Tag Archive for: healing

Foot and Heel Pain: How to Move Beyond Short-Term Relief

If you’ve ever stepped out of bed and felt a stabbing pain in your heel, there’s a good chance you were experiencing plantar fasciitis – one of the most common causes of heel pain in adults.

More than two million Americans struggle with it each year. Cortisone shots, orthotics, and rest are often prescribed, but these strategies usually provide only temporary relief – and in some cases, can even prolong the problem.

Recovering from plantar fasciitis starts with understanding why it happens in the first place. Once you know the root cause, the path forward becomes clearer – and today there are modern, natural options that focus on healing rather than simply masking pain. That’s the aim of this article. 

So let’s dive in: how do you move past short-term relief and get back to doing the activities you love, without heel pain holding you back?

What is Plantar Fasciitis?

The plantar fascia is a thick band of tissue running along the bottom of your foot, connecting your heel bone to your toes. Its job is to support your arch and absorb shock when you walk, run, or jump. When this tissue is overloaded, it can become irritated – and if that continues, the fascia begins to degenerate. The result is plantar fasciitis, marked by pain at the base of the heel, especially during the first few steps in the morning or after long periods of sitting.

Many assume plantar fasciitis is an inflammatory condition, but that isn’t the full picture. It’s more accurately a degenerative process, where the collagen fibers of the fascia weaken and lose their ability to tolerate load. This helps explain why treatments aimed only at reducing inflammation, such as cortisone shots, rarely provide lasting relief.

Why Traditional Treatments Fall Short

Cortisone injections have long been a standard treatment for heel pain. While they may reduce pain briefly, research shows the benefit is temporary – often only a few weeks or months. Repeated injections also carry risks. Cortisone does not repair the damaged fascia – in fact – it can weaken collagen and allow the problem to persist. Worse, by masking pain, injections often encourage continued activity that aggravates degeneration.

Custom orthotics are another common approach. These shoe inserts, often prescribed by podiatrists, can redistribute pressure and provide comfort in the short term. But research shows little difference between costly custom orthotics and high-quality prefabricated ones. More importantly, they do not address the underlying weakness or tissue degeneration. Once the initial benefit wears off, the pain often returns – and relying on orthotics indefinitely is impractical and prevents restoration of natural foot strength.

Both cortisone and orthotics may play a role in daily function. But if the goal is to truly heal the fascia and return to full activity, more is needed.

Stimulating Healing – Don’t Mask It

Instead of suppressing symptoms, you want to encourage true healing and pair it with corrective strengthening to keep the tissue healthy. Modern treatments such as shockwave therapy, EMTT, and PRP aim to jump-start your body’s own repair mechanisms instead of impeding them.

A good place to start is extracorporeal shockwave therapy, or ESWT. This non-invasive treatment sends acoustic waves into the fascia to create controlled “microtrauma,” which stimulates collagen regeneration and promotes tissue recovery.

An important complement is Extracorporeal Magnetotransduction Therapy, or EMTT. A 2022 multicenter study in the Journal of Clinical Medicine found that 80 percent of patients with chronic musculoskeletal conditions improved after EMTT, with more than 75 percent maintaining benefits six to twelve months later. In practice, EMTT appears to extend and amplify the positive effects of shockwave therapy by sustaining cellular activity long after treatment sessions.

For those needing an additional boost, platelet-rich plasma (PRP) injections are another option. Though invasive, PRP delivers concentrated growth factors directly into damaged tissue, enhancing the body’s natural healing. A 2023 randomized trial in BMC Musculoskeletal Disorders reported that PRP outperformed corticosteroid injections at reducing pain, improving function, and thinning the plantar fascia at six months. Case reports in the German Journal of Sports Medicine also show excellent outcomes when ESWT and PRP are combined, including full return to sport in runners who had failed other treatments.

Taken together, these therapies form a layered strategy: shockwave jump-starts the healing cascade, EMTT helps sustain it, and PRP provides an extra regenerative boost (if needed). When combined with a structured rehabilitation program, this approach offers a pathway to lasting recovery rather than temporary relief.

Beyond the Foot: Make the Healing Last

What many don’t realize is that chronic plantar fasciitis can also be linked to dysfunction higher up the chain. The pelvic floor, deep core muscles, and hip stabilizers all influence how forces travel through the legs and feet. If these areas are weak or poorly coordinated, the plantar fascia often absorbs stress it wasn’t designed to handle.

Clinical experience shows that individuals with weak core and pelvic floor control often develop altered gait mechanics, leading to excessive strain on the heel with each step. In these cases, treating only the fascia leaves the root cause unaddressed.

A comprehensive plan should therefore include strengthening of the core and pelvic floor, along with intrinsic foot training, alongside regenerative therapy. When these muscles are retrained to provide stability and load-sharing, the fascia is no longer forced to work alone. Over time, this reduces reinjury risk and creates a long-term fix. In essence, regenerative therapy jump-starts tissue healing, while strengthening ensures the fascia remains supported once it recovers.

The Bottom Line

Foot and heel pain can be stubborn, and plantar fasciitis in particular has a reputation for lingering. Cortisone shots and orthotics may provide temporary relief, but they do not restore the health of the fascia or solve the underlying problem. Regenerative therapies, especially shockwave, are supported by strong evidence for reducing pain and improving function in people with chronic plantar fasciitis. When combined with mobility, strength training, and – critically – core and pelvic floor retraining, they provide a durable solution that not only relieves pain but helps prevent it from coming back.

If your heel pain has been persisting for months, it’s worth considering a plan that goes beyond masking symptoms. Lasting relief comes when you treat both the tissue that hurts and the movement system that created the overload in the first place.

Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH, and writes for Seacoast Media Group. If local to Portsmouth, NH, and looking for help, request a FREE Discovery Visit with one of her Specialists by CLICKING HERE.

Setting Goals for the New Year: Part Three — Achieving Your Long Term Goal

If you’re keeping up with our goal-setting series, you may have already chosen a long term goal (or several) for 2019. If not, check out the post here!

Choosing a goal is an important step, but there’s no use having a goal if you’re not going to put the work in to achieve it. The downside to big, long term goals is that they can be overwhelming. Even when you can visualize where you want to be, it’s hard to know how to get there!

The answer? Break your long term goal into a series of short term goals.

Short term goals are things you know you can get done. For example, buying a new pair of running shoes or replying to an email. They’re simple, straightforward, and easy to build on. If you break your long term goal into the right short term goals, you may reach your objective without even realizing it!

So for example, let’s say your long term goal was to lose a certain amount of weight by the end of 2019. You want to be more active in order to lose the weight, but your knees bother you when you walk for prolonged periods. Here’s an example of what some of your short term goals could look like.

By January 15th: Make an appointment with a physical therapist to address knee pain.

By March 1st: Sign up for a group Pilates class to improve fitness.

May: Take a 20 minute walk outside 3 times per week.

June: Take a 30 minute walk outside 3 times per week.

July: Take a 30 minute walk outside 5 times per week.

By August 1st: Sign up for another Pilates class or other fitness class.

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Pilates class with Jennifer in our Portsmouth office at CJPT & Pilates!

Every short term goal should have a specific time frame and directly aid in reaching your long term goal.

The more you simplify each step, the more attainable your ultimate goal will feel! Plus, you’ll have rewards along the way for each short term goal—like getting rid of chronic pain, spending more time outdoors, and even meeting new people in Pilates class. No matter what you want to achieve, you can always break it down into manageable chunks that yield their own worthwhile perks.

Ready to incorporate physical therapy and Pilates into your health-related goals for 2019? Check out our website to sign up for a free Pilates Taster or free PT Discovery Session!

Physical therapy WORKS – Take it From the Ones Who’ve Done it!

Still not sure about PT? Have you heard a lot of conflicting information about what we really do as physical therapists? Do you need relief from an injury or chronic pain but you’ve been told surgery is your only option?

You’re not alone.

So many of our clients have come through our doors for the first time with those same questions. They may have been told over and over again by doctors that their pain or injury isn’t fixable – or if it is, they need extensive surgery and/or drugs. Many have never tried physical therapy before. Some are nervous because they think that it will be painful, and others doubtful that they’re going to learn anything new or helpful. But time and time again, those same individuals end up seeing amazing improvements in strength, mobility, health, and lifestyle. They consistently report how grateful they are to be simply living pain-free or able to participate in their favorite activities again. And we are always so proud of them for putting in the work and being an active participant in their individualized treatment plan!

I could go on and on about the results our awesome clients have seen, but no one says it better than themselves.

When Jeff first came to us he had a shoulder problem that was keeping him from working out at the gym the way he wanted. He’s also a dentist so leaning over his patients all day wasn’t helping. We worked on strategies during the day to help his mobility and then we tackled his stability! He came in and let us know that he was back to his full chest workout and pushups – with zero pain!

David, age 56, suffered from chronic neck and shoulder pain before coming to us for help.

“I couldn’t run more than 2 miles without radiating neck and shoulder pain and I was really uncomfortable at work. Working with CJ Physical Therapy, I learned how to manage my neck without going the surgery route. Now I can run as far as I like without any neck or shoulder pain.”

Another 56 year old, Kathie, took advantage of both our physical therapy and Pilates programs to resolve her shoulder pain.

“Before coming to CJPT & Pilates I was dealing with a shoulder problem that kept me from things like buckling my seat belt, walking the dog, and putting dishes away. I wanted to try something different from the traditional routes I’d tried in the past. Combining physical therapy and Pilates, and working with someone who understood my personal needs, was the difference that gave me my life back.”

Gale, age 65, experienced a positive difference with our practice that she hadn’t received in the physical therapy that was referred to her following a surgery.

“I was dealing with terrible pain and numbness in my arm and wrist after surgery, and there was still no relief after 15 weeks of regular physical therapy. After coming to therapy here, I can now cook, put on make-up, and I’m no longer worried about getting back to hiking or backpacking which I love. Best experience ever!”

Nothing makes us happier than getting to be a part of a positive change in someone’s life. And we love to hear how PT has impacted not just our clients’ health, but their lives overall! Several of our clients have even shared video testimonials of their experience working with us, which can be found here. They are living proof that anyone can benefit from physical therapy. You can be as skeptical as you want – you just have to be willing to give PT an honest shot. And chances are, you’ll be glad you did!

If you’re wondering if physical therapy is right for you – or if a different kind of physical therapy is right for you – please reach out!  We are so happy to help.  If we can’t help you – we’ll find someone that can.