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Plantar Fasciitis and Heel Pain: Physical Therapy in Brooklyn

By Dr. Jack Engelberg, PT, DPT · · 4 min read

That sharp, stabbing pain in your heel when your feet first hit the floor in the morning is the hallmark of plantar fasciitis. It may ease as you walk around, only to return after sitting or a long day on your feet. In a city where we walk everywhere, from subway stairs to long blocks of errands, heel pain can quickly take over your day. Most people with plantar heel pain improve with conservative care, and physical therapy can help speed things along.

What Is Plantar Fasciitis?

The plantar fascia is a thick band of connective tissue running along the bottom of the foot from the heel bone to the base of the toes. It supports the arch and helps the foot act as a spring when you walk and run.

When the fascia is overloaded, it can become irritated where it attaches to the heel. Although the name includes "-itis," the condition often involves tissue changes rather than active inflammation, so many clinicians now prefer the terms plantar fasciopathy or plantar heel pain.

Common Symptoms

  • Sharp or aching pain on the bottom of the heel, often toward the inside
  • Pain with the first steps in the morning or after sitting
  • Pain that eases with gentle walking but worsens after long periods of standing or walking
  • Pain after (rather than during) exercise
  • Tenderness when pressing on the bottom of the heel

What Causes Plantar Fasciitis?

  • Sudden increase in activity — more walking, running, standing or a new job on your feet
  • Prolonged standing, especially on hard floors
  • Tight calf muscles or Achilles tendon — reduced ankle flexibility increases strain on the fascia (see Achilles tendinopathy)
  • Footwear — unsupportive shoes, worn-out sneakers, or going barefoot on hard floors
  • Body weight — higher loads on the foot
  • Foot shape — both very flat and very high arches can play a role
  • Age — it's most common in middle age

How Physical Therapy Helps Plantar Heel Pain

Clinical guidelines support stretching, manual therapy, taping, footwear and orthotic advice, and education as part of treatment for plantar heel pain.

Evaluation

Your therapist will confirm the diagnosis, assess ankle mobility, calf and foot strength, footwear, and how you walk, and review your activity and work demands. They'll also consider other causes of heel pain, such as nerve irritation or stress fractures.

Treatment May Include

  • Plantar fascia and calf stretching — particularly first thing in the morning
  • Strengthening — high-load calf raises and intrinsic foot muscle exercises
  • Manual therapy — soft tissue work and joint mobilization of the ankle and foot
  • Taping — low-Dye taping can reduce pain in the short term
  • Footwear and orthotic guidance — supportive shoes and, for some people, arch supports or heel cups
  • Night splints — for persistent morning pain in some cases
  • Load management — adjusting walking, running and standing time while the tissue settles

What You Can Do at Home

  • Stretch before your first steps. Before getting out of bed, pull your toes back toward your shin with your hand and hold for 10 to 15 seconds, a few times.
  • Stretch your calves against a wall with the knee straight and then slightly bent.
  • Roll your arch over a water bottle (frozen, if you like ice) or a ball for a few minutes.
  • Wear supportive shoes, even around the house. Avoid walking barefoot on hard floors.
  • Replace worn sneakers.
  • Modify activity. Swap some walking or running for cycling or swimming while symptoms calm down.
  • Build strength. Slow calf raises, progressing over time, can help the foot handle load.

When to See a Physical Therapist

Book an evaluation if:

  • Heel pain lasts more than two weeks
  • Morning pain is getting worse
  • You're limping or avoiding activity
  • You've tried stretches and new shoes without improvement

See a physician if heel pain started after a fall or injury, if you can't bear weight, if there is significant swelling or bruising, if you have numbness or tingling in the foot, or if you have diabetes and notice changes in the skin or sensation of your feet.

Frequently Asked Questions

How long does plantar fasciitis last?

Most people improve within several months with conservative care, though some cases take longer. Early treatment can help.

Do I need a heel spur removed?

Heel spurs are common on X-rays, including in people without heel pain, and are usually not the cause. Surgery for plantar heel pain is rarely needed.

Are custom orthotics necessary?

Not always. Many people do well with supportive shoes and over-the-counter inserts. Your therapist can advise based on your foot and activity.

Ready to get started? Call the Refuah office nearest you

Schedule an evaluation by phone, or book online at refuahpt.com.

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About the author. Dr. Jack Engelberg, PT, DPT is a Doctor of Physical Therapy and owner of Refuah Physical & Occupational Therapy, with offices in Midwood and Boro Park, Brooklyn, and on Staten Island.

Medical disclaimer: This article is for general education only and is not medical advice, diagnosis or treatment. Everyone’s situation is different. Talk with your physician or a licensed physical therapist about your symptoms. If you think you have a medical emergency, call 911.

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