How to Handle Plantar Fascia Pain?

Dr. Rebecca Acevedo, PT, DPT • September 26, 2025

Physical Therapy for Plantar Fasciitis in Holly Springs, NC

You woke up and went to take your first step out of bed, only to be jolted fully awake with an intense pain at your heel. Plantar fasciitis is the term used to describe acute inflammation of the plantar fascia, which is a connective tissue that runs from the heel to the toes. However, research has shown that more often what we are seeing is a chronic issue of degenerative changes to the tissue instead of an acute inflammatory response. This condition can become functionally debilitating by negatively impacting walking and standing tolerance. 


Although rest may seem like a good treatment option for pain with weight bearing, plantar fasciitis normally is worse during the transition between resting and walking. Instead of avoiding rest or movement altogether, a quick warmup prior to getting up from bed or standing up to walk will help increase blood flow to the area and increase muscular activation to help stabilize the ankle/foot. An example of 3 exercises that may help prep the foot prior to walking include seated calf raises, toe yoga, and seated arch raises. 


Evidence based treatment for heel pain includes stretching of the plantar fascia, gastrocnemius and soleus as well as hands on manual therapy techniques to address joint restrictions and muscle tightness for temporary pain management. Dry needling of trigger points in the gastrocnemius, soleus and/or plantar fascia is recommended for reducing pain. Long term pain management strategies include a progressive strengthening program that improves the loading tolerance of the foot. Orthotics should not be used alone in the treatment of plantar fasciitis, but may be beneficial when combined with other supported treatment recommendations. For those that deal with consistent pain with the first step in the morning, a 1-3 month night splint program is recommended. Ultrasound is not recommended in the treatment of plantar fasciitis. 


Are you dealing with chronic nagging plantar fascia pain and ready to get long term pain relief? Book a consultation with us to discuss if physical therapy would be a good fit for you!



Dr. Rebecca Acevedo, PT, DPT



Reference:

J Orthop Sports Phys Ther. 2023;53(12):CPG1-CPG39. doi:10.2519/jospt.2023.0303


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