Plantar Fasciitis
If your heel screams when you get out of bed, eases as you move, then flares again after you sit, that is plantar fasciitis. Once it is chronic it rarely resolves on its own. It is one of the conditions we treat most, and we treat it with more than one tool.
What Is Going On
The plantar fascia is the thick band of connective tissue that runs from your heel bone to the ball of your foot and holds up the arch. Every step loads it. When micro damage accumulates faster than the tissue can repair it, the fascia thickens at its heel attachment, the collagen becomes disorganized, and the repair process stalls.
That is why the standard advice plateaus. Rest, ice, and anti inflammatories treat inflammation, but chronic plantar fasciitis is mostly degeneration, not inflammation. Orthotics and night splints reduce strain on the fascia, which helps, but they do not restart the healing the tissue abandoned months ago.
The first step pain tells the story. Overnight the fascia rests shortened. The first steps stretch thickened, poorly healed tissue all at once. Until the tissue itself remodels, that morning routine repeats.
How We Treat It
No single therapy fits every heel. These are the four we use for plantar fasciitis. Which ones you get, and in what combination, is decided at your exam.
Acoustic pressure waves delivered to the fascia attachment break up disorganized tissue, restore circulation, and restart the remodeling process. It is the tool with the strongest track record for heel pain that has already outlasted orthotics, stretching, and cortisone. How shockwave works.
Low level laser raises cellular energy and circulation in the fascia without any mechanical stress. It is painless, and it is used both on its own and alongside the other therapies. How laser works.
Heel pain rarely lives in the heel alone. Tight calves, restricted ankles, and trigger points along the foot and calf chain keep loading the fascia. Needling releases that chain and calms the pain signaling that keeps a chronic heel feeling fragile. How acupuncture works.
Anti inflammatory and regenerative injectables placed precisely at the fascia attachment and surrounding points, used when the tissue needs more support than needling alone provides. How injection therapy works.
What To Expect
Heel pain can also come from the Achilles, a stress fracture, or a nerve. We examine the foot, the calf, and your history before treating anything.
Shockwave, laser, acupuncture, and injections all treat this condition. Which ones lead, and in what order, comes out of the exam. We will tell you what we recommend and why.
Fascia rebuilds in response to load. We tell you what to keep doing, what to scale back, and which calf and foot work supports the treatment between visits.
First step pain is easy to track. If the plan is working, you will feel it. If it is not, we adjust it or tell you plainly what we recommend instead.
Is This You
This approach tends to work best when:
When it is something else. A sudden pop with sharp pain can mean a fascia rupture, pain that is worse at night or at rest can mean a stress fracture, and burning or numbness usually points to a nerve problem rather than the fascia — see our neuropathy page. We screen for all of these at the consultation and will send you for imaging or to the right specialist if the picture does not fit.
Common Questions
The Tools We Use
Start Here
Schedule a free 20 minute consultation and we will tell you which of our tools fits your heel, and whether we can help at all.