Physical Therapy for Plantar Fasciitis

Plantar fasciitis is a common cause of heel pain; approximately one in 10 people will develop it at some point in their life. The plantar fascia is a tissue that supports and helps maintain the longitudinal foot arch. Plantar fasciitis is an over-stretch injury; inadequate arch support can lead to plantar fasciitis. The good news: nearly 90 percent of individuals respond to conservative treatment such as physical therapy.

However, not all heel pain is plantar fasciitis. Plantar foot pain, or pain on the bottom of the foot, can be caused by many conditions, including posterior tibial tendonitis, tarsal tunnel syndrome, and subtalar synovial impingement. The pain patterns of these conditions mimic plantar fasciitis, but the management of each is different. This is why it is important to seek an assessment from a physical therapist to ensure proper diagnosis and treatment.

What to Do If You Have Plantar Fasciitis

Step 1: Stop stretching an over-stretch injury. Online searches will often provide exercises that can aggravate the over-stretch injury; doctor Google may be wrong!

Step 2: Physical therapy is part of first-line treatment. Your physical therapist will be able to pinpoint the injury type, define the causes, and design a custom plan to meet your goals.

By improving the mobility of the plantar fascia and the neighboring tissue and strengthening the supporting muscles, exercise can decrease the load on the plantar fascia to help it heal. For example, a physical therapist may determine that tight calf muscles may be contributing to an individual’s plantar fasciitis and prescribe personalized exercises to help address it. This is why individualized care is important. In this example, stretching a muscle that was not tight would be unnecessary and possibly aggravate symptoms. A physical therapy evaluation ensures that you receive targeted, individualized treatment. Depending on the individual, your physical therapy plan of care may include additional exercise, manual therapy, modifications to footwear, gait training, low-level laser therapy, and other techniques to help manage pain and restore function.

Research shows that utilizing these treatments can result in fewer medical visits and decrease the overall cost of care. Therefore, we recommend physical therapy early on to help quickly resolve symptoms.

A licensed physical therapist can help diagnose your foot pain and administer proper treatment. To schedule an appointment with a physical therapist at Sheltering Arms Institute, please visit www.shelteringarmsinstitute.com/contact-us or call (804) 764-1000.

References:

Plantar Fasciitis: Will Physical Therapy Help My Foot Pain? J Orthop Sports Phys Ther. 2017 Feb;47(2):56. doi: 10.2519/jospt.2017.0501. PMID: 28142369.

Siriphorn A., Eksakulkla S. Calf stretching and plantar fascia-specific stretching for plantar fasciitis: A systematic review and meta-analysis. J. Bodyw. Mov. Ther. 2020;24:222–232. doi: 10.1016/j.jbmt.2020.06.013

Thomas A. Koc Jr, Christopher G. Bise, Christopher Neville, Dominic Carreira, Robroy L. Martin, and Christine M. McDonough. Heel Pain – Plantar Fasciitis: Revision 2023. Journal of Orthopaedic & Sports Physical Therapy 2023 53:12, CPG1-CPG39

Uden H, Boesch E, Kumar S. Plantar fasciitis – to jab or to support? A systematic review of the current best evidence. J Multidiscip Healthc. 2011(4):155-164.

Zhiyun L, Tao J, Zengwu S. Meta-analysis of high-energy extracorporeal shock wave therapy in recalcitrant plantar fasciitis. Swiss Med Wkly. 2013 Jul 7;143:w13825. doi: 10.4414/smw.2013.13825. PMID: 23832373.

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