Plantar Fasciitis Fasciopathy Treatment

Sharp and increasing pain that begins in your heel and radiates toward your foot arch may signal plantar fasciitis, also called plantar fasciopathy, a condition that affects the tough ligamentous band connecting your heel to your toes. The disorder may feel at first like you have a bruise or bone spur in your heel, but the pain will continue to worsen if ignored and left untreated.

Plantar fasciitis is an overuse syndrome, often seen among athletes, but also common in people who spend long hours standing or walking, especially on concrete. Non-supportive or ill-fitting footwear can contribute to plantar fasciitis pain. Being out of shape and carrying excess body weight may make the condition worse.

Plantar Fasciitis Symptoms

As with many overuse syndromes, plantar fasciitis symptoms often begin as a minor annoyance that gradually becomes more noticeable, and eventually debilitating.

Common symptoms include:

  • Sharp or tender heel pain
  • Pain that worsens after rest: Pain may be excruciating first thing in the morning, or after sitting for a prolonged time
  • Pain that worsens after physical activity: Pain may subside during exercise, but return full-force, once your body cools down
  • Pain when dorsiflexing the ankle (flexing toes towards shin)
  • Tingling or burning in the affected foot

Plantar Fasciitis Causes

Plantar fasciitis occurs when the plantar fascia, a thick band of connective tissue that spans the bottom of your foot, becomes injured. Injury often occurs from repetitive overuse, where demands placed on the fibers of the plantar fascia exceed their capacity to withstand them. Micro-tears in the fascia or a full-blown rupture cause pain that worsens over time.

Some causes of plantar fasciitis include:

  • Faulty walking or running gait mechanics
  • Walking or standing for extended periods in non-supportive footwear
  • Poor posture when standing or walking
  • Worn or poorly fitting athletic shoes
  • Overtraining during repetitive motion sports like running
  • Weak intrinsic foot core muscles
  • Unusually flat or unusually high arches
  • Tight Achilles tendons
  • Uneven leg length
  • Poor physical conditioning/sedentary lifestyle
  • Pregnancy

Diagnosis of Plantar Fasciitis


Diagnosis begins with a patient interview and health history review, followed by a physical exam. Because plantar fasciitis is relatively common, it is easy to overlook other less common potential causes of heel pain. Misdiagnosis is a primary cause of plantar fasciitis becoming a chronic condition. Compression of the small tibial nerve branch is a common mimicker of plantar fasciitis. About 25% of patients with chronic plantar fasciitis have a secondary tibial nerve involvement. Accurate diagnosis is key to treatment and recovery.

At NYDNR, we use the highest resolution diagnostic ultrasonography with SMI ( superior microvascular imaging) and elastography to diagnose plantar fasciitis, and rule out other possible causes of heel pain.

Musculoskeletal diagnostic ultrasound is the only radiological modality that can:

  • image the small nerves in the foot.
  • examine the plantar fascia in motion.
  • measure the elasticity of the plantar fascia.

Ultrasound also gives us the ability monitor the progress of treatment pre and post intervention with SMI.

Please explore more advanced diagnostic option unavailable anywhere else:


Plantar Fasciitis Treatment NYC

If you are suffering plantar fasciitis pain in NYC, the foot pain specialists at NYDNRehab can help. We use innovative treatment methods and state-of-the-art technologies to accelerate healing and increase the strength and integrity of the plantar fascia, to reduce the risk of future injury.

Plantar fasciitis physical therapy

At NYDNR, we provide an individualized plantar fasciitis rehabilitation protocol for each patient, not a one-size-fits-all treatment plan. Contact NYDNR today, and get to the bottom of your foot pain, so you can get back to your active lifestyle.



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Plantar Fasciitis Physical Therapy

Plantar fasciitis pain results from an inflammation of the thick tissue on the bottom of the foot known as plantar fascia. Because plantar fasciitis pain may create serious abnormalities in a person’s gait, finding the right plantar fasciitis treatment is essential. New York Dynamic Rehabilitation clinic (NYDNRehab) employs technologically advanced methods like shockwave therapy, gait analysis, and Computer-Assisted Rehabilitation Environment (C.A.R.E.N) to diagnose and rehabilitate injured feet.

The plantar fascia begins at the heel bone and runs along the bottom of the foot, forming thick, tendinous sheathes that help to hold the toes in place. Within and surrounding the plantar fascia are small nerves that innervate the foot and register pain in the lower part of the body. This is one of the reasons plantar fasciitis is so painful. The plantar fascia tissue is composed of three sections, of which the middle portion is the largest and most vulnerable. The plantar fascia is instrumental in providing support and shock absorption to the foot, carrying up to 14 percent of the weight supported by the foot.

Plantar fasciitis occurs as a result of exercise or other strenuous activity, which is one reason athletes are so susceptible to it. Patients may develop plantar fasciitis from running and jumping that loosens the plantar fascia. Athletes may also render themselves vulnerable through sudden and drastic changes in their exercise routine because the body has not had sufficient time to adjust to the new pressures it’s undergoing.

Plantar fasciitis treatment includes copious amounts of rest and exercises designed to stretch the calves and plantar fascia. Plantar fasciitis pain physical therapy exercises are designed to disrupt the cycle of pain and inflammation that patients are likely to experience throughout the day. One method of doing this is through morning calf stretches undertaken before getting out of bed, during that moment in the day that is typically most painful for a sufferer of plantar fasciitis. Individuals undergoing plantar fasciitis therapy may also be given shoe inserts, also known as orthotics, to stabilize the feet. Orthotics prevent tearing and inflammation of the plantar fascia by elevating the foot. Elevation prevents excessive pressure from being placed on the plantar fascia.

At NYDNRehab we provide several important options for plantar fasciitis treatment. Technological running and gait analysis uses a treadmill to expose and diagnose abnormalities in a patient’s movement, often before the symptoms of a painful condition even begin to manifest. The runner is placed on a treadmill and markers are affixed to his or her body. These markers send information to a computer that provides real-time feedback. With this information the physician and patient are able to make strategic decisions about the best methods of rehabilitation available. Extracorporeal shockwave therapy (ESWT) has proven effective in relieving inflammatory conditions by treating the tissue surrounding an injury. High-frequency shockwaves are sent through the skin of the plantar fascia, halting the inflammation process. Finally, C.A.R.E.N is a highly advanced technology that re-trains the patient’s movement through the creation of virtual-reality exercises that can’t be done in a normal clinical environment. Each of these has its place in the treatment of plantar fasciitis, and NYDNRehab offers them.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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