Do you ever wake up with pain in the bottom or heal of your foot? If so, you may have plantar fasciitis. Plantar fasciitis is the most common type of heel pain and can affect 7-15% of people in the U.S. at any time in their life.

The plantar facia stretches along the bottom of the foot and is responsible for maintaining the arch of the foot. When the plantar facia becomes weak it starts pulling away from the heel and a heel spurs forms.

Plantar fasciitis is common among runners, walkers, and other endurance athletes. Overweight people and those whose jobs require a lot of standing and walking are also at risk. Other factors include flat or high-arched feet, worn out shoes, increasing age and poor healing.

The typical person with plantar fasciitis will experience heel pain in the morning upon rising and it can progress to heel pain with activity and even with just walking. Plantar fasciitis is not typically the result of any injury. Instead, this condition usually develops gradually and, if untreated, may get worse over time.

A study published in the Journal of Orthopedic & Sports Physical Therapy, written by Dr. Renan-Ordine, looked at the effectiveness of hands-on physical therapy and stretching in treating patients with heel pain. The study divided a group of 60 patients with heel pain into 2 treatment groups. One group performed calf and foot stretches and had hands-on therapy provided by a physical therapist, while the other group only performed the stretches. The stretches were performed using 20-second hold, 20-second recovery time and were repeated 3 times, twice a day. The treatment provided by the physical therapist focused on treating the trigger points. Trigger points are small sections of muscles that feel knotty and when pressed, become more painful.

The research shows that patients who received manual therapy in conjunction to the stretches had greater improvements. This finding is important because it suggests that people who are not getting better on their own may benefit from hands on treatment.

If you have heel pain, you may wish to seek the help of a physical therapist who can instruct you on the proper stretching techniques to perform. The physical therapist can also determine if you are a candidate for trigger point therapy or manual therapy. For more information, call us at 516-829-0030.


Renan-Ordine R, et al. Effectiveness of Myofascial Trigger Point Manual Therapy Combined With a Self-Stretching Protocol for the Management of Plantar Heel Pain: A Randomized Controlled Trial. (J Orthop Sports Phys Ther 2011;41(2):43-50.