Plantar Fasciitis Treatment in Vancouver
Plantar fasciitis is a common cause of heel and arch pain. One of the classic symptoms is pain or stiffness with the first few steps in the morning or after getting up following a period of sitting.
At Vancouver Orthotics, Dr. Michael Horowitz & Associates assess plantar fasciitis together with foot structure, biomechanics, footwear, activity and other factors that may be contributing to heel or arch pain.
Treatment recommendations depend on the individual assessment and may include changes to activity, stretching and exercises, footwear recommendations, custom orthotics and other appropriate conservative treatment options.
What Is Plantar Fasciitis?
The plantar fascia is a strong band of connective tissue along the bottom of the foot, extending from the heel toward the toes. It helps support the foot and plays an important role when standing, walking and moving.
Plantar fasciitis commonly causes pain near the heel or along the bottom of the foot. Symptoms can vary from person to person and may be associated with repetitive loading, activity, footwear and foot biomechanics.
Plantar Fasciitis & Heel Pain Video
In this video, Dr. Michael Horowitz discusses plantar fasciitis, heel pain and some of the factors considered when assessing and treating patients with these symptoms.
Symptoms of Plantar Fasciitis
Plantar fasciitis symptoms often develop around the underside of the heel or along the plantar fascia on the bottom of the foot.
Common symptoms can include:
- Heel pain with the first few steps after getting out of bed in the morning
- Pain or stiffness after sitting or resting for a period of time
- Pain underneath or toward the inside of the heel
- Arch pain or discomfort along the bottom of the foot
- Symptoms that increase after prolonged standing or walking
- Heel or arch discomfort associated with changes in activity or exercise
Not every case of heel pain is plantar fasciitis. Heel pain can have a number of possible causes, which is why an individual assessment can be useful when symptoms persist or interfere with normal activity.
What Causes Plantar Fasciitis?
Plantar fasciitis does not necessarily have one single cause. Symptoms can develop when the plantar fascia is repeatedly stressed or when the demands being placed on the foot exceed what the tissue can comfortably tolerate.
Factors that may be considered during an assessment include:
- Foot structure and biomechanics
- Changes in walking, running or other activities
- Prolonged standing or walking
- Footwear
- Changes in activity level or training
- Calf and lower-extremity flexibility
- Previous foot or lower-extremity injuries
The contribution of these factors varies from person to person. An assessment can help identify which factors may be relevant to an individual's symptoms.
How Is Plantar Fasciitis Assessed?
A plantar fasciitis assessment involves more than simply identifying where the foot hurts. Dr. Michael Horowitz & Associates may consider the location and history of your symptoms together with foot structure, biomechanics, footwear, activity and other clinical findings.
Depending on the individual and clinic location, the assessment may include:
- A clinical foot and lower-extremity examination
- Review of your heel or arch pain symptoms
- Foot and biomechanical assessment
- Evaluation of footwear
- A 3D digital foot scan when appropriate
- Gait analysis or an electronic walking gait scan when appropriate and available
A 3D foot scan and an electronic gait scan provide different information. A 3D scan captures the three-dimensional shape and contours of the feet, while an electronic gait scan evaluates aspects of how the feet function while walking.
Plantar Fasciitis Treatment Options
Treatment depends on the findings of the individual assessment, how long symptoms have been present and the activities that aggravate the condition.
Conservative treatment recommendations may include a combination of:
- Temporary modification of aggravating activities
- Stretching and appropriate exercises
- Footwear changes
- Supportive shoes
- Custom orthotics when clinically appropriate
- Other conservative treatment strategies based on the individual assessment
There is no single treatment that is appropriate for every person with plantar fasciitis. The objective is to identify relevant contributing factors and develop a treatment approach appropriate for the individual.
Custom Orthotics for Plantar Fasciitis
Custom orthotics may be considered for some patients with plantar fasciitis, particularly when foot structure or biomechanics appear to be contributing to heel or arch symptoms.
Custom orthotics are individually prescribed devices designed to fit inside footwear. The prescription can take into account findings from the clinical and biomechanical assessment as well as the patient's foot shape, symptoms, footwear and activities.
When custom orthotics are prescribed at Vancouver Orthotics, a 3D digital foot scan may be used as part of the orthotic process. The digital scan provides information about the three-dimensional shape of the feet and is considered together with the clinical assessment.
Patients considering custom orthotics can also review our custom orthotics cost and pricing information.
Plantar Fasciitis Stretches & Exercises
Stretching and exercise can form part of a conservative treatment program for plantar fasciitis. The appropriate exercises depend on the individual, and exercises that are comfortable for one person may not be appropriate for another.
Common areas addressed in exercise programs can include the plantar fascia, calf muscles, Achilles tendon and muscles involved in supporting the foot and lower leg.
Examples of commonly discussed approaches include:
- Gentle plantar fascia stretching
- Calf stretching
- Achilles tendon stretching
- Foot and lower-leg strengthening exercises
- Gradual return to activities as symptoms allow
If an exercise causes significant or increasing pain, stop the exercise and seek appropriate clinical advice.
For additional information, visit our Plantar Fasciitis Exercises page.
Footwear for Plantar Fasciitis
Footwear can be an important consideration for people experiencing plantar fasciitis or recurring heel pain. Shoes differ considerably in their construction, cushioning, stability, fit and ability to accommodate an orthotic.
Depending on the individual, footwear considerations may include:
- Comfortable fit
- A stable base
- Adequate room for the foot
- Appropriate cushioning
- Compatibility with custom orthotics when required
Vancouver Orthotics also carries selected stock orthopedic footwear, including APEX footwear. These are off-the-shelf shoes and should not be confused with custom-made orthopedic shoes.
Learn more on our Plantar Fasciitis Shoes page.
Can a Night Splint Help Plantar Fasciitis?
A plantar fasciitis night splint is designed to maintain the ankle and foot in a position that keeps the plantar fascia and related structures gently stretched while sleeping.
Night splints may be considered as part of conservative management for some people, particularly when morning heel pain is a significant symptom. They are not necessary or appropriate for every patient.
Learn more about plantar fasciitis night splints.
Plantar Fasciitis, Heel Spurs & Heel Pain
Plantar fasciitis and heel spurs are often discussed together, but they are not the same thing. A heel spur is a bony growth that can develop around the heel bone, while plantar fasciitis involves irritation and pain associated with the plantar fascia.
The presence of a heel spur does not automatically establish the cause of someone's heel pain. Similarly, plantar fasciitis can occur without a heel spur.
Because several conditions can produce heel pain, persistent or significant symptoms should be assessed rather than assuming that every painful heel is caused by plantar fasciitis.
Plantar Fasciitis Frequently Asked Questions
What does plantar fasciitis feel like?
Plantar fasciitis commonly produces pain underneath the heel or along the bottom of the foot. Pain with the first few steps in the morning or after sitting for a period of time is frequently reported.
Why does plantar fasciitis hurt in the morning?
People with plantar fasciitis commonly report stiffness or heel pain when they first get out of bed. Symptoms may ease somewhat after moving around, although the pattern varies between individuals.
Can custom orthotics help plantar fasciitis?
Custom orthotics may form part of a treatment plan when the clinical assessment indicates that additional foot support or changes in how forces are managed through the foot may be appropriate. They are not required for every case of plantar fasciitis.
Do I need a 3D foot scan for plantar fasciitis?
A 3D foot scan is not a diagnostic test for plantar fasciitis. It captures the three-dimensional shape of the feet and may be used as part of the custom orthotic process when orthotics are prescribed.
Is a gait scan the same as a 3D foot scan?
No. A 3D foot scan captures the shape and contours of the feet. An electronic gait scan evaluates aspects of foot function while walking. Learn more about the difference on our Gait Analysis page.
What shoes should I wear for plantar fasciitis?
The appropriate shoe depends on the individual's foot shape, symptoms, activities and whether an orthotic is being worn. In general, fit, comfort, stability and appropriate cushioning are important considerations.
Should I stretch plantar fasciitis?
Stretching is commonly included in conservative plantar fasciitis management. The appropriate type and amount of stretching depend on the individual and the severity and stage of the symptoms.
How long does plantar fasciitis take to improve?
Recovery time varies. Factors such as how long symptoms have been present, activity demands, contributing biomechanics and the treatment approach can all influence progress.
Is plantar fasciitis the only cause of heel pain?
No. Heel pain can have several possible causes. An assessment may be appropriate when pain persists, becomes severe, follows an injury or significantly interferes with walking and normal activities.
Plantar Fasciitis Assessment in Vancouver
Dr. Michael Horowitz & Associates provide foot and biomechanical assessments for patients experiencing plantar fasciitis, heel pain and related foot concerns at Vancouver Orthotics clinic locations.
Assessment and treatment recommendations are based on the individual. When appropriate, custom orthotics, 3D digital foot scanning, gait assessment, footwear recommendations, stretching and other conservative options may form part of the overall management approach.
Information on this page is provided for general educational purposes and is not a substitute for an individual clinical assessment or medical diagnosis.
