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Don’t Just Stretch for Plantar Fasciitis!

a person holding a heal in pain
Plantar fasciitis is a common orthopedic condition that affects over 1 million people a year in the United States. More than 90% of patients with plantar fasciitis fully recover without requiring surgery. Often, patients are given recommendations to take anti-inflammatories, wear shoes at all times, perform stretching exercises for the plantar fascia, great toe and calf musculature.  Depending on the patient, they may also receive custom orthotics or over-the-counter soft inserts to put in their shoes to minimize the stress on the planter fascia.

What are the symptoms of plantar fasciitis?

Plantar fasciitis commonly causes a stabbing pain in the bottom of the foot near the ankle when the first steps of the day are taken. As you move, the pain will typically decrease, but may return after long periods of standing or rising after sitting.  Persons with plantar fasciitis will experience pain after exercising.

Who is at risk for plantar fasciitis?

Those with an increased risk of plantar fasciitis are usually runners or individuals who are overweight. Another risk factor is inadequate shoe support.

The anatomy and function of the plantar fascia

The plantar fascia is the thick connective tissue (called the aponeurosis), which supports the arch on the bottom (plantarside) of the foot.  This tissue runs from the heel bone to the metatarsal bones (the bone between each toe and the bones of the mid-foot).

Treatment of plantar fasciitis

The main intervention when treating patients with plantar fasciitis is stretching the plantar fascia, great toe and calf musculature.  Other interventions include foam-rolling techniques for the plantar fascia and calf musculature or direct massage to these areas. In some cases, there is limited relief from these interventions.  Often the root cause of this condition emanates from poor strength in the small muscles that make up the foot or limitations in calf, gluteal, and hip strength.

In addition to strength deficits contributing to plantar fasciitis, a patient’s other conditions may be causing heel pain.  In conservative care and time don’t resolve symptoms, you may be experiencing a compression of the small lateral plantar nerve, referral of pain originating from the lumbar spine in the S1 nerve distribution, atrophy of the fat pad and possible tarsal tunnel syndrome. 

When in doubt, seek a thorough physical therapy evaluation so you can direct the proper treatment to the problem area. If you are not seeing results, it may the approach to treatment or an entirely different condition.

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Tom Willemann

Tom Willemann

Tom Willemann is a premier physical therapist based out of Bergen County, New Jersey. He holds an MS in physical therapy from the University of Miami, is credentialed in the world-renowned McKenzie Method of Mechanical Diagnosis and Therapy (MDT), and holds an OCS (Orthopedic Clinical Specialist) certification. As of 2018, there are approximately 14,000 ABPTS certified specialists in the nation and less than 400 of them are located in the state of New Jersey. Tom is the owner and director of Apex Orthopedic Rehabilitation in Paramus. He opened the clinic, which specializes in spine and sports injury prevention, in 2004 after many years of experience in the field. Tom’s caring interest in others and his strong belief in continuity of care, combined with his clinic’s ability to find solutions for the most difficult orthopedic problems, have earned Apex Orthopedic Rehabilitation its excellent reputation with patients and medical professionals in northeastern New Jersey and beyond. A true “family man,” Tom takes pride in his clinic’s warm and welcoming environment.
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