GREAT NORTHERN PHYSICAL THERAPY P: 406-586-4678

Plantar Fasciitis is one of the most common causes of foot pain affecting about 1 of 10 people.  It is caused by injury to the thick tissue or fascia that connects the heel to the toes and transfers the force of the calf muscles to the ball of the foot.  This tissue is vital for supporting the arch of the foot when you walk or run.  Plantar Fasciitis can start traumatically but it is more often an overuse injury that slowly worsens over time.  The most common location for Plantar Fasciitis to develop is where it attaches to the bottom of the heel. 

The most common symptom of plantar fasciitis is pain with the first few steps in the morning or after a period of inactivity.  One may also have worsened pain after prolonged standing or walking.  Rising up onto one’s toes, running, and jumping are also painful. 

Predisposing risk factors include:

  • Age: Plantar fasciitis can occur at any age but is most common between the ages of 40 and 60.
  • High activity levels that are demanding on the plantar facia such as long-distance running or dance. Training errors often precipitate the onset of Plantar Fasciitis.  These training errors may include improper footwear, to aggressive advancement of training protocol, or running on unyielding surfaces.
  • Foot mechanics: both flat feet and a high arch can place increased stress on the plantar facia and thus increased your risk of developing plantar fasciitis.  
  • Obesity: because increased weight puts more strain on the plantar facia it is not surprising that obesity is also a risk factor. 
  • Occupations that require prolonged standing – particularly on hard surfaces.
  • Decreased strength in the foot and ankle.
  • Decreased range of motion into dorsiflexion of the ankle or tightness in your calf muscles.

Diagnosis: 

Plantar fasciitis is diagnosed clinically by your physician or physical therapist.  There is usually no need for imaging unless there is reason to suspect other pathologies (stress fractures for example). 

Treatment

Treatment can be divided into three main categories based on their objective:

  1. Symptom control
  2. Reduction of the stress placed on the plantar fasciitis
  3. Improving the plantar fasciitis’s ability to tolerate the stress placed on it.

Symptom Control:

Reducing the stress placed on the plantar fascia:

  • Orthotics: Either over the counter or custom orthotics may be used to decrease the stress placed on the plantar fascia and thus reduce pain.  Interestingly research indicates that there does not appear to be any difference between custom and over the counter orthotics.  Furthermore, the benefit appears to be relatively short term 3 months to 1 year.  There is currently no evidence supporting long term (> 1 year) use of either custom or over the counter orthotics for plantar fasciitis. 
  • Stretching: Improving the range of motion at the ankle can reduce the strain placed on the plantar fascia and thus improves healing.  Not everyone has restriction in ankle and calf mobility, but if you do it will significantly impair your ability to recover. 
  • Activity modification: Decreasing one’s activity level and limiting aggravating activities can be an important aspect of recovery.  Your physical therapist can help guide you in what to limit and what activities are appropriate for you to continue. 

Improving the plantar fasciitis’s ability to tolerate the stress placed on it:

  • This is the most important treatment component and is often the most neglected. Without improving the tissue’s ability to tolerate the stress of your normal activities you will not achieve long lasting recovery. 
  • Strengthening: A progressive strengthening program at a level that is hard enough to encourage adaptive strengthening but not so hard that it injures the tissue is imperative.  This can be a tricky process and is highly individual.  Your physical therapist will help you acheive this balancing act. 
  • Manual therapy techniques: Instrumented assisted soft tissue mobilization techniques can be utilized by your physical therapist to provide a mechanical stress to the tissue to stimulate adaptive strengthening and improve your tissue’s ability to tolerate stress placed on it.  It is an adjunct to strengthening and is not to replace strengthening but can be a valuable addition to the treatment plan. 

Treatment should focus on the individual’s impairments and stage of recovery.  In the acute phase anti-inflammatory measures and rest may be most appropriate.  However, as the patient progresses it becomes more important to address tightness and weakness in the patient’s calf muscle.  Night splints and/or warm up stretches to improve pain with the first step in the morning is also often helpful. 

Returning to your prior level of activity can be tricky for people and should be guided by your physical therapist.  The strengthening exercises should be tailored by your physical therapist to help you return to your specific activities. 

If you are experiencing heel pain, give us a call.  We would be glad to help you recover from your heel pain.  Plantar fasciitis does not have to end your active lifestyle. 

Keeping Young Athletes Safe

Sep 18, 2025

Keep Young Athletes Safe: Your Guide to Preventing Sports Injuries

School is back in session, and so are fall sports! Whether your child plays soccer, football, volleyball, or is running cross country, keeping them injury-free should be your top priority. The good news? Most youth sports injuries can be prevented with the right approach.

Start with Smart Conditioning
Conditioning is the foundation of injury prevention. Young athletes should begin training at least 4-6 weeks before their sport starts. This gives their bodies time to adapt slowly.

Start with the basics like jogging, jumping jacks, and bodyweight squats. Add sport-specific drills gradually. A soccer player might begin with light ball work, while a runner starts with short, easy distances. The key word here is “gradually” – adding too much too soon leads to injuries.

The Power of a Proper Warm-Up
Never skip the warm-up! A good warm-up is like starting your car on a cold morning. It gets everything moving smoothly. Spend 10 – 15 minutes doing light cardio and dynamic stretches. Think leg swings, arm circles, and gentle lunges. Save static stretching (where you hold the stretch) for after practice.

Recovery is Not Optional
Here’s what many parents don’t realize: rest days are as important as training days. During rest, muscles repair and grow. Young athletes need at least one full rest day per week. They also need 8-9 hours of sleep each night.

Watch for signs your child needs more rest. Are they more tired than usual? Getting sick often? Complaining of aches and pains? These are red flags that they’re overdoing it.

Fuel the Machine
Good nutrition powers performance and prevents injuries. Make sure your young athlete eats regular meals with plenty of fruits, vegetables, lean proteins, and whole grains. Don’t forget hydration! Water should be their go-to drink, save the sports drinks for when they’re exercising for over an hour.

Listen to Their Body
Teach your child that pain is not normal. The old saying “no pain, no gain” is dangerous for young athletes. Some muscle soreness after hard workouts is normal, but sharp pain or pain that doesn’t go away needs attention. Help your young athlete learn to pay attention to their body, and to understand the difference.

When to See a Professional
If your child has pain that lasts more than a few days, affects their daily activities, or keeps them from playing their best, it’s time to see your physical therapist. Early treatment prevents small problems from becoming big ones.

Remember, the goal is to keep sports fun while building lifelong healthy habits. With proper preparation and smart training, your young athlete can have a safe and successful season!

NEURO PT

Nov 19, 2024

A cornerstone to treating the whole person in physical therapy is providing patient-
centered care. This is true for all forms of physical therapy, and perhaps more profound
when applied to those who’ve experienced a neurologic injury or disease. But
regardless of your reasons for seeking physical therapy services, we all want to be
seen, understood, and valued in our care.
Patient-centered care relates to understanding and honoring your unique situation and
goals. We value shared decision-making between yourself and your physical therapist,
and ensure that your physical therapy is tailored to align with your goals. We strive to
have a strong therapeutic-alliance with our patients, establishing an effective working
relationship and empowering our patients to become active participants in their care,
leading to more meaningful outcomes.
Our approach to understanding your unique situation and goals includes the use of a
biopsychosocial model of care. This model emphasizes the interconnectedness of our
biological, psychological, and socio-environmental factors in our lives. When this model
is applied to physical therapy care, we work to understand, assess, and intervene in
varied domains of your health to improve your overall well-being and to achieve your
goals.
In neurologic physical therapy, we may look at a variety of aspects of your health to
better understand how we can work together to reach your goals. This may include
assessing and treating one or more of the following:
– Physical limitations; including strength, range of motion, neural dynamics, joint
integrity, and biomechanics.
– Motor control; including our bodies ability to utilize and integrate multiple systems
to produce a movement or complete a task.
– Sensory systems; including vestibular, proprioceptive, tactile and visual systems
that impact our ability to use our bodies effectively.
– Autonomic nervous system; including the regulation of our internal processes to
help improve your functional abilities.
– Lifestyle; including understanding your sleep, nutrition, stress, and substance use
as it relates to your health and function.
– Psychosocial; understanding your self-efficacy, or confidence, in your condition
and abilities, how behavioral health may affect your physical health and function,
and your needs for autonomy and motivation in your care.

If you’d like to learn more about neurologic physical therapy and how it may be of
benefit to you in your journey, please contact us at Great Northern PT!
Phone: (406) 586-4678
Email: rita@greatnorthernpt.com

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