Plantar fasciitis: One of the most common causes of foot pain
Friday, September 20, 2019

Plantar fasciitis affects nearly 2 million people in the United States alone, and it doesn’t discriminate. The condition, which produces pain on the bottom of the foot, plagues athletes and non-athletes alike.

Plantar fasciitis is inflammation of the tissue spanning the bottom of the foot supporting the arch and connecting the heel to the toes.

“Most often, it’s due to a muscular imbalance occurring in the lower leg muscles and tightness in the heel cord,” said Jill Goodwin, PT, MSPT, physical therapy director for OrthoCincy Orthopaedics & Sports Medicine. “It’s the result of foot and ankle mechanics that aren’t working properly or not wearing good enough shoes to support your feet.”

Avid runners and walkers can experience plantar fasciitis, but it can also affect people who spend a lot of time on their feet, in professions such as waiting tables, working an assembly line or teaching.

Active individuals can overstress the tissue in the foot, causing the inflammation, and inactive individuals can bring the symptoms on after a long day on their feet without proper support.

It is also not uncommon for growing and developing adolescents to experience the symptoms of plantar fasciitis. In the case of kids who have growth spurts, the bones grow and stretch the muscles and soft tissue, creating a temporary imbalance in the biomechanics of budding athletes.

Causes and symptoms

Improper alignment and movement of the foot is typically what causes the symptoms of plantar fasciitis.

While plantar fasciitis can affect individuals of all ages, lifestyles types and genders, it is somewhat more common as people age. As the ligaments in the foot stretch out, the bone structure of the foot can widen, weakening the arch and causing more pressure by pushing down on the tissue along the bottom of the foot.

All cases of plantar fasciitis are different, but most often, people experience:
•Pain on the bottom of the foot from the heel to the ball of the foot
•Increased pain with walking after periods of sleep or inactivity
•More discomfort after exercise, not during activity


Physical therapy is an effective treatment for plantar fasciitis. With a combination of stretching, strengthening and training for proper movement, the body can heal from plantar fasciitis.

Other effective treatments include:
•Soft tissue mobilization, or a form of massage to release the inflamed tissue
•Dry needling, a technique to use needles inserted into the tissue to release the tension in the muscles
•Anti-inflammatory medicines

“Sometimes, we’ll use orthotics or foot support to control the biomechanics of the foot,” Goodwin said. “It takes stress off the tissue and lets it heal, while we are correcting the muscle imbalances that need to be fixed.”

For individuals who experience greater pain after periods of inactivity, like first thing in the morning, Goodwin suggests “ankle pumps.” This technique involves stretching the foot back and forth to soften and loosen the tissue, so the first step isn’t as uncomfortable.

“Plantar fasciitis can be very painful early in the morning,” Goodwin said. “Inflammation builds up during the day and stays there overnight, causing the tissue to draw up really tight.”

Being seen by a physical therapist at the first signs of plantar fasciitis is the first step to experiencing a pain-free, active lifestyle again.

“We can do a lot of good things for people with plantar fasciitis,” Goodwin said. In addition to the therapy, a physical therapist can provide insights into changes in lifestyle that can improve symptoms, including assessing proper footwear for the runner, weekend hiker or assembly line worker.