Plantar Fasciitis: How Physical Therapy Can Help

Plantar fasciitis affects two million Americans each year. It is a common condition that causes foot and heel pain, affecting those of all ages, athletes and non-athletes, men and women. Physical therapy helps patients effectively manage and overcome plantar fasciitis, reduce pain, and restore walking ability. 

What is Plantar Fasciitis?

Plantar fasciitis is a foot condition that frequently develops due to repeated activities that strain the plantar fascia of the foot. Plantar fascia is a thick band of connective tissue located at the bottom of the foot, running from the bottom of the heel bone and connecting to the toes at the ball of the foot. Plantar fascia is an important part of the foot as it helps with shock absorption when walking and supports the arches of the foot while weight-bearing.

If tension or stress on the plantar fascia become too great, small tears can occur in the fascia; repeated stretching and tearing can irritate and inflame the fascia. Weakness or dysfunction of the muscles and tendons of the foot can increase the demand for stabilization on the plantar fascia, which can lead to heel pain. Dysfunction in the hip or leg muscles also changes gait and weight-bearing distribution which can negatively affect the planta fascia.

[Source: American Physical Therapy Association, Choose PT Blog, Accessed at https://bit.ly/choosept-plantar-fasciitis]

Symptoms of plantar fasciitis usually occur with a sudden increase in activity and include stabbing pain on the underside of the heel and a sensation of tightness and tenderness along the arch. Pain of the plantar fascia commonly takes place when stepping out of bed in the morning, standing for a long period of time, standing up after sitting for an extended period of time, after intense running or jumping, when climbing stairs, or when walking barefoot or in shoes with poor support. Pain can fluctuate throughout the day as the body warms up and worsen later in the day after activity.

Risk factors for Plantar Fasciitis:

• Stiff ankle joint, leading to abnormal movement in lower leg and arches of foot that strain plantar fascia

• High body weight that increases the force placed on the arches of the foot

• Flat feet, a high arch, or abnormal walking pattern that affects the way weight is distributed when standing

• Activities that place stress on the heel and attached tissues, such as long-distance running, athletics that involve jumping, ballet dancing, and aerobic dancing

• Those in jobs that require prolonged standing or walking on hard surfaces, such as retail workers, cashiers, police officers, and restaurant workers

Physical Therapy Treatment for Plantar Fasciitis

Physical therapy treatment for plantar fasciitis depends on the factors that are irritating the foot and causing pain. Research has shown that evidence-based physical therapy care for plantar fasciitis leads to recovery, fewer overall healthcare visits, and lower cost of care than other medical interventions. The American Physical Therapy Association (APTA) clinical guidelines recommend manual therapy and rehabilitative exercise as effective treatment for plantar fascia. The physical therapist initially completes an evaluation to assess the condition of the patient with plantar fasciitis; this includes palpitation of the heel area, arch of foot, and toward the toes; gentle stretching of the ankle, bending the top of the foot toward the leg and the toes toward the ankle; and a gait assessment.

 Physical therapy treatment for plantar fasciitis includes:

• Gait training to improve walking ability and weight distribution

• Stretching exercises to improve flexibility of ankle and plantar fascia

• Strengthening exercises to improve strength of supporting muscles, particularly muscles of the hip, knee, ankle, and foot

• Use of ice to decrease pain and inflammation

• Kinesiotaping for short-term pain relief

• Orthotics and supportive footwear to minimize abnormal foot motion, cushion the heel to absorb shock, and support the arch to reduce stress on the plantar fascia

• Dry needling of leg muscles to release trigger points in muscles that are causing pain and altering movement to address weight distribution on the foot

• Manual therapy: soft-tissue and joint mobilization exercises to improve pliability of the plantar fascia for improved weight-bearing and walking 

Plantar fasciitis is a common condition that contributes to foot and heel pain that physical therapy can effectively treat and reduce pain. Give us a call to set up an evaluation today and get back to your regular activities without persistent foot pain!