Understanding Plantar Fasciitis: Causes, Pain & Modern Treatment Options
What is Plantar Fasciitis?
Plantar fasciitis, often called “plantar heel pain”, is one of the most common causes of heel discomfort. The plantar fascia is a thick band of connective tissue that runs from your heel to your toes, supporting the arch and absorbing impact when you walk or run.
Although it sounds inflammatory (“-itis”), research now shows it’s often a degenerative or overload condition, involving small micro-tears and collagen changes. That’s why treatment focuses on improving tissue health, load tolerance, and mechanics, not just rest.
Common Causes and Contributing Factors
Plantar fasciitis typically develops from repetitive strain over time rather than a single injury.
Risk factors include:
- Overuse or sudden increase in activity (new workout, standing all day, long walks)
- Poor foot mechanics: flat feet, high arches, or limited ankle mobility
- Tight calves or weak foot muscles
- Improper footwear or worn-out shoes
- Higher body weight increasing heel load
- Prolonged standing or walking on hard surfaces
What Pain Feels Like
Sharp heel pain with first steps in the morning or after rest
- Pain that eases briefly with movement, then returns later in the day
- Tenderness near the inner heel
- Discomfort after long periods of standing or activity
Pain arises when the plantar fascia loses elasticity, causing micro-strain at its heel attachment.
Our Treatment Approach: Restoring Movement, Strength & Function
1. Early Stage: Reducing Load and Tissue Irritability
When you come for physical therapy in the early stages of plantar heel pain, we start with a focus on controlling irritation and allowing healing without total rest. Our goals are to reduce load, improve mobility, and stimulate gentle circulation to facilitate a reduction in pain and start the healing process.
We may use:
- Manual therapy and fascia-specific stretching for short-term pain relief
- Unloaded Total Gym work allows you to perform exercise at a reduced body weight to safely load the plantar fascia, calf, and foot muscles early in recovery without aggravating symptoms
- Targeted self mobilization techniques of the plantar fascia alongside strengthening the lower body chain in unloaded positions
- The AlterG Anti-Gravity Treadmill is a specialized machine that enables walking, jogging, and running at reduced body-weight percentages, promoting normal gait while decreasing strain on the fascia
- Vasopneumatic Compression Therapy is an intermittent air-pressure treatment provided to reduce swelling, improve circulation, and speed recovery
- Immobilization / Pressure Reduction by using a CAM boot for several weeks to allow time for your foot to cool off
We have additional cash-based services and modalities that may be offered to speed up the healing timeline:
- CureWave™ Cold Laser Therapy is available to stimulate tissue healing and circulation, and reducing inflammation of the injured tissue
- Dry Needling with Electrical Stimulation to relieve tension in the calf and foot muscles, improve blood flow, and decreases pain sensitivity
- Focused Shockwave Therapy (ESWT) for both acute and chronic or stubborn cases, which helps to break down scar tissue and triggers healing at the fascia attachment
2. Mid Stage: Building Strength and Tissue Tolerance
As pain improves, the focus shifts to progressive loading and restoring stability through the lower leg and foot.
This stage includes:
- Targeted strengthening of intrinsic foot muscles, calf complex, and hip stabilizers in more upright positions
- Eccentric and isometric exercises for tissue remodeling using a combination of unloaded and loaded exercises
- Balance and proprioceptive training to improve foot control needed for walking and running over uneven terrain
3. Later Stage: Return to Impact and Performance
Once baseline strength and mobility are restored, we guide patients through dynamic and sport-specific loading to ensure full, safe return to desired activities.
This includes:
- Dynamic Total Gym work – progressing to higher incline and resistance for controlled eccentric loading
- Targeted dynamic exercises such as single leg calf raises, hopping, lunging, and jumping progressions based on your specific goals
- AlterG treadmill for gradual reintroduction to walking, jogging, or running
- Functional movement retraining with a focus on mimicking job or sport demands
- Education on self-management for long term maintenance including footwear, pacing during walking or running, and a home program customized to your specific needs
- Footwear assessment and recommendations to ensure you are in the right shoes to avoid a return of symptoms
This phase is crucial for preventing recurrence and restoring full confidence in movement.
Typical Recovery Timeline
- 4–6 weeks for mild or early cases
- 8–12+ weeks for chronic or recurrent pain
Progress depends on duration, activity level, and tissue response. Your therapist will guide progression step-by-step, adjusting based on comfort and goals.
Key Takeaways
- Plantar fasciitis is common, treatable, and rarely permanent
- Addressing both pain relief and mechanical causes ensures lasting success
- Our clinic combines proven physical therapy techniques with advanced technology for faster recovery: • AlterG Anti-Gravity Treadmill
- CureWave Cold Laser
- Focused Shockwave Therapy
- Dry Needling + E-Stim
- Vasopneumatic Compression
- Unloaded Total Gym Training
