Cause of plantar fasciitis is multifactorial, but can be caused by:

• Repetitive strain causing micro-tears of the plantar fascia.

• Pes planus (flat foot)

• Pes cavus (high arch foot)

• Limited ankle range of motion

• Prolonged standing or jumping,

• Biomechanical causes ex excessive pronation or supination.

• Obesity

• Sudden increase in activity (ex increased mileage in runners)

• Inflammatory conditions (Ex rheumatoid like condiitons)

• Heel pad atrophy

• Excessive barefoot walking

• Shoe gear

Common symptoms include

• Progressive pain at the bottom of the heel

• Pain is described as sharp and worse with the first few steps out of bed in the morning.

• Pain often decreases with activity or the beginning of an athletic activity but then increases throughout the day as activity increases.

Conservative Treatment

• “RICE” Rest, Ice, Compression, Elevation

• Reduction of activity levels.

• Oral medications

• Shoe gear changes/Orthotic/Supportive devices

• Night splint

• Immobilization

• Physical therapy

  • Stretching exercises (particularly at the ankle/foot)

  • Manual therapy, Graston, Dry needling

• Pain laser, extracorporeal shock wave therapy (ESWT)

• Injection Therapy , cortisone, biologic/amniotic, PRP

Surgical therapy is utilized for patients who fail conservative therapy.

• Plantar fasciotomy/ Endoscopic release

• Topaz or Tenax