Intro: What is Plantar Fasciitis?
Plantar fasciitis is an inflammation of the thick fascia at the bottom of your foot that runs from the base of the toes back to the heel.
Plantar fasciitis is a common foot injury and it builds up over time. It occurs in about 2 million Americans per year and 10% of the population over their lifetimes.
It’s there to absorb shock when you weight bear through the foot for standing, walking, running, dancing, etc. But over time, if it’s overused, has poor support, or too much weight bears through it there can be small tears that develop leading to inflammation. This can irritate the fascia!
Symptoms of Plantar Fasciitis
When inflamed, this can cause symptoms like:
Stabbing pain at the heel
Tightness along the arch or bottom of foot
Pain that is worse first thing in the morning
Pain going up and down stairs
Common Causes of Plantar Fasciitis
This injury is common in people who are on their feet a lot throughout the day, runners, athletes, older individuals (over 40), and also people who are overweight. It’s especially more prominent when poor shoes are worn often that don’t provide heel or arch support (i.e. sandals, heels, flat tennis shoes). Good shoes are especially necessary for people who have flat feet or a high arch which can cause abnormal weight bearing and walking patterns.
Another cause of this can be a bone spur near the heel. This is something I had quite a few patients struggle with. Some improved with PT whereas some required surgery to shave down that bone spur. I recall one patient in particular was a frequent volleyball player so he was doing a lot of jumping on sand and landing without shoes on. His heel bone spur grew and grew over the years to the point it was so large he had to have surgery. But he recovered quickly and was able to return to the sport he loved.
Testing for Plantar Fasciitis
It’s pretty clear upon palpation (feeling the plantar fascia) if you have this injury. Press down into the bottom of the heel and then up toward the toes. You’ll have a sharb, stabbing pain and tight feeling if it’s inflamed.
Consult with your Doctor who may order an Xray to determine if there is a bone spur or MRI to determine the extent of damage to the fascia. Most of the time, PT will be ordered first. In addition, a night splint may need to be worn at night, you may have to reduce the physical activity causing it, and you may even need to get better shoes or orthotics. A night splint is essentially a contraption that holds the ankle in dorsiflexion (foot flexed toward you) for a prolonged achilles and fascia stretch all night while you’re sleeping. Consult your doctor and therapist on the best treatment for you.
Most of the time, plantar fasciitis issues can be resolved with Physical therapy alone. However if conservative treatment does not resolve it, the next step is to get imaging done to determine if there is more going on like a tendinopathy, tear, fracture, etc..
Physical therapy for it is hugely successful for most people within 6 months to help with mobilizing the fascia and muscles, strengthening the weakened muscles, and lengthening the restrictions.
If conservative treatment doesn’t help, other potential treatments include injections, ultrasound, or surgery.
Conservative Treatment for Plantar Fasciitis
Disclaimer: The information provided is not intended to be a substitute for professional medical advice, diagnosis or treatment. Never disregard professional medical advice, or delay in seeking it, because of something you have read on this website. Never rely on information on this website in place of seeking professional medical advice.
Treatments for Plantar fasciitis (from basic to advanced):
Reduce the activity (or prolonged weight bearing) that may be aggravating it
Joint mobilization of the ankle (level depends on stage of injury & restrictions)
Range of motion exercise (within a pain-free range)
Stretching especially of the calves & arch of foot (plus contract-relax technique)
Strengthening exercise (including isometrics and neuromuscular stimulation) to load the ligaments and muscles progressively
Cardio (to help vascularization or bring blood flow to the area for healing)
Functional exercise (form training for unilateral exercises especially)
Manual/Massage: soft tissue massage (especially of the plantar fascia, calves, and feet)
Modalities: Ice
Below are some Amazon links to foot pain related products that may be helpful:
Physical Therapy Exercises for Plantar Fasciitis
I’ve got three general ANKLE exercise videos that are helpful at teaching you the most important ankle exercises.
Before I share those, I did make one video specific to plantar fasciitis and mobility+stretching for the big toe region. Watch this one first.
Watch the video below for some of the best Mobility exercise ideas for plantar fasciitis.
Watch the video below for some of the best Strengthening exercise ideas for plantar fasciitis.
Watch the video below for some of the best balance exercise ideas for plantar fasciitis.
Mission: Mobilize, Modify, Move
It’s my goal to ensure you learn three things with every blog post: how to mobilize your body, how to modify exercise, and how to optimize your movement.
Above I shared a video for foot mobility and strengthening exercises.
Now, let’s cover some ideas for how to modify exercise if you have foot pain:
Do bilateral exercises so your other leg can help out more
Focus more on upper body and core exercises while the foot heals
Do more open chain lower body exercises (think leg extensions and leg curls) so you don’t have to press through the foot as much now
Finally, here are some day-to-day changes you can make to optimize your movement:
Before stepping foot out of bed each morning, do some foot and ankle stretches to warm them up
Get orthotics and wear supportive shoes more often
I hope you get feeling better soon!
Want 1-on-1 coaching from a Physical therapist and online trainer who can write you workouts around your injury? That way you can train despite your pain and retain your identity in the sport and your strength? Checkout 1-on-1 VIP coaching with me here!
Thanks for reading!
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