The Joint Ventures' Blog

Plantar Fasciitis - Dealing With Morning Pain

Monday, December 09, 2013

Have you ever gotten out of bed in the morning and noticed that you had to take quite a few steps before your foot stopped hurting?  Or feel pain in the heel, like you stepped on a rock?  You may have what is known as Plantar Fasciitis!

Plantar fasciitis is an inflammation of the plantar fascia, a thick band of tissue on the under surface of the foot.  The plantar fascia attaches at the tip of the heel bone (calcaneus) and onto each toe.  The most common description of plantar fasciitis is a “stabbing or sharp” pain in the heel or having increased difficulty when taking steps early in the morning.

What causes plantar fasciitis?  This condition may be caused by a few reasons, like frequent high heel /flat shoe use, running, or prolonged periods of standing (such as teachers, warehouse workers).  People that have faulty foot mechanics, like a flat foot (A.K.A. pronator or pes planus) or high arch (supinator-pes cavus) may also be susceptible to tightening of the plantar fascia.  Bone spurs may be created by the constant tension on the plantar fascia, causing greater symptoms, as bones have increased amount of nerve endings.

So, How do you treat plantar fascia?

One-on-One physical therapy is a great way to address plantar fascia and foot pain issues. Here at Joint Ventures, we use a variety of techniques, such as soft tissue mobilization, flexibility exercises -gastrocnemius/soleus/plantar fascia tissue, strengthening, ultrasound and balance/proprioception activities.  Biomechanics of the foot are also analyzed by a licensed physical therapist, possibly with the use of orthotic devices.  Use of splinting during the night time may also be beneficial in treating plantar fasciitis.  While we sleep, the foot is pointed downwards (plantarflexed), which shortens the tissue along the bottom of the foot.  When wearing a night splint, the foot is held in a neutral or dorsiflexed  (pulled back) position, with or without big toe extension, to keep the tissue on stretch.  There is a plethora of splints that can be purchased but one of the most common splints is called a Strassburg Sock (pictured on the Left).  Night splints can be very large and bulky, but depending on severity of symptoms felt in the foot and heel region, they may be a better option.

Another “Do it Yourself” technique to decrease plantar fascia symptoms is the use of a tennis ball.  By placing the tennis ball underneath the bottom of the foot and rolling around (with the amount of pressure you can tolerate), you are mobilizing the tissue and any restrictions that maybe present.   You can also use an ice bottle (freeze a plastic water bottle) the same way to massage the foot by rolling it back and forth.  By using the ice bottle, you are using two excellent techniques for tissue inflammation: massage and ice!

The best thing you can do once you begin to have this “nagging” pain in your heel or foot is to seek medical attention quickly so that other issues in the body (hip, knee, ankle) do not occur! This issue may subside on its own, but by addressing the issue you may be able to prevent future occurrences!

If you have any other questions about plantar fasciitis or foot pain, please contact me in out Kenmore Square Office at  If you would like to have someone do a Free Consultation at any of our Boston Physical Therapy or Wayland Physical Therapy Offices, please call us at 617 536 1161, ext 9. 

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