what is plantar fasciitis

What is Plantar Fasciitis Physical Therapy?

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Medically reviewed by Misty Seidenburg

What is Plantar Fasciitis? One in ten people experience persistent foot pain due to plantar fasciitis. Also referred to as plantar heel pain, this shooting or stabbing sensation can make it difficult to walk or stand for even short periods of time. Without intervention, plantar fasciitis symptoms can become chronic, lasting up to a year or more.

However, there is good news for the estimated 2 million Americans living with plantar heel pain (PHP.) Research shows that physical therapy can help reduce pain and improve walking for individuals with plantar fasciitis. This is what you can expect from treatment.

What Is Plantar Fasciitis?

The plantar fascia ligament is a thick, fibrous band of tissue that runs along the bottom of each foot, connecting the heel bones to the toes. It helps to support the arch of the foot and provides shock absorption. It also plays a role in normal foot mechanics during walking and other movements.

Repeated or prolonged stress or tension on the plantar fascia can cause irritation, inflammation, and pain. Pain typically occurs at the bottom of the foot near the heel, and is typically more noticeable with the first few steps after waking up, or after long periods of sitting or standing.

What Causes Plantar Fasciitis?

Although plantar fasciitis is quite common, the causes are not entirely understood. It is generally considered an overuse injury caused by repetitive strain resulting in micro-tears of the ligament.

There are several risk factors for plantar fascia pain. Some are anatomical, while others have more to do with a person’s job or lifestyle.

Plantar fasciitis risk factors include:

  • Age (most common among people ages 40-60)
  • Certain foot mechanics including a high arch or flat feet
  • Elevated BMI (particularly among non-athletes)
  • High-impact activities like running, dance, and basketball
  • Improper shoe fit / poor arch support
  • Standing for long periods of time, especially on hard surfaces

It is possible to develop plantar fasciitis without a known cause. The good news is treatment with physical therapy is often highly-effective regardless of how or why you have heel pain.

Diagnosing Plantar Fasciitis

If you have the telltale signs of plantar fasciitis with no other underlying injury, you are a probably good candidate for physical therapy.

The process begins with an initial evaluation where the physical therapist reviews your health history to rule out other conditions that may be contributing to foot pain. They ask about your daily activities to identify habits and tasks that may exacerbate tension and stress on the plantar fascia.

From there, your physical therapist conducts tests to determine which movements trigger your pain. They may gently press the toes toward the ankle and massage and press on the heel to see if that is painful. They also assess your gait to see if how you walk is affecting your symptoms.

Your Plantar Fasciitis Physical Therapy Journey

Physical therapy for plantar fasciitis involves a multi-faceted approach to treating symptoms. Each treatment plan is unique and customized to your specific needs. Your physical therapy program might include:

  • Dry needling to release tight bands of muscle (trigger points) causing foot pain
  • Exercise to strengthen the muscles that support the foot and ankle
  • Gait training helps reduce the load on the plantar fascia during walking
  • Night splinting for maintaining proper toe and ankle positioning when sleeping
  • Orthotics prescribed to cushion the heel and support the arch of the foot
  • Soft tissue and joint mobilization breaks up adhesions and improves blood flow to the area
  • Stretching to improve flexibility in the ankle and plantar fascia

Unlike many other conditions treated with physical therapy, relief for plantar fasciitis is typically not immediate. It can take several weeks or months to experience noticeable improvement.

However, the techniques you learn in physical therapy can benefit you for a lifetime. If you follow the exercise and stretching program prescribed by your therapist along with simple lifestyle modifications, you can avoid painful plantar fasciitis flare-ups in the future.

Podiatrist or Physical Therapist for ?

You have several options for providers to see for PHP. Podiatrists are doctors of podiatric medicine who are licensed and trained to provide surgical and medicinal treatments for foot and ankle conditions.

They treat numerous conditions including broken bones, infections, growths, and cuts, cracks, and discolored or thickened nails. Podiatrists diagnose and treat these issues, and they also prescribe medication and perform surgery.

Physical therapists concentrate on correcting impairments causing heel symptoms using rehabilitative exercises and treatments. It’s common for podiatrists to refer patients to physical therapists for plantar fasciitis and other musculoskeletal conditions.

One study of participants diagnosed with plantar heel pain found that patients who completed treatment with both types of providers had better secondary outcomes than patients who only received treatment from a . Ideally, a healthcare collaboration between both providers can lead to the best outcome.

If you choose to see your physical therapist first, in a state that has direct access, know that your physical therapist will recommend podiatric care if they suspect an underlying condition that is beyond their scope and training to diagnose and treat.

You don’t have to wake up to stabbing heel pain every morning. Relief from plantar fasciitis symptoms is possible with movement therapy. Find a physical therapy clinic near you to take the first “step” on your plantar fasciitis treatment journey today.

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Medically reviewed by

Misty Seidenburg

Vice President of Clinical Programs

Dr. Misty Seidenburg has been a practicing physical therapist since 2006 after obtaining her Doctor of Physical Therapy Degree from Gannon University. Dr. Seidenburg completed an Orthopedic Residency in 2009 and subsequent Spine Fellowship in 2010 where she discovered a passion for educating clinicians. Since 2019, she has developed and refined several post-professional residency and fellowship programs and currently serves as the Vice President of Clinical Programs for Upstream Rehab Institute. She serves on several APTA committees to help advance the profession, is adjunct faculty at Messiah University, and is also a senior instructor and course developer for the Institute of Advanced Musculoskeletal Treatments with a special interest in exercise integration. Outside of work, she enjoys challenging herself with new adventures and is currently competing as an endurance athlete.

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