Plantar Fasciitis: Symptoms, Causes, and How Physical Therapy Speeds Up Recovery

If you feel heel pain (or pain along the bottom of your foot), especially during the first steps in the morning, it’s very likely you’re dealing with plantar fasciitis—often referred to, in longer-lasting cases, as plantar fasciopathy (an overload-related condition that may become less “purely inflammatory” over time).

The good news: for most people, with a well-structured plan, it’s possible to reduce pain and return safely to daily life and sport.

Quick recap (what tends to help most)

• Adjusting load (walking/running/standing at work) without stopping everything.

• Targeted stretching (plantar fascia + calf/soleus).

• Strengthening the foot and lower leg to better tolerate impact.

• Short-term relief strategies (taping, orthotics, footwear, education).

• A progressive plan guided by a physical therapist—especially if symptoms have become chronic.

  
  

Figure 1 – Plantar fasciitis.

What is plantar fasciitis?

The plantar fascia is a thick fibrous band along the sole of the foot that helps support the arch and manage forces during walking and running. When it’s repeatedly overloaded (or activity increases too quickly), pain, tenderness, and stiffness can develop—often worst when you first get out of bed.

Important note: a heel spur can coexist, but it’s not always the main cause of pain. The focus should be on function and load tolerance, not just “the bone.”

Common symptoms

• Heel pain or pain at the inner side of the heel.

• Stiffness and pain with the first steps in the morning or after sitting.

• Pain that may ease after warming up, then returns with more load (long periods of standing, running, or jumping).

• Tenderness when pressing near the heel’s underside.

When to seek medical evaluation sooner

• Fever, significant numbness, a wound, or intense night pain not linked to movement.

• Recent trauma with inability to bear weight.

• Symptoms that persist despite 6–8 weeks of a well-followed plan.

Causes and risk factors (what most commonly increases strain on the fascia)

The most frequent contributors:

• A rapid increase in training or daily activity (running, long walks, jumping).

• Many hours standing.

• Worn-out shoes or footwear with poor support/cushioning.

• Arch variations (flat feet or high arches)—not always a “problem,” but may require load and support adjustments.

• Limited ankle mobility and calf tightness (gastrocnemius/soleus).

• Higher body weight (more load every step).

Treatment: what evidence-based physical therapy recommends

Current recommendations for plantar heel pain prioritize a combination of education + therapeutic exercise + mechanical strategies (as needed), with supportive evidence for:

• Stretching the plantar fascia and calf/soleus

• Manual therapy (foot/ankle) when mobility restrictions are present

• Taping for short-term pain relief

• Orthoses/insoles (custom or prefabricated) in selected cases

• Night splints, especially when morning pain is marked

• Modalities such as extracorporeal shockwave therapy (ESWT) may be helpful for chronic, stubborn cases.

Plantar fasciitis exercises (a simple, safe plan)

Practical rule: mild to moderate discomfort can be okay during exercises, but pain shouldn’t “spike” and remain worse over the following 24 hours.

1) Plantar fascia-specific stretch (2–3x/day)

• Sit and cross one leg over the other.

• Pull your toes upward toward your shin until you feel a stretch along the sole.

• 3 sets of 30–45 seconds.

2) Calf/soleus wall stretch (1–2x/day)

• Back leg straight (gastrocnemius), then bent knee (soleus).

• 3 sets of 30–45 seconds for each variation.

3) Foot strengthening (3–4x/week)

Short-foot exercise (raise the arch without curling the toes)

• 2–3 sets of 8–12 reps, holding 5–8 seconds.

Progressive calf raises

• Start with both legs → progress to single-leg as tolerated.

4) Day-to-day symptom management

• Temporarily reduce the most aggravating activity (e.g., running/jumping), but keep an alternative that you tolerate (bike, elliptical, manageable walking).

• Avoid going barefoot on hard floors if it worsens symptoms.

• Adjust footwear and, if needed, use orthotics/taping for a period while building strength and tolerance.

Orthotics, night splints, and shockwave therapy: when do they make sense?

• Orthotics/insoles: often help reduce pain and improve function, especially early on, by decreasing local strain.

• Night splints: can be useful when morning pain is severe and stiffness is pronounced.

• Shockwave therapy (ESWT): commonly considered for chronic cases (months) that don’t respond to a solid conservative plan.

How long does recovery take?

It mainly depends on:

• How long symptoms have been present (acute vs. chronic),

• Your daily load (work demands, sport),

• Adherence to the plan (exercises + load adjustments).

Many people start noticing improvement within 2–6 weeks, but chronic cases may require a longer, more progressive approach with periodic reassessment and plan adjustments.

How I can help (in-home physical therapy in Lisbon)

In the initial assessment, the goal isn’t only to “confirm plantar fasciitis.” It’s to understand why the overload is happening, including:

• Foot and ankle mobility,

• Strength (foot/lower leg/hip),

• Walking/running mechanics,

• Footwear and day-to-day load.

  
  

Then we build a personalized rehabilitation plan, including:

• Pain control and immediate strategies (taping/education),

• Progressive strengthening (foot + lower leg),

• A safe return to activity and long-term relapse prevention.

  
  

If you prefer, I can provide in-home physical therapy in Lisbon, in the comfort of your home.

For additional support, you can also check my recommended tools/material (for example, a mobility/massage ball for the foot—when appropriate).

Conclusion

Plantar fasciitis is common, but it doesn’t have to mean months of pain. With a well-guided plan—therapeutic exercise, load management, and mechanical strategies—most people improve steadily and return to the activities they enjoy with confidence.

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FAQ

Can plantar fasciitis go away on its own?

It can improve, but it often takes longer without a structured plan for load and exercises. Physical therapy typically helps you recover faster and reduces recurrence risk.

Should I use ice?

It can help with symptom relief, but the key is correcting overload and following the right exercise progression.

Do orthotics actually work?

For many people, yes—especially early on to reduce pain and improve function while you build strength and load tolerance.

Is a night splint worth it?

It can be helpful when morning pain is severe and stiffness is significant.

When is shockwave therapy considered?

Usually when symptoms are chronic and don’t improve with a well-executed conservative treatment plan.

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Ricardo Vargues | Physical therapist

Watch the video about Plantar fasciitis:

References:

1. Heel Pain—Plantar Fasciitis: Revision 2023 (Clinical Practice Guideline, JOSPT).

2. Rhim HC et al. Systematic review of systematic reviews (inclui evidência para alongamentos e intervenções conservadoras).

3. Roos E et al. Foot orthoses and anterior night splints (ensaio clínico).

4. Melese H et al. Meta-analysis RCTs: extracorporeal shockwave therapy in chronic plantar fasciitis.

5. Lee WCC et al. Night splint + orthosis (ensaio clínico).