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Plantarfascitis: A pain in my heel!

Sara Shupe, MSPT, Dip. MDT, is a physical therapy specialist and founder of J.O.Y. Physical Therapy. She recently shared her research related to low back pain at the North American Spine Society summer meeting in San Diego.

Did you ever think you would live long enough to know what a word like "plantarfascitis" means, let alone have the unfortunate experience of it? Although it may greatly assist you in improving your Jeopardy scores, it will have the opposite effects on your mornings. The first few steps of sharp stabs of pain in your heel or bottom of the foot can sometimes bring tears to your eyes. You'll think twice about getting up out of your office chair after working a while on your spreadsheets. The water cooler can wait!


For some patients, early intervention with physical therapy can help reduce the initial sharp pain of plantarfascitis with a protocol of heel cord stretching, ice massage and inserts in your shoes. It has also been suggested it may prevent more invasive measures like injections down the road. But for those of you reading this who have been there, done that to no avail, there is Good News!

Manual Therapy for plantarfascitis.

Recent data has suggested that most patients benefit from early intervention of physical therapy. But a recent article in the Journal of Manual and Manipulative Therapy (JMMT) has suggested that those patients with plantarfascitis respond especially well to applications of manual therapy in conjunction with your exercise program (Fraser et al 2018). 

What is manual therapy? Well, I'm glad you asked!

Your physical therapist can perform manual therapy on your foot by 1) massaging it, 2) mobilizing it, or 3) manipulating it. Due to the absence of massage from the physical therapy world, I will explain the latter two.

2) Manual therapy is most commonly applied by a physical therapist by mobilization. There are levels of force used in a graded manner, when applied correctly, to concurrently monitor your symptoms while moving the joint(s) in a specific direction. In Mechanical Diagnosis and therapy (MDT), mobilization is  applied to your foot/ankle when your own movements are not providing the desired effects. It is not THE treatment, but an adjunct to make the exercise you are prescribed more effective. 

3) Manipulations, much like your adjustments at your chiropractor, are typically high-velocity movements of your joints applied from an external source. The idea is to get the joint in "the optimal" position for function as quickly as possible. If your therapist is trained in MDT, they will always test your plantarfascitis, slowly progress forces and re-testing FIRST, BEFORE every applying a manipulative force. 

We believe this is safest. 

  • Call or go to www.joy-pt.com today to get your appointment for your plantarfascitis or find a MDT Provider in your area at www.mckenzieinstituteusa.org/findaprovider

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