Dr. McCauley April 2014
Physical Therapist's Guide to Plantar Fasciitis
Plantar fasciitis is a condition causing heel pain. Supporting the arch, the plantar fascia, a thick band of tissue connecting the heel to the ball of the foot, can become inflamed or can tear. You experience pain when you put weight on your foot—particularly when taking your first steps in the morning. The pain can be felt at the heel, or along the arch and the ball of the foot.
Plantar fasciitis is a common foot condition. It occurs in as many as 2 million Americans per year and 10% of the population over their lifetimes.
Factors that contribute to the development of plantar fasciitis include:
Age (over 40 years)
A job, sport, or hobby that involves prolonged standing or other weight-bearing activity
Rapid increases in length or levels of activity, such as beginning a new running program or changing to a job that requires a lot more standing or walking than you are accustomed to
Decreased calf muscle flexibility
Increased body weight (Body Mass Index greater than 30)
Tendency to have a flat foot (pronation)
Plantar fasciitis affects people of all ages, both athletes and non-athletes. Men and women have an equal chance of developing the condition.
Signs and Symptoms
The onset of symptoms of plantar fasciitis frequently occurs with a sudden increase in activity. You might feel a stabbing pain on the underside of your heel, and a sensation of tightness and/or tenderness along your arch.
People with plantar fasciitis may experience pain:
In the morning, when stepping out of bed and taking the first steps of the day
With prolonged standing
When standing up after sitting for awhile
After an intense weight-bearing activity such as running
When climbing stairs
When walking barefoot or in shoes with poor support
How Can a Physical Therapist Help?
Physical therapists are trained to evaluate and treat plantar fasciitis.
When you are diagnosed with plantar fasciitis, your physical therapist will work with you to develop a program to decrease your symptoms that may include:
Stretching exercises to improve the flexibility of your ankle and the plantar fascia
Use of a night splint to maintain correct ankle and toe positions
Selection of supportive footwear and/or shoe inserts that minimize foot pronation and reduce stress to the plantar fascia
Application of ice to decrease pain and inflammation
Iontophoresis (a gentle way to deliver medication through the skin)
Taping of the foot to provide short-term relief