately, plantar fasciopathy).

WHY

Your fascia doesn’t track macros. It tracks load, repetition, and how many times you’ve sprinted in bad shoes while late for school pickup. You can stretch, eat your protein, lift heavy weights, and still wake up one morning unable to walk to the bathroom without cursing the gravitational pull that requires you to be vertical.

Plantar fasciitis is the #1 cause of heel pain and ranks in the top 10 issues women deal with in perimenopause and menopause.

Under a microscope, chronic plantar heel pain shows collagen wear-and-tear (“fasciosis”) rather than classic inflammation. Your fascia is the exhausted overworked intern of your musculoskeletal system – underpaid, under-rested, and starting to crack. PubMed

Women are the chosen ones. Perimenopause is like a years-long endurance test to see what we’re really made of… at least that’s what I’m telling myself because there HAS to be a reason we’re playing whack-a-mole with our midlife ailments!

Here’s the kicker (because I know you’re loving all this great news): As estrogen falls, your tendons and fascia lose elasticity and resilience.

Estrogen normally keeps collagen supple and tissues hydrated. Without it, those tissues become stiffer and slower to repair – so any repeated load (heels, chasing kids, strength training) can push your fascia past its limit. With no warning. PubMed Central+2BioMed Central+2

Babies, Parties, and Ugly Shoes

If you’ve had kids, pregnancy, post-partum, and perimenopause make a charming tag team. Weight gain in pregnancy plus ligament laxity (relaxin) flattens the arches and can permanently lengthen the foot, raising plantar‑fascia strain. PubMed Central+1

I remember my foot went up an entire size in the 2 years following the birth of my children! Add in years of narrow shoes or heels, and, well… you get the picture. PubMed Central+1

Now, ya girl here loves her a good pointy heel in a dress when the time and occasion call for it. So I’m not saying never wear heels! I’m just saying, can we choose shoes with a wide base (where the toes are) and no heel most of the time?

It's like our diet. It's not like you can never have chocolate. It’s no problem when your diet is made up of primarily good protein, fruits, and veg.

I have recently discovered a brand of shoes, Saguaro (use code BETTER for 10% off!), that are both cute and inexpensive (my fave combo!) that I am using for everything – leg day, walks, and my Z2 stairmaster cardio days.

Now, usually functional footwear is ugly (sorry not sorry), but these are so good I even have buy-in from my husband, who, if you know him, has a pretty sizeable sneaker collection.

Put Ya Dang Feet Up

Other big risk factors for plantar fasciitis are obesity, long hours on hard floors, and tight calves (reduced ankle dorsiflexion).

And again, women are over‑represented in many standing occupations like nurses, waitresses, flight attendants, etc, so get yourself some good shoes ASAP. PubMed

 

HOW

In my clinic, the telltale sign of plantar fasciitis was tenderness at the medial calcaneal tubercle (inner side of the heel bone). Or, I could reproduce the pain – and risk an ear-piercing scream from my patient – by lifting the big toe back for the windlass test. NCBI

Once that was confirmed, we started rehabbing.

Fix Your Footwear

• If your shoes taper like a carrot, they’re strangling your fascia. Swap out the narrow ballerina flats with a wide-toe box. Minimize heel wearing for now.

Stretch It Out

• Do that windlass stretch. Sit down, cross the sore foot over the other knee, grasp the toes, and pull them up. Hold for 10-20 seconds, 10 reps, 2-3x/day. PubMed+1

Load It Slowly

• You can’t ice your way out of a load problem. Do high-load heel raises with your toes on a towel (for dorsiflexion). Do 3 sets of 8-12 reps at a slow tempo and add weight as tolerated. PubMed
• You can add intrinsic foot work like short-foot holds (press the ball of your foot down without curling your toes) or towel curls to support the arch, which acts as your fascia’s bodyguard. PubMed Central

Help It Along

• Use kinesiotape for the first 3-7 days to unload the fascia. You’ll likely need a practitioner’s help. BioMed Central
• Wear circulation socks if morning pain is brutal. I like the ones from Incrediwear (use code DRSTEPH20 for 20% off)
• Do some gentle rolling with a lacrosse or yoga ball

 

NOW

Here’s your 2-week Mini Pause protocol for plantar fasciitis:

Days 1-3

• Switch to a wide toe box shoe for everyday life (code BETTER for 10% off)
• Do the windlass stretch 10× (10–20 s) morning & evening and roll foot 1–2 minutes after stretches. PubMed
• Apply taping if first‑step pain is high and re‑tape every 48–72 h for up to one week. BioMed Central
• Sleep in circulation socks (code DRSTEPH20 for 20% off)

Days 4-7

• Start high‑load heel raises with towel under toes: 3×/week, 3×8–12 slow reps (add a backpack or weighted vest for load). PubMed
• Add short‑foot holds (10×10 s) daily. PubMed Central
• Avoid long static standing and any heel‑dominated shoes. OUP Academic

Week 2

• Keep stretching daily; continue heel‑raise progression.
• If mornings are still rough, try a night splint for 2–4 weeks. MLTJ

Still >5/10 pain with first steps after 2–3 weeks of consistency?

Book a doctor’s visit (chiropractor or physical therapist preferred if you have one!) to confirm the diagnosis, optimize loading, and look at more aggressive care.

Bottom Line

Plantar fasciitis isn’t a forever injury. It’s a tissue tolerance problem. Basically adaptive biology in a bad mood.

Load it right, support it smartly, and remember that the goal is to future-proof your facia so your next decade isn’t spent limping before coffee.

 

Sending you soft heels,

Dr. Stephanie

 

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WHAT I'M LOVING THIS WEEK

BiOptimizers Magnesium Breakthrough¹

A few years ago, I hit that “tired and wired” era. I’d be at the clinic treating patients all day, squeeze in my training, be full-on with the kids, and then collapse into bed exhausted after winning bedtime battles… and then… nothing.

My brain would rev like a Formula 1 car. I’d wake up in the morning and feel sore as hell from my workout and be completely demotivated to get out of bed, let alone back to the gym.

As a practitioner, it was a lightbulb moment. I need magnesium, and I needed it fast.

Ever since, I have taken magnesium nightly after dinner – non-negotiable. Within a week of starting, I wasn’t clenching my jaw. I wasn’t waking up at 3 AM replaying my to-do list. My muscles were ready to go crush a lift.

Now, not all magnesium is created equally. Most supplements only cover one or two forms, which is like giving your body a screwdriver when it needs a toolbox.

I use Magnesium Breakthrough from BIOptimizers because it has all seven forms of magnesium I want.

For women in midlife, cortisol is a moving target, and sleep feels like an Olympic event. Magnesium is your ticket to downshifting your nervous system without wine or willpower. It’s like an exhale in a capsule.

Try BIOptimizers and get a good rest. Be sure to use code ESTIMA for 15% off.

 

Attn: Grace Hybrid Pads²

Periods and bladder leaks… excuse me, but why did nobody warn us about this absolute faceplant of a combination?!

Perimenopause can lead to the return of high school-level period chaos, like the encore performance no one wanted. Add in some post-baby, midlife pelvic floor weakness, and you’ve got yourself a real party.

But period products aren’t made to absorb bladder leaks and the bladder leak products don’t deal with the menstrual cycle needs, and honestly… who wants to feel like they’re in a diaper in their 40s?!

Attn: Grace’s Hybrid Pads have become my default recommendation for women who whisper about bladder leaks or wild periods that have never met a calendar they couldn’t defy.

I absolutely love the women behind Attn: Grace because they treat midlife bodies like the sophisticated, powerful, sometimes unpredictable systems they are. They are all about keeping dignity as a top priority.

I want you to feel cared for, not managed or shoved to the side. You deserve these shockingly comfortable pads that keep all the toxins far away.

Try Attn: Grace’s Hybrid Pads now, and check out their full collection to get exactly what you need for the body you have right now. Use code ESTIMA20 for 20% off your first order on attngrace.com

 

Manukora Honey

When I was deep in postpartum recovery, I became obsessed with immune resilience and gut repair. The clock had started on 20+ years of kids counting on me to show up, and getting sick was not something I would have time for anymore.

I dug into the research (some people scroll Instagram, I scroll PubMed – don’t judge) and found that my kale and kombucha weren’t going to be enough anymore. I needed honey… and not just any honey. Manuka honey.

Manuka honey is unique because it contains methyglyoxal (MGO), a compound that gives it antimicrobial and anti-inflammatory power. Clinical data backs it to support wound healing, oral bacteria balance, and stronger gut mucosa.

Sign. Me. Up!

I keep a jar of Manukora MGO 850+ Manuka Honey on my counter and guard it like liquid gold. If I’m feeling ambitious, I’ll stir a spoonful into a cup of tea or a bowl of oatmeal. If I’m any level of rundown, I’m SO not above just downing it straight off the spoon.

The taste is WILD… earthy, floral, and caramel-y. It’s like medicine that forgot to taste like a punishment.

Every batch of Manukora honey is tested for purity and MGO levels, and every jar has a scannable QR code that traces it right back to the hive.

Biohacking on a spoon? Get yours now to save up to 31% plus $25 worth of free gifts with the Starter Kit, which comes with an MGO 850+ Manuka Honey jar, 5 honey travel sticks, a wooden spoon, and a guidebook!

 

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🌟 Love these recommendations? Find more resources to support your health in midlife in my Health Toolkit!

 

 

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Notes:

1. Use code ESTIMA for 15% off

2. Use code ESTIMA20 for 20% off your first order