Plantar fasciitis is a common musculoskeletal injury that affects almost 10% of the population. Consequently, it’s responsible for nearly 1 million outpatient visits in the US per year2,5. People might commonly know it as sharp pain in the heel with the first few steps after inactivity. Common knowledge has connected it to inflammation of the plantar fascia. However, current evidence suggests that the disease deals more with microscopic degeneration and thickening of the tissue3. The diagnosis of “plantar fasciosis” has been used more frequently lately. This refers to the degenerative nature of the condition.

In a clinical practice guideline published in 2014 by the Orthopaedic Section of the American Physical Therapy Association, several recent studies strongly recommended manual therapy and stretching (common treatments performed by physical therapists)4. At Therapeutic Associates Sellwood Physical Therapy, our physical therapist is certified in ASTYM. This is a technique that uses the body’s own natural healing properties to help regenerate the degenerative tissue. It’s most effective when used with a stretching and strengthening program of the area.

Plantar fasciosis is a common musculoskeletal condition. But, in a study of over 800,000 cases, only 7.1% of patients had an evaluation by a physical therapist1. This unfortunate gap can come from several issues. For example, a clinician’s lack of access to evidence or difficulty with understanding the evidence can limit this. Also, a clinician may have lack of training with searching, analyzing, and applying evidence1.

Direct Access

Physical therapy in Oregon is a direct access state. That is to say, most insurance companies will cover physical therapy examination and treatment costs without a physician referral. If you are suffering from plantar fasciosis or any other common musculoskeletal condition, take matters into your own hands. Seeing a physical therapist directly! As a result, you will have the peace of mind knowing you’re following evidence-based practice to a faster recovery.

Do you have a doctor’s visit in the near future and having heel pain? Be an advocate for yourself and ask about a referral to physical therapy.

To learn more about direct access or how physical therapy can help your pain, please call us at (503) 236-3837 or send an email to [email protected].


  1. Fraser J, Glaviano NR, Hertel J. Utilization of Physical Therapy Intervention Among Patients With Plantar Fasciitis in the US. JOSPT. 2017; 47: 49-55.
  2. Goff JD, Crawford R. Diagnosis and treatment of plantar fasciitis. Am Fam Physician. 2011;84:676-682.
  3. Lemont H, Ammirati KM, Usen N. Plantar fasciitis: a degenerative process (fasciosis) without inflammation. J Am Podiatr Med Assoc. 2003;93:234-237. https//doiorg/10.7547/87507315-93-3-234
  4. Martin RL, Davenport TE, Reischl SF, et al. Heel pain – plantar fasciitis: revision 2014. J Orthop Sports Phys Ther. 2014;44:A1-A33.
  5. Pfeffer G, Bacchetti P, Deland J, et al. Comparison of custom and prefabricated othoses in the intial treatment of proximal plantar fasciitis. Foot Ankle Int. 1999;20:214-221.