Guide | Physical Therapy Guide to Plantar Fasciitis | Choose PT
Symptoms of plantar fasciitis often appear 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.
In the morning, when stepping out of bed and taking the first steps of the day.
When standing for a long time.
When standing up after sitting for a long time.
After intense activity such as running or jumping.
When walking barefoot or in shoes with poor support.
Your pain can fluctuate during the day, with pain improving as your body warms up and worsening later in the day after activity. As the condition gets worse, you may begin to limp.
The physical therapist's diagnosis is based on your health and activity history, and on a clinical evaluation. Your physical therapist also will take a medical history to make sure that you do not have other conditions that may be causing your pain. Sharing information about your work and recreation, and reporting any lifestyle changes will help your physical therapist diagnose your condition and tailor a treatment program for your specific needs.
To diagnose plantar fasciitis, your physical therapist may conduct the following physical tests to see if symptoms occur:
Massaging and pressing (palpation) on the heel area, arch of the foot, toward the toes.
Gently stretching the ankle to bend the top of the foot toward the leg (dorsiflexion).
Gently pressing the toes toward the ankle.
Assessment of your gait (how you walk) and how this may impact your symptoms.
Stretching exercises to improve the flexibility of your ankle and the plantar fascia.
Strengthening exercises to improve the strength of supporting muscles.
Application of ice to decrease pain and inflammation.
Iontophoresis (a gentle way to deliver medication through the skin).
Taping of the foot for short-term relief.
Orthotics (shoe inserts) and supportive footwear to minimize abnormal foot motion, or to help support your arch, reducing stress to the plantar fascia.
A night splint to help you maintain correct ankle and toe positions while sleeping.
Gait training to help lessen symptoms and improve your walking ability.
Research shows that most cases of plantar fasciitis improve over time with these conservative treatments, and surgery is rarely needed.
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 of standing or walking.
Decreased calf muscle flexibility.
Increased body weight (Body Mass Index greater than 30).
Wearing shoes such as high heels, or those with inadequate arch support.
Choosing shoes with proper arch support and heel height.
Replacing your shoes regularly, before they wear out.
Using a thick mat if you must stand in one place for much of the day.
Adjusting your exercise program to include a warmup and a gradual buildup, to avoid straining the plantar fascia.
Stretching your calves and feet before and after running or walking.
Your physical therapist will design an individualized treatment program to help heal your plantar fasciitis and prevent future injury.
All physical therapists are prepared through education and experience to treat plantar fasciitis. However, you may want to consider:
A physical therapist who is experienced in treating people with orthopedic and sports injuries, particularly those with experience working with the ankle and foot.
A physical therapist who is a board-certified clinical specialist or who completed a residency or fellowship in orthopedic or sports physical therapy, meaning that this physical therapist has advanced knowledge, experience, and skills that may apply to your condition.
Search the internet to find reviews on local clinics and provider backgrounds.
Contact a physical therapy clinic and ask about the physical therapists' experience in helping people who have heel pain.
Be prepared to describe your symptoms in as much detail as possible, including when symptoms started, what makes your symptoms worse, and what makes them better.
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PT, PhD, board-certified specialist in orthopaedic physical therapy