Plantar fasciitis is a foot problem that leads to significant heel pain, particularly among individuals who are active or spend long hours on their feet. This condition occurs when the plantar fascia (PF), a thick band of tissue connecting the heel bone to the toe becomes irritated and in most cases compresses the local nerves. Understanding the underlying causes, recognizing the symptoms, and receiving effective and most current interventions are essential for managing this condition effectively.

Dr. Dean’s Evidenced-Based Opinion: This cause of heel pain is an over-diagnosed ailment of the foot and ankle. Dr. Dean has been involved with Olympic Athletes for the last ten years and rarely is treating the PF itself the solution. 

• Dr. Dean is performance therapist, a published speaker at sports performance conferences, and has consulted with over fifty Olympic athletes globally.

Here’s Why:

“Itis” means inflammation, but research has shown that said fascia has no inflammatory cells. Arch pain is most likely derived from other local tissues such as the nerves, fascia, and reticulum. 

This is also why most treatment approaches are targeting the wrong tissue and hence it’s become chronic and debilitating rather than experience immediate relief. 

What Does Dr. Dean Do Different?

Dr. Dean utilizes the best interventions from across the globe and Transverse Nerve Mobilizations (he invented) to manually release the fascia, gently stretch the nerves and restore optimal function to all the joints of the foot. The entire foot and ankle need to be treated and what once was a pesky condition is now a simple intervention. 

No surgery, no needles, and no expensive regenerative medicine protocols are generally needed (but can beneficial).

Most Commonly Missed Causes:

• Saphenous Nerve Entrapment- This cutaneous nerve courses directly over the inside of the ankle and is rarely considered, but frequently causing the issue. 
• Tibial Nerve Entrapment- Also known as Tarsal Tunnel Syndrome
• Referral from the lower back- The most commonly missed cause in athletes and essentially a form of sciatica. 

Real-World Results:

• 96% of Dr. Dean’s patients report full resolution of heel pain in under 5 visits

• 99% avoid surgery using nerve mobilization therapy
  (Based on internal tracking from 2023–2024 patient data)

Causes

Several factors can contribute to development of heel pain, including:

• Overuse: Activities that place excessive stress inner ankle, such as running, dancing, or standing for extensive periods.
• Foot Structure: Abnormalities like flat feet, high arches, or an contorted walking loading patterns can increase strain upon the arch of the foot.
• Age: The risk of developing arch related pain increases with age, as the fascia loses extensibility and strength over time.
• Weight Factors: Being overweight can place additional duress on the ankle and foot, exacerbating the issue.

Identifying Symptoms

The primary symptom of plantar fasciitis is a sharp pain in the heel, often most pronounced in the morning or following prolonged periods of inactivity. Others commonly experience:

• Stiffness in the foot is particularly noticable after rest.
• Pain that intensifies following exercise or physical loading.
• Swelling or tenderness in the heel area.

Best Treatments in 2025

• Examination of the lower back for disc herniations that commonly cause referral to the foot and ankle.
• Mobilization of the saphenous and tibial nerve and surrounding tissues
• Fascial release therapy of the entire foot and ankle.
• Restoring proper extension to the big toe is vital for proper foot function.

Standard Treatment Alternatives

Addressing heel discomfort typically includes of self-care strategies and professional interventions. Here are widely recommended treatment options:

• Rest and Ice Therapy: Take breaks from activities that aggravate the condition and apply ice.
• Stretching Exercises- Incorporating gentle stretching routines for the calf muscles and arch of the foot can alleviate tension and enhance flexibility. Dynamic movements, not aggressive holding
• Orthotic Devices- Using custom or over-the-counter arch supports can provide additional cushioning and support for the foot.
• Physical Therapy- Tailored exercise program to strengthen the foot.
• Medications Nonsteroidal anti-inflammatory drugs (NSAIDs)- Possibly help alleviate pain and reduce inflammation.
• Surgical Options- In severe cases, surgical procedures may be considered to relieve tension on the plantar fascia.

Innovative Treatment Approaches

In addition to traditional treatment methods, several innovative therapies have been created that may yield aide for those experiencing plantar fasciitis. Here are some noteworthy options:

Shockwave Therapy– A non-invasive treatment that uses acoustic waves to promote healing in the plantar fascia, but causing micro injuries to the tissue.  Effective for chronic pain; minimal downtime. Multiple sessions may be necessary; not suitable for all.

Platelet-Rich Plasma (PRP)-Injections Involve injecting a concentration of platelets from the patient’s blood into the affected area to promote healing. Utilizes the body’s natural healing actions; and can lessen inflammation. Costly; results may vary.

Ultrasound Therapy- This therapy uses sound waves to promote tissue healing and reduce inflammation. Painless; can be combined with other treatments. May require several sessions; effectiveness can vary.

Custom Footwear- Specially designed shoes that provide optimal support for the feet. Improves comfort; minimizing strain on the plantar fascia. Can be expensive; take’s time to adjust.

• Opinion: Money maker for doctors, but patients now have to use them all the time in order for them to be effective

Conclusion

Plantar fasciitis can significantly impact daily life, but understanding the condition and exploring various treatment options can lead to effective management and recovery. From traditional methods to innovative therapies, there are numerous methodologies to explore.

Remember, taking proactive steps and being informed about your alternatives is the optimal method to combat plantar fasciitis and regain foot’s function.

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Best way to schedule a treatment is by texting Dr. Dean directly 323-354-6077

Medically Reviewed and written by Dr. Justin Dean, DC on March 28th, 2025

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