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Plantar Fasciitis


Also known as “heel pain syndrome," plantar fasciitis is the most common cause of heel pain,

resulting from a gradual degeneration of the plantar fascia or sudden trauma to the area. Patients may describe the sensation as a sharp stab or deep ache in the middle of the heel or along the arch, that typically occurs during walking or standing. Often, pain occurs early in the morning, when patients are taking their first few steps out of bed, or after other long periods of sitting/lying down/non-activity. As the foot naturally tightens at night, the fascia may gain new tears in the morning, initiating a painful cycle. Appearing in one heel or both, the condition tends to be chronic and can be difficult to heal without a combination of aggressive, conservative treatments and total patient compliance.


The plantar fascia is the connective tissue that runs from the calcaneal tubercle (heel), to the base of the toes, with five slips of tissue that form a bridge to each toe. Conditions like calcaneal fat pad atrophy, calcaneal stress fracture, nerve entrapment, and rheumatoid arthritis can exist alongside plantar fasciitis and may also cause pain.


Improper footwear, strenuous activity, even obesity can bring on plantar fasciitis. Over - pronation, high arches or flat feet, and  poor shock absorption in shoes can also put excessive stress on the foot’s soft tissues. Plantar fasciitis is commonly seen in middle- aged patients, but the young can be affected as well. We see it often in those who place a great deal of stress on their feet – such as runners, athletes and soldiers.


Plantar fasciitis affects approximately 2 million people in the United States annually.


In the office:

  • Therapeutic Manipulation to restore normal joint mechanics & reduce tension.
  • Progressive resistance exercises.
  • Functional  Orthotics for  pain  reduction and to position  the  foot  for  healing.  Use  in  all shoes  for best results.



At home:

  • At first sign of soreness, patients should apply ice and massage the area, perhaps by rolling a Foot Levelers’ Foot Wheel beneath afflicted foot. The Foot Wheel is recommended, but a golf ball will also work.
  • Advise running on soft surfaces, stretching of area before activity.



Stretching before activity, maintaining a healthy weight, and wearing supportive footwear all help with prevention. Functional Orthotics are recommended to keep the foot in proper alignment and reduce stress on the plantar fascia.



Recovery can be slow, with 90% of patients recovering in 6 to 9 months. A combination of therapies as described above is the most effective approach.