Plantar Fasciitis Treatments - Pursuit Physical Therapy
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PLANTAR FASCIITIS

Are you not able to continue your cherished hobbies or everyday activities because of sharp pain in your foot or ankle when you move? With our expert doctors’ help, you can get to the root of your symptoms and get back to doing what you love quicker and easier.

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Best Orlando Treatment for a

PLANTAR FASCIITIS

Are you not able to continue your cherished hobbies or everyday activities because of sharp pain in your foot or ankle when you move? With our expert doctors’ help, you can get to the root of your symptoms and get back to doing what you love quicker and easier.

Read More Ask A Question

Here Is Everything You Need To Know About Plantar Fasciitis, What Causes It, and The Best Way to Treat It

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What is plantar fasciitis?

Plantar fasciitis is an inflammation in the tissue that connects the heel to the toes. This tissue is a ligament called the plantar fascia. The plantar fascia supports the arch of the foot and is integral to standing and walking. Development of plantar fasciitis can make walking, running, or even just standing painful and difficult.

What are common causes of plantar fasciitis?

Plantar fasciitis can affect both feet or just one foot. Plantar fasciitis develops when the ligament is overstrained and develops small tears. These tears are painful, and may cause the ligament to swell, putting pressure on the foot.

Most people that develop plantar fasciitis are middle aged, as repetitive strain can bring about the condition. However, jobs that require intense strain on the plantar fascia may cause the condition to develop in younger patients. Professional athletes, service industry workers, and soldiers are at high risk for plantar fasciitis.

Other risk factors that put patients at a higher risk for developing plantar fasciitis include:

  • Being overweight
  • Having flat feet or high arches
  • Being between the age of 40 and 60
  • Doing exercises that put excess strain on the arch of the foot, such as ballet
  • Wearing improperly fitting shoes
  • Wearing shoes with poor arch support

Where does it hurt?

In most cases of plantar fasciitis, patients will complain of pain right on the bottom of the heel. To be specific, it will be right at the medial calcaneal tubercle where the plantar fascia connects to the heel. Other people with complaints of “plantar fasciitis” will have general heel and foot pain due to other causes. This is what makes plantar fasciitis a complex case and there are many different causes of heel and foot pain. Even your low back can cause heel pain. Because of this, it’s possible to feel the pain in other parts of your body. This is called referred pain. Understanding the root cause of your pain is fundamental to treating your pain in the long run & will decrease your dependence on painkillers or treatment that only addresses the symptoms.

What are common symptoms of plantar fasciitis?

Sharp pain in the bottom of the heel of the foot is the most common symptom of plantar fasciitis. Plantar fasciitis stiffness and pain is often felt when the patient takes the first steps in the morning, but may worsen as strain is put on the foot and as the day persists. Plantar fasciitis pain may also increase immediately after running, climbing stairs, or exercising the foot or legs. Pain in the foot that does not match these symptoms may be indicative of other conditions.

Learn how to get rid of your foot & ankle pain

Sign up for our free webinar when we break down 3 actual patient cases and show you, exactly, how we got them pain free.

We’ll show you:

  • The most common cases of foot & ankle pain
  • How some foot & ankle pain can be commonly misdiagnosed
  • How to tell what type of foot & ankle pain you have
  • Self treatment that you can try at home

Can plantar fasciitis be treated?

Yes, plantar fasciitis pain can be treated and with great results. Even better, many times it can be treated conservatively without needing injections, pain medications, or surgeries if you can address it early enough. The key to treatment is to solve the root cause of your pain so you can get the best results and a long term outcome.

Some root causes of plantar fasciitis pain can be:

  • Decreased hip and knee range of motion
  • Poor running form
  • Lack of ankle range of motion
  • Weak hip and glute muscles
  • Overload in training
  • Poor lifting and running biomechanics
  • Neural tension
  • Leg length discrepancy
  • Previous leg or hip injury
  • Calf muscle weakness
  • Poor shoe wear or running shoes
  • Poor biomechanics with sports
  • Trigger points in calf muscles
  • Lack of foot range of motion

If you have failed multiple treatment approaches already, your clinician missed the real root cause of your pain and was just chasing the symptoms. The pain or symptom is the effect, not the cause. What do I mean by this? Say your fire alarm goes off in your house. Its purpose is to protect you and make you aware that something is wrong, i.e., that there is a fire in your house. The “alarm” is like your pain (your body’s way of telling you something is wrong) and the “fire” is the root cause. When the fire alarm goes off, you don’t run upstairs and just turn it off, right? You run through the house with the fire extinguisher, trying to find the room where the fire is at. You try to find out what caused the alarm to go off so you can put it out. Once the fire is out, then the fire alarm can go off. Solve the “root” cause of your pain, and then the pain (“the effect”) eventually goes away.

Additionally, there is a common root cause which many clinicians misdiagnose. They treat the foot pain with a cookie cutter approach, hoping it will work and treat it as a simple muscle problem. They tend to rely on stretching, ultrasound, massage and focus treatment directly on the foot. However, often the root cause is missed and the symptoms return. If you have failed multiple treatments and still have foot pain, then maybe it’s not just a foot problem? There is probably something else adjacent to the foot, like the knee, calf muscle, or ankle, that is overloading or stressing the joint to cause your pain. So many healthcare clinicians treat pain like this and thus show poor treatment outcomes which results in the pain coming back. Why? They missed the root cause of your foot pain. This is also the case when patients turn to injections, nerve blocks and other surgeries which are still not effective because the actual problem still is not solved, their treatment was just chasing the pain.

The first step in treatment is to identify the root cause of your pain. A specific and individualized treatment approach for your type of pain can lead to a successful outcome for you and resolve your symptoms for the long term. This is why you can’t rely on a standard cookie cutter approach; you need a customized and individualized treatment approach specifically for your type of plantar fasciitis pain.

“Great physical therapist, I’ve tried EVERYTHING for my plantar fasciitis and gotten numerous injections, but Ron was the first doctor to actually look at my foot and assess the actual cause and show me how to fix it rather than just tell me to stop running and have it come back again!

What happens if it goes untreated?

Minor case – If it is a minor case of plantar fasciitis pain, research shows that many acute cases of pain may spontaneously go away in 4-8 weeks. The key to prevent from becoming a more severe chronic case is to solve the root cause of the foot pain and determine what actually is causing it. Many times, it’s not really a foot problem and the problem is actually somewhere else. But who wants to wait 8 weeks to get pain free? Let’s try to solve the root cause of your pain in 2-3 weeks and address all of the risk factors present (so it never returns!) and get you back to your favorite activities faster! We still recommend that you get it checked out by one of our board-certified physical therapists to ensure that it is just a minor case, to solve all risk factors, and to get the optimal outcome in the fewest visits needed. Most minor cases resolve on their own in time or get better with some stretching and strengthening. But, the sooner you take action, the sooner you are pain-free. (And research supports this!)

Severe case – If it’s more of a severe and chronic case of plantar fasciitis pain, your pain will probably start to worsen and increase because the root cause and underlying risk factors of the pain are not being treated. These cases, if chronic, may take 1-2 years to go away. Many people turn to pain medication and injections at this time but this only blocks the pain for short term. You may not feel the pain when taking pain medications, but the underlying problem is still there. Many people say after the pain medication and injection wears off, then usually the pain returns and sometimes it returns even worse. Your first step out of bed hurts, walking barefoot is painful, and you cannot exercise now due to foot pain. If it continues to worsen, then this is when you cannot run, jump, or play sports. Many times with these severe chronic cases of plantar fasciitis there is an underlying risk factor that is being missed and this is why you still have the foot pain. Once the root cause is addressed, then we can start decreasing your pain, regardless of how chronic and severe the pain is. This is the crucial first step. It just may take more time to recover from a chronic case. Usually with chronic and severe cases, the longer you have your pain and injury, the longer it takes to resolve.

What outcome can you expect from treatment?

As we’ve discussed, the first step is to solve the root cause of your plantar fasciitis pain. This is the most essential step to plan a treatment specialized for you and your unique type of pain. Your root cause will guide your treatment and dictate what is the best way to treat your pain. This, along with identifying risk factors that may be predisposing you to have your pain and injury, will allow you to start getting pain free again. The next step is to start decreasing pain, modifying activities, and start addressing all of the impairments causing your pain which we discovered during your evaluation. With each session, pain should start to decrease and you should start to regain range of motion with less pain and symptoms. Any radicular and referred pain should resolve fast as well. At this point, we begin light and basic strengthening only if it does not increase pain. Treatment will consist of a lot of manual therapy and light exercises.

The next step is to achieve full range of motion, (which should correlate to being pain-free) and now we can start progressive strengthening. Strengthening the muscles is crucial and research shows that this gives you the best long-term outcome! As you start to get stronger and maintain your mobility, your pain will continue to decrease if it is not already gone. Your increased strength will allow you to perform more activities and prevent flare-ups. This usually does take up to 4 weeks. As you clear our goals, then we can start easing you back into sport, golf, running, and whatever your favorite activities are. This is when we start winding down treatments and getting you back into functional strengthening, sport specific training, return to run programs, golfing, and whatever your goals are. In the end, we reassess everything, making sure we achieved all of our goals, your goals, that all risk factors are gone, and finalize your long term home exercise program. There are many factors which can influence your outcome, but 85-90% of our patients respond well to our treatment approach and achieve a successful outcome when completing their plan of care.

Learn how to get rid of your foot & ankle pain

Sign up for our free webinar when we break down 3 actual patient cases and show you, exactly, how we got them pain free.

How is it diagnosed?

When you seek help for plantar fasciitis foot pain, we will perform a comprehensive evaluation and ask questions about your pain and your daily activities.

These may include:

  • How and when the pain started: Did the pain begin spontaneously or was there any trauma or injury experienced in the area?
  • Where are the symptoms located, and have they changed location or intensity since the onset?
  • What things make the symptoms better or worse?
  • What type of work do you perform?
  • What hobbies or household activities do you regularly perform?
  • What is the worst your pain gets throughout the day?
  • What activities throughout your day make your pain worse?

One of our board-certified physical therapists will perform a thorough assessment of your evaluation, testing: movement, the range of motion, joint mobility, strength, muscle activation, nerves, and functional movement. The therapist will also check your reflexes, do a medical screening (to rule out medical red flags and serious pathologies), and conduct special tests on your primary area of pain to determine what specifically may be involved and to rule out other conditions. The key to getting an accurate and correct diagnosis is the reproduction of your pain during the evaluation. We want to find out if we change (or even decrease) your pain during the evaluation. This is the key! To provide a definitive diagnosis, your therapist may also collaborate with an orthopedist or other healthcare providers. The orthopedist may order further tests, such as magnetic resonance imaging (MRI) or electromyography (EMG) if medical red flags are present. After the evaluation, you will know exactly what your diagnosis is and what exactly is causing your pain. You will have plenty of time to ask questions to ensure that you fully understand what is going on. The next step, then, is to determine what is the best way to treat it.

Do you need an X-ray and MRI imaging for plantar fasciitis foot pain?

For most common orthopedic cases, imaging is not needed and the diagnosis can be made with a simple physical therapy evaluation. No need to waste thousands of dollars on unwarranted diagnostic imaging. We also have clinical tests which we can perform to help rule in and rule out pathologies that correlate to MRI findings (which is WAY cheaper than an MRI!). An expensive MRI may just tell us what we already know. Also, often times the positive findings found on x-rays, MRIs, and EMGs may not actually be the root cause of your pain. What does that mean? Many positive findings on an MRI are also found in asymptomatic (pain-free) individuals, so diagnostic imaging may not be able to tell us what is actually causing your pain. For example: many people have a herniated disc in their low back but do not have any low back pain. So if herniated discs can cause no pain, just because someone with low back pain has a herniated disc does not mean that is what’s causing their pain. The key is to find out if your clinical evaluation findings during your evaluation at Pursuit match the MRI findings. If so, then we can decide what is the best way to treat it.

How can a Physical Therapist treat it?

If a patient has been diagnosed with plantar fasciitis, resting the feet can allow the body to heal. Patients should cut back on activities that put any extra strain on the feet. Ice packs and over the counter pain relievers may help to ease pain sensations. Doing low-impact exercises such as calf stretches may help to gently rehabilitate the feet. Shoes with good arch support may help to prevent further injury, and may relieve some symptoms of plantar fasciitis.

Medication and Surgery
In cases where plantar fasciitis does not respond to other treatment, physicians may prescribe injections of medications directly into the heel. In many cases, medication is coupled with a recommendation for nighttime splints. If plantar fasciitis does not respond to these forms of treatment, surgery may be necessary.

“After at least three years of doctor-hopping […] looking for someone to alleviate my constant dizziness and neck pain, I finally found Dr. Miller. I have more energy and less pain, and have halved my dependence on painkillers. He shouldn’t be the last stop on your road to recovery, he should be the first.”

How long does it take for recovery?

Recovery time for plantar fasciitis depends on multiple factors:

  • The severity and chronicity of your pain
  • Whether your pain is an easy or complex case
  • If the root cause of your pain was solved or if it was missed (this is the key to getting a great recovery!)
  • How long you have been in pain for and when you need to be pain-free by
  • Other therapies and treatments you have tried
  • Which medical professional(s) you saw prior to seeing us
  • How active you are in trying to resolve your pain
  • Which treatment approach is chosen and if it is proven to work for your pain

There are many factors that influence your recovery time and every patient’s recovery time is different. If you do nothing and don’t pursue treatment, it could gradually get better on its own, you could continue to have the same pain persist, or it could continue to get worse. As stated earlier, most acute cases may or may not resolve in 4-8 weeks. If you get expert treatment that solves the root cause of your pain, some cases resolve in 1-3 weeks! Then you can get back to sports, exercise, and your favorite activities without flare-ups and recurrences. Some of our patients are pain-free in 1-3 visits and back to 100% in 2 weeks!

If it is a complex case with chronic pain, your recovery may take longer, but you can still get a good outcome. Some chronic cases can resolve as fast as 2 months but can take as long as 4-6 months. It varies with every patient because every case of plantar fasciitis pain is different. Every patient’s recovery varies depending on the factors listed above. After a thorough evaluation here at Pursuit Physical Therapy, you will know your exact timeline of recovery, your prognosis, and when you should reach your goals.

How much does it cost?

The average cost of care for a case of spine pain in the US is $1800-$6600. This high price is due to many factors: the over-inflated cost of healthcare, the over expensive cost of unwarranted imaging (x-rays, CT scans, and MRIs) that is not needed, over-utilization of care (which increases the number of visits needed to be treated, requiring multiple visits to different doctors and physical therapists for the same diagnosis), and getting billed for unnecessary and unproven treatments that you don’t even need. All of these factors increase cost and this is why healthcare is so expensive. We strive to end that unnecessary, expensive cycle. In fact, we are currently publishing our first-year data with the University of Central Florida that shows the cost-effectiveness of our treatment approach.

This year, the average cost of our care was shown to be $814-$1141. Some of our patients get even as low as $315 for the full treatment! So if you have a deductible of $3,000-$10,000 and you have to pay out of pocket for your treatment, we can save you lots of money.

Remember, every case of pain is different and not all foot pain is the same. It is hard to predict exactly how much your treatment is going to cost you. But after a thorough evaluation, we can tell you exactly what is causing your pain, how long it is going to take, what the best way to treat it will be, and exactly how much it is going to cost. We have no hidden fees, no co-pays, and no miscellaneous bills that you will be surprised by 3 months after you receive treatment. Your pain, your diagnosis, your goals, and what is best for you dictate your treatment and how much it will cost, and while it varies for every patient, treatment at Pursuit is still much more affordable than standard healthcare.

How long are sessions?

Our evaluations are always one-on-one with one of our board-certified specialists and 60-90 minutes long. We like to perform thorough evaluations so we can solve the root cause of your pain, identify all risk factors, and make sure that we do it right. After the evaluation, you will know your diagnosis, the root cause of why you have your pain and symptoms, your prognosis, an expected timeline of when you should see results, what the best way to treat your pain is, how much it will cost, and your expected recovery outcome. We want you to fully understand everything about your pain and injury. What is best for you and will get you the best outcome is what will dictate your care and treatment. There will be plenty of time for you to ask questions so we can make sure you fully understand why you have your pain and what the best way to treat it will be. After the evaluation is completed, all treatment sessions are 60 minutes going forward and still one-on-one with your physical therapist. You and your physical therapist will design a customized treatment plan that works for you and that will achieve your goals.

What are next steps?

Getting started is simple. The first step, and the key to getting you pain free again, is to solve the root cause or your case of pain. Remember, not all pain is the same. Your pain is different than someone else’s pain, even though it may be in the same area. If you’re ready to get pain free, give us a call at (407) 494-8835 or fill out the form below. The next step is to schedule your evaluation so we can solve the root cause for you. We’re happy to answer any questions you may have and we would love the opportunity to help you.

BECOMING PAINFREE  IS EASIER THAN YOU THINK

Step 1:

Call our expert team.

Step 2:

We’ll work with you to find and treat the root of your pain.

Step 3:

Get back to doing what you love.

Call us to schedule your appointment

(407) 494-8835
(407) 494-8835

Ask one of our Board Certified Specialists a question about your pain. Just fill out the form below.