.png){kind=small}
Management of Plantar Fasciitis: What Works and What Doesn’t
- Yannick Sarton
- Nov 4, 2024
- 4 min read
Updated: 2 days ago
Understanding what plantar fasciitis really is
Plantar fasciitis is one of the most common causes of heel pain. Despite the name, it is rarely a true “inflammation.” In most cases, it is a mechanical overload problem affecting the plantar fascia — a thick connective structure that supports the arch of the foot.
The pain typically appears during the first steps in the morning or after sitting for a long time. What people interpret as “sharp inflammation” is often a combination of tissue sensitivity, reduced load tolerance, and changes in how the foot handles stress.
Why plantar fasciitis happens
The condition usually develops when the plantar fascia receives more mechanical demand than it can handle. The causes vary: increased walking or running distances, poor load management during training, sudden changes in footwear, reduced calf flexibility, or prolonged standing.
It is not a sign of damage or structural failure but rather of overuse without adequate conditioning. The tissue becomes sensitive because it is not coping with the forces applied to it.
What treatments actually work according to evidence
Plantar fasciitis responds extremely well to physiotherapy, especially when rehabilitation focuses on graded loading and sensible progression rather than passive treatments.
The cornerstone of recovery is a progressive strengthening program targeting the plantar fascia and the calf complex. Strengthening increases the tissue’s capacity to absorb load and reduces sensitivity over time.
Stretching of the calf muscles and plantar fascia helps reduce morning symptoms, especially during the early stages. Tugging sensations are normal and safe as long as pain stays within mild levels.
Why passive treatments alone are rarely enough
Ice, massage, ultrasound, shockwaves, taping, and insoles can help reduce symptoms temporarily, but none of these approaches solve the underlying problem on their own.
They can support recovery, but they cannot replace strengthening and load management. Relying on passive treatments without addressing tissue capacity is one of the main reasons symptoms become chronic.
Load management is the real game changer
Recovery depends less on finding a perfect exercise and more on adjusting daily load. Reducing excessive walking or running volumes for a few weeks helps calm irritation. Then, reintroducing activity progressively builds capacity again.
The key is not complete rest — which weakens tissues further — but controlled activity based on symptom behaviour.
What a complete physiotherapy plan looks like
Rehabilitation usually includes:
• strengthening of the plantar fascia (for example, calf-raise variations)
• progressive loading of the foot arch
• stretches for calf and plantar fascia
• optimisation of walking mechanics
• graded return to running or long walks
• strategies to reduce morning pain
This structured approach gives the fascia time to adapt while ensuring the foot continues to receive enough stimulation to recover.
When symptoms persist or become severe
Plantar fasciitis is usually straightforward, but symptoms may persist if load increases too fast or if strengthening is inconsistent.
More persistent cases may benefit from additional options such as night splints or shockwave therapy — but only as adjuncts, never substitutes, to a proper strengthening plan.
Red flags are rare, but sudden, intense pain accompanied by a “pop” sensation may indicate a partial fascia tear, which requires assessment.
The key message
Plantar fasciitis is not a dangerous condition. It is a mechanical sensitivity problem that responds extremely well to structured physiotherapy. Strengthening, stretching, and smart load management are the pillars of recovery.
Consistent, progressive rehabilitation does not just reduce pain — it increases tissue capacity and prevents recurrence.
Whether you are in Phnom Penh or abroad, you can book your next in-clinic or online physiotherapy session today.I’m available worldwide for online consultations — simple, fast, and evidence-based.
Explore Studio On — Physiotherapy & Online Care
Physiotherapy & Osteopathy in Phnom Penh (BKK1), offering evidence-based treatments for pain, injuries, mobility issues, and rehabilitation
The Studio
Discover the clinic in Phnom Penh: central location, private room, calm environment, professional equipment.
Overview of the physiotherapy and osteopathy services provided in-clinic: assessment, manual treatment, exercise therapy, rehabilitation.
Detailed information about all conditions treated: back pain, neck pain, joint pain, tendinopathy, muscle injuries, sports injuries, nerve irritation, acute & chronic pain.
Physiotherapy available worldwide: video consultation, diagnosis, personalised rehab plans, follow-up, and exercise programming.
Evidence-based articles helping you understand your condition and take control of your recovery.
Book your physiotherapy session in Phnom Penh or your online consultation in one click.
All the essential details: address, directions, phone number, and opening hours.
References:
Thong-On S, Bovonsunthonchai S, Vachalathiti R, Intiravoranont W, Suwannarat S, Smith R. Effects of Strengthening and Stretching Exercises on the Temporospatial Gait Parameters in Patients With Plantar Fasciitis: A Randomized Controlled Trial. Ann Rehabil Med. 2019 Dec;43(6):662-676. doi: 10.5535/arm.2019.43.6.662. Epub 2019 Dec 31. PMID: 31918529; PMCID: PMC6960082.
Sun J, Gao F, Wang Y, Sun W, Jiang B, Li Z. Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: A meta-analysis of RCTs. Medicine (Baltimore). 2017 Apr;96(15):e6621. doi: 10.1097/MD.0000000000006621. PMID: 28403111; PMCID: PMC5403108.
Lim AT, How CH, Tan B. Management of plantar fasciitis in the outpatient setting. Singapore Med J. 2016 Apr;57(4):168-70; quiz 171. doi: 10.11622/smedj.2016069. PMID: 27075037; PMCID: PMC4853481.
Whittaker GA, Munteanu SE, Menz HB, Tan JM, Rabusin CL, Landorf KB. Foot orthoses for plantar heel pain: a systematic review and meta-analysis. Br J Sports Med. 2018 Mar;52(5):322-328. doi: 10.1136/bjsports-2016-097355. Epub 2017 Sep 21. PMID: 28935689.
Kashif M, Albalwi A, Alharbi A, Iram H, Manzoor N. Comparison of subtalar mobilisation with conventional physiotherapy treatment for the management of plantar fasciitis. J Pak Med Assoc. 2021 Dec;71(12):2705-2709. doi: 10.47391/JPMA.1049. PMID: 35150524.
Comments