top of page

Plantar Fasciitis

Dr. Michael Hoiles has created this resource to help you better understand Plantar Fasciitis, including its common causes, symptoms, treatment options, recovery expectations, and when it may be appropriate to seek an assessment. Whether your symptoms started suddenly or developed gradually over time, this guide is designed to provide clear, evidence-informed information to help you make informed decisions and return to the activities you enjoy with confidence.

 

What Is Plantar Fasciitis

Plantar fasciitis is a condition involving irritation of the plantar fascia—a thick band of connective tissue that runs along the bottom of the foot from the heel bone to the toes. The plantar fascia helps support the arch of the foot and plays an important role in absorbing forces during walking, running, and jumping. 

Although the name suggests inflammation ("-itis"), many long-standing cases involve degeneration and reduced tissue capacity rather than ongoing inflammation. For this reason, improving the strength and resilience of the tissue is often just as important as reducing pain. 

​

 

Common Causes 

Plantar fasciitis often develops when the plantar fascia is exposed to more stress than it can tolerate. Common contributing factors include: 

  • Sudden increases in walking, running, or exercise  

  • Prolonged standing on hard surfaces  

  • Running or walking on uneven terrain  

  • Tight calf muscles or Achilles tendons  

  • Reduced ankle mobility  

  • Weakness of the foot, ankle, or lower leg muscles  

  • Poor footwear or worn-out shoes  

  • Flat feet or very high arches  

  • Carrying excess body weight  

  • Occupations that require prolonged standing  

​

Often, several contributing factors are present rather than one single cause. 

​

 

Common Symptoms 

Symptoms commonly include: 

  • Sharp pain underneath or near the heel  

  • Pain with the first few steps in the morning  

  • Heel pain after prolonged sitting  

  • Pain that improves after walking for a few minutes but returns later  

  • Tenderness when pressing on the inside of the heel  

  • Pain during prolonged walking or standing  

  • Discomfort after running or exercise  

  • Tightness through the arch or calf  

​

Symptoms often develop gradually and may worsen if left untreated. 

​

 

What Makes It Worse? 

Symptoms may become worse with: 

  • Standing for long periods  

  • Walking on hard surfaces  

  • Running or jumping  

  • Barefoot walking on hard floors  

  • Tight calf muscles  

  • Wearing unsupportive footwear  

  • Sudden increases in activity  

  • Skipping rehabilitation exercises  

 

Repeatedly overloading the plantar fascia without allowing adequate recovery can prolong symptoms. 

​

 

What Helps? 

Many people experience improvement with a combination of: 

  • Activity modification rather than complete rest  

  • Stretching the calf muscles and plantar fascia  

  • Strengthening the foot and lower leg muscles  

  • Improving ankle mobility  

  • Wearing supportive footwear  

  • Using temporary taping or orthotics when appropriate  

  • Gradually returning to activity  

  • Managing training loads appropriately  

​

Long-term improvement typically comes from addressing the underlying mechanical factors rather than simply reducing pain.

​

 

How Chiropractic Can Help 

A chiropractic assessment aims to identify the factors contributing to your heel pain rather than focusing solely on the painful area. 

Treatment may include: 

  • Assessment of walking and movement patterns  

  • Joint mobilization of the foot and ankle  

  • Soft tissue therapy  

  • Instrument-assisted soft tissue therapy (Graston or FAKTR)  

  • Calf and plantar fascia stretching  

  • Exercise prescription  

  • Foot strengthening exercises  

  • Balance and stability training  

  • Footwear recommendations  

  • Education on activity modification and gradual return to sport  

The goal is to reduce pain, improve foot function, restore normal movement, and help prevent future episodes. 

 

Shockwave Therapy for Plantar Fasciitis 

Shockwave Therapy is a non-invasive treatment option that can be particularly helpful for persistent or chronic cases of plantar fasciitis that have not responded fully to stretching, strengthening exercises, or other conservative treatments. 

During treatment, acoustic pressure waves are delivered to the affected tissue. These pressure waves are thought to stimulate the body's natural healing response by improving blood flow, encouraging tissue repair, and reducing pain sensitivity within the plantar fascia. 

Current research suggests that shockwave therapy can be an effective addition to a comprehensive rehabilitation program for many people with chronic plantar fasciitis. It is most effective when combined with progressive strengthening exercises, mobility work, activity modification, and addressing the underlying factors contributing to the condition. 

Treatment is performed in the clinic, requires no injections or surgery, and most people are able to return to their normal daily activities immediately afterward. 

​

Is Shockwave Therapy Right for Me? 

Shockwave therapy may be appropriate if: 

  • Heel pain has persisted for several months  

  • Home exercises have not provided sufficient relief  

  • Walking, work, or sport continues to be limited  

  • You are hoping to avoid more invasive treatment options  

  • Your assessment indicates that the plantar fascia is the primary source of your symptoms  

Not every case of heel pain requires shockwave therapy, which is why a thorough assessment is important before determining whether it is an appropriate treatment option. 

​

 

Recovery Timeline 

Recovery varies depending on symptom duration and the severity of the condition. 

  • Mild: Recent cases often improve within 4–8 weeks when contributing factors are addressed early. 

  • Moderate: Symptoms present for several months may require 2–4 months of progressive rehabilitation. 

  • Chronic: Long-standing plantar fasciitis may require 6–12 months or longer for complete recovery, particularly if symptoms have been present for many months before treatment begins. 

​

Consistency with rehabilitation exercises and gradual progression of activity are often the most important factors influencing recovery. 

​

 

Exercises Commonly Recommended 

Exercise programs should be individualized but often include: 

Early Phase 

  • Calf stretches  

  • Plantar fascia stretches  

  • Ankle mobility exercises  

  • Gentle walking within tolerance  

Recovery Phase 

  • Heel raises  

  • Single-leg calf raises  

  • Toe yoga  

  • Towel scrunches  

  • Short-foot exercises  

  • Balance exercises  

Performance Phase 

  • Single-leg balance with movement  

  • Plyometric progression  

  • Running drills  

  • Hopping exercises  

  • Sport-specific rehabilitation  

Exercises should be progressed based on symptoms and functional improvement.​

​

Can I Still Exercise? 

In many cases, yes. 

Complete rest is rarely necessary and may actually delay recovery by reducing tissue capacity. Instead, modifying activities while maintaining overall fitness is usually recommended. 

Many people can continue activities such as cycling, swimming, or upper-body training while temporarily reducing high-impact activities like running or jumping. 

As symptoms improve, walking, running, and sport can gradually be reintroduced through a structured rehabilitation program. 

​

​

 

When To Seek An Assessment 

Consider booking an assessment if: 

  • Heel pain has lasted longer than 2–3 weeks  

  • Pain is limiting walking, work, or exercise  

  • Symptoms are becoming progressively worse  

  • Morning heel pain is persistent  

  • You have difficulty returning to running or sport  

  • Home treatment has not been effective  

  • Symptoms continue to return despite previous treatment  

Early assessment often leads to faster recovery and may help prevent the condition from becoming chronic. 

​

Common Mistakes That Slow Recovery 

  • Continuing to run through severe heel pain  

  • Wearing unsupportive or worn-out footwear  

  • Stretching without strengthening  

  • Returning to sport too quickly  

  • Ignoring calf tightness  

  • Performing rehabilitation exercises inconsistently  

  • Stopping exercises once pain improves  

  • Expecting symptoms to resolve with rest alone  

A progressive strengthening program combined with appropriate activity modification generally produces better long-term outcomes than passive treatments alone. 

​​

Why an Accurate Diagnosis Matters 

Not all heel pain is caused by plantar fasciitis. Conditions such as Achilles tendinopathy, heel fat pad syndrome, stress fractures, nerve irritation, or arthritis can produce similar symptoms but require different treatment approaches. 

A thorough assessment helps determine the source of your pain, identify contributing factors such as strength deficits, movement patterns, or footwear, and develop an individualized treatment plan to help you return to walking, running, work, and the activities you enjoy. 

​

 

When Should I worry?  

Seek prompt medical evaluation if you experience: 

  • Sudden inability to bear weight after an injury  

  • Significant swelling, bruising, or deformity  

  • Fever, redness, or warmth around the heel  

  • Severe pain following trauma  

  • Persistent numbness or tingling in the foot  

  • Pain that occurs primarily at night or without weight-bearing  

  • A wound or ulcer on the foot that is not healing, particularly if you have diabetes  

​

These symptoms may indicate a condition other than plantar fasciitis and should be assessed promptly. 

​

 

Summary 

Plantar fasciitis is one of the most common causes of heel pain and often responds well to conservative care. 

✔ Stay active while modifying activities that significantly increase pain. 

✔ Improve calf flexibility, ankle mobility, and foot strength. 

✔ Wear supportive footwear appropriate for your activity. 

✔ Follow a progressive rehabilitation program rather than relying on rest alone. 

✔ Seek an assessment if symptoms persist, interfere with daily activities, or continue to return despite home management. 

​

 

Ready to Get Back to Moving Comfortably?

If your plantar fasciitis pain isn't improving, keeps returning, or is preventing you from working, walking, exercising, or enjoying your daily activities, an assessment can help identify the underlying cause and determine the most appropriate treatment plan. 

Dr. Michael Hoiles is a Calgary chiropractor who provides evidence-informed care combining hands-on treatment, exercise-based rehabilitation, and practical advice to help people recover from injury, move better, and stay active. 

Book an appointment with Dr. Michael Hoiles today to start your recovery and get back to doing what you enjoy. 

​

​

bottom of page