Self Help Series: Plantar Fasciitis

Self Help Series: Plantar Fasciitis

Self Help Series:  Plantar Fasciitis

By:  Dr. Anna Staehli Wiser, DPT, FAAOMPT

The term plantar fasciitis is synonymous with debilitating pain at the instep of the foot and heel.  The plantar fascia (PF) is a band of thick fibrous connective tissue that supports the longitudinal arch of the foot.  It attaches to the medial calcaneal tubercle on the bottom of the heel.  When the connective tissue becomes stressed beyond it’s limits due to aggressive activity such as running, jumping, or prolonged standing, the fibers can become torn.  Over-stress to the tissue can also occur due to inadequate foot structure or faulty mechanics of the foot and ankle joints.  PF tears usually occur right at the attachment point (enthesis) at the medial calcaneal tubercle.  This is why most people experience so much pain in the heel.  Pain is usually worse with initial standing in the morning, or after periods of inactivity.  Pain also can intensify with any prolonged standing activity.  


This debilitating foot injury is very common, and there are over a million physician visits each year due to plantar fasciitis 1.  Women between the ages of 45 and 64 are affected the most.  Also, those people with flat feet (planus), or high arched feet (cavus) are more at risk for developing this condition1.  

Current literature supports the use of foot orthotics2, taping3, stretching exercises4, strengthening exercises5,  manual therapy6, and electrical dry needling7 in the treatment of plantar fasciitis.

What you can do right now on your own to start managing plantar fasciitis pain:

  • Proper footwear: Start by purchasing a high quality pair of motion control sneakers with foot orthotics to keep your foot in a neutral position and prevent over-pronation of the foot and over-stretching of the plantar fascia.  

  • Tape: There are several techniques for taping your own foot to support the arch.  The video link below includes a tutorial on foot taping. 

  • Calf stretching: Many foot problems are partly caused by tightness in the calf, primarily the gastrocnemius and soleus muscles.  These muscles are very important for stability and forward propulsion during ambulation.  Because they are so thick and strong, the muscles tend to become shortened, which can eventually lead to restricted ankle mobility.  When the ankle does not move properly, forces will be transferred through the ankle and into the midfoot which results in injury to the midfoot over time. 

  • Foot strengthening:  Key muscles that support the arch of the foot are the tibialis anterior and posterior, peroneus longus, abductor hallucis, and quadratus plantae.  Placing your foot in a neutral position and then isometrically holding it there when standing is a good way to strengthen those muscles. 

What can Osteopractic Physical Therapy do to help?

A thorough evaluation of the injured area as well as the knee, hip, pelvis, and lumbar spine will be performed first.   Any structural issues, impairments of strength, flexibility, or joint mobility will be identified.  A comprehensive evaluation is essential to guide the treatment.  

Any dysfunctions in the lumbar spine may be treated first order.  Pain in the extremities is modulated through the spine, and therefore, reducing spine pain will also serve to reduce pain in the limbs.  This is one of the foundational principles of chiropractic care and why chiropractic manipulation is proven to be an effective pain relieving tool8.  Although Osteopractic physical therapists are not chiropractors, they are well trained in spinal manipulative therapy. 

Any other joint restrictions at the hip, knee, ankle, or foot will also be addressed with peripheral joint manipulation techniques.  It is quite common to see joint restrictions at the ankle and hind foot.   

Joint manipulation  is then followed by soft tissue treatment.  Any areas of of tenderness or poor flexibility will be addressed with various massage techniques.  Different techniques may include trigger point release, body tempering (the use of a heavy weighted cylinder to compress and stretch the tissue), and instrument assisted soft tissue massage (scraping and cupping).  

Electrical Dry needling would also be utilized if possible, as this modality has been proven to be extremely effective in the the treatment of PF7. Dry needling is the use of acupuncture needles inserted into areas of tissue dysfunction.  The needle can penetrate into areas where fingers tips cannot reach, such as the tissue enthesis of the plantar fascia at the medial calcaneal tubercle.  The penetration of a thin needle into the deep tissue layers where the heart of the injury lies serves to stimulate blood flow and facilitate the healing process in a way that no other modality is capable of doing.  The use of acupuncture needles is a treatment approach proven to be extremely effective in injury management.  Although Osteopractors are not acupuncturists, they are well trained in the use of acupuncture needles to treat injuries of the muscles, tendons, ligaments, joints, and nerves. 

Lastly, a well-designed home exercise program along with education regarding self treatment strategies is key to long term success with this injury.  Understanding the importance of proper footwear along with active rest and proper exercise is usually the catalyst to full recovery from plantar fasciitis. 

In summary, the most effective treatments for any injury include chiropractic care, acupuncture, massage therapy, and physical therapy.  The goal of osteopractic physical therapy is to eliminate the need for the consumer to require several different practitioners when they can get all of their needs met in one location.  


If you or someone you know is suffering with plantar fasciitis, fear not.  Successful, treatment is only a phone call away. 



1. Thompson JV, Saini SS, Reb CW, Daniel JN. Diagnosis and management of plantar      fasciitis.  J Am Osteopath Assoc. 2014;114(12):900-906. doi:10.7556/jaoa.2014.177


2. Yucel U, Kucuksen S, Cingoz HT, et al. Full-length silicone insoles versus ultrasound-guided corticosteroid injection in the management of plantar fasciitis: a randomized clinical trial. Prosthet Orthot Int. 2013;37(6):471-476. doi:10.1177/0309364613478328

3. Podolsky R, Kalichman L. Taping for plantar fasciitis. J Back Musculoskelet Rehabil. 2015;28(1):1-6. doi:10.3233/BMR-140485

4. Siriphorn A, Eksakulkla S. Calf stretching and plantar fascia-specific stretching for plantar fasciitis: A systematic review and meta-analysis. J Bodyw Mov Ther. 2020;24(4):222-232. doi:10.1016/j.jbmt.2020.06.013

5. Huffer D, Hing W, Newton R, Clair M. Strength training for plantar fasciitis and the intrinsic foot musculature: A systematic review. Phys Ther Sport. 2017;24:44-52. doi:10.1016/j.ptsp.2016.08.008

6. Mischke JJ, Jayaseelan DJ, Sault JD, Emerson Kavchak AJ. The symptomatic and functional effects of manual physical therapy on plantar heel pain: a systematic review. J Man Manip Ther. 2017;25(1):3-10. doi:10.1080/10669817.2015.1106818

7. Dunning J, Butts R, Henry N, et al. Electrical dry needling as an adjunct to exercise, manual therapy and ultrasound for plantar fasciitis: A multi-center randomized clinical trial. PLoS One. 2018;13(10):e0205405. doi:10.1371/journal.pone.0205405

8. Gevers-Montoro C, Provencher B, Descarreaux M, Ortega de Mues A, Piché M. Clinical Effectiveness and Efficacy of Chiropractic Spinal Manipulation for Spine Pain. Front Pain Res (Lausanne). 2021;2:765921. doi:10.3389/fpain.2021.765921