Plantar Fascitis or heel pain is a rather common complaint with an estimated 10% experiencing this condition at some point during their life. Most often it is caused by repetitive stress or micro-trauma to the tissues that builds to the point where the body can no longer regenerate itself fast enough and thus pain begins. Often, pain begins near the heel, but as it progresses, may move into your arch.

This condition has long been viewed as an inflammatory process, however, as the time from onset lengthens in the presence of pain, the inflammatory state goes away and the individual is left with what is called fasciosis or an altered and weakened state of the fascia or tissue. It is this condition that results in chronic pain and commonly presents to our physical therapy clinic. I am sure most of you have heard or read about this condition and likely know someone who has dealt with or is currently dealing with this issue.

One of the greatest complaints with plantar fasciitis is “heel” pain first thing in the morning. However, after the individual is up and moving for a few minutes, the pain begins to subside. A similar complaint is likely to occur after sitting for an extended period of time. This phenomenon occurs because as you sleep or are off your feet, the plantar fascia goes into a relaxed state and becomes relatively “tight.” Immediately upon standing, the plantar fascia is rapidly stretched, pulling on the painful spot, thus reproducing pain.

If one is suffering from this condition, good treatment options are available to you. A comprehensive physical therapy exam can help to determine the root cause of the issue and develop a plan to get you walking again without pain. Therapy sessions are likely to include a mix of hands on interventions, exercise, stretching and possibly modalities such as ultrasound. Current evidence suggests a multi-modal treatment approach to plantar fasciitis is best. Other treatment options may include night splints to keep the arch stretched to reduce that initial morning weight bearing pain, orthotics (off-the-self or custom) and potentially injections from your doctor or podiatrist.

Waiting to seek treatment for such a condition will only lead to frustration and a lengthier recovery process. See your physical therapist soon, and get back to walking and activity comfortably again faster.