Plantar Fasciitis · Kitchener, Waterloo & Cambridge
Plantar fasciitis is pain under the heel or along the arch, from the plantar fascia, the thick band of tissue that supports the bottom of the foot. The 2023 clinical guideline for heel pain backs stretching, hands-on treatment, taping and foot strengthening. At CARESPACE a physiotherapist or chiropractor assesses the foot and starts that plan at the first visit.
What plantar fasciitis is
The plantar fascia runs from the heel bone to the base of the toes and helps hold up the arch. In plantar fasciitis the tissue near the heel becomes sore and sensitive. You may also see it called plantar fasciopathy. “Plantar heel pain” is the broader term: it covers plantar fasciitis and a few other causes of pain under the heel.
Symptoms of plantar fasciitis
- Sharp pain under the heel with your first steps in the morning
- Pain when you stand up after sitting for a while
- Pain that eases as you warm up, then returns after a long time on your feet
- Tenderness on the inside edge of the heel
- Tight calves
What causes plantar fasciitis
It usually builds gradually after a change in how much your feet are doing: a jump in running or walking distance, a new job on your feet, worn-out shoes, or stiff ankles and tight calves that shift load onto the heel. That might be a run of shifts on a concrete plant or warehouse floor, or the first long runs on the Iron Horse Trail after a winter indoors.
If the pain does not fit that pattern, or is not improving with treatment, the guideline says to look for other causes, such as a stress fracture of the heel bone, an irritated nerve or inflammatory arthritis. The NHS advises seeing a doctor if the pain is severe, is getting worse or keeps coming back, or has not improved after two weeks of looking after it yourself.
What the evidence says about treating plantar fasciitis
- Stretching, hands-on treatment and taping come first. The 2023 clinical practice guideline for heel pain gives its top grade to stretches for the plantar fascia and the calf, manual therapy to the joints and soft tissue of the leg and foot, and taping alongside other treatment for short-term relief.
- Night splints get the same top grade for people whose pain is consistently worst with the first steps in the morning, used for one to three months.
- Strengthening and dry needling come one grade lower: resistance exercise for the foot and ankle muscles, and dry needling of trigger points in the calf and the sole of the foot. Acupuncture was not evaluated.
- Orthotics are not a treatment on their own. They should not be used alone for short-term pain relief, and may be used together with other treatment.
- Shockwave comes later, if at all. A 2021 best-practice guide in the British Journal of Sports Medicine puts taping, stretching and individual education first, and says people who do not improve enough may then be offered shockwave therapy, followed by custom orthoses. The physiotherapy guideline makes no recommendation on shockwave.
- Expect weeks to months. The best-practice guide says to give the first-line approach about four to six weeks before adding anything, and its experts describe the outlook as good but slow.
How each CARESPACE service treats plantar fasciitis
Physiotherapy
A physiotherapist checks that the plantar fascia is the source, measures ankle movement and calf flexibility, and teaches you the plantar fascia and calf stretches the guideline recommends. Taping is often added early for short-term relief, with strengthening for the foot and ankle muscles after that. Some CARESPACE physiotherapists also offer dry needling and custom orthotics as part of a wider plan.
Chiropractic
The guideline’s hands-on recommendation covers the joints as well as the soft tissue of the leg and foot. A chiropractor assesses how the ankle and the joints of the foot are moving and uses mobilization and soft-tissue work where movement is restricted, together with the same stretches.
Massage Therapy
A Registered Massage Therapist works on the calf and the muscles of the sole of the foot. This soft-tissue work is part of the recommended hands-on treatment, and it is done alongside your stretches, not in place of them.
See our massage therapy team →
Dry needling and acupuncture
Dry needling of tight points in the calf and the sole of the foot is recommended in the guideline, at its second-highest grade. The guideline did not evaluate acupuncture, so we cannot point to the same support for it. Either one is an add-on to stretching and strengthening. About dry needling →
See our acupuncture practitioners →
Kinesiology
Strengthening the foot and ankle muscles is part of the recommended plan. A kinesiologist builds that program and progresses it, and plans the return to running, or to long days on your feet, in steps.
Where most people start
A physiotherapist or a chiropractor is the place to start. Either one will assess the foot and begin treatment at the first visit.
How your team works together
The guideline’s top recommendations cover more than one kind of treatment: stretches you do yourself, hands-on work and taping, then strengthening. Your physiotherapist or chiropractor sets the plan and the stretches. Massage therapy can add soft-tissue work on the calf and foot, and a kinesiologist takes on the strengthening and the return to full activity.
Physiotherapists
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Available this week
Eric Bowman, BSc, MPT, PT
Physiotherapist
If you are looking for physiotherapy in Waterloo, you are probably not looking for a rushed appointment or a generic sheet of exercises.
Chiropractors
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Available today Weekend availability
Danial Dimitri, BSc (Hons), DC
Chiropractor, District Manager
You do not need to keep building your life around jaw tension, headaches, back pain, or a body that no longer feels like it moves the way it…
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Shannon Webster, BA (Hons), DC
Chiropractor, Clinic Director
You should not have to keep organizing your life around pain when Dr.
No availability About Shannon Kinesiologists
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Available this week
Ian Alishaw, BHSc, CPTN, RKin, FST
Kinesiologist/Fitness Trainer/Fascial Stretch Therapist, Clinic Director
You should not have to choose between getting stronger and respecting a body that needs a smarter plan.
Osteopathic Manual Practitioners
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Available today Evening availability Weekend availability
Tejinder Paul, DOMP
Osteopathic Manual Practitioner
I am a dedicated Osteopath committed to helping clients improve their overall well-being, movement, and quality of life through personalized, hands-on care.
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Evening availability
Aliya Malek, BPT, DOMP
Osteopathic Manual Practitioner, Assistant Director
You don’t need another rushed appointment when your body is asking for careful, skilled hands and a plan that finally makes sense.
Find a practitioner by service: physiotherapists, chiropractors, registered massage therapists or kinesiologists.
What to expect at your first visit
- How it began. When the heel pain started, what changed around then, and what your feet do in a normal week.
- A foot and ankle assessment. Where it is tender, how far the ankle and big toe bend, how flexible the calves are, and how you stand and walk.
- An answer on whether it is plantar fasciitis or something that looks like it.
- Treatment at that visit, usually hands-on work, taping and your first two stretches.
What you can do at home
- Stretch the sole of your foot and your calf gently every day.
- Wear shoes with cushioned heels and good arch support, and avoid walking barefoot on hard surfaces.
- Avoid walking or standing for long periods, and rest with the foot raised when you can.
- Hold an ice pack wrapped in a towel on the sore area for up to 20 minutes every two to three hours.
- Ask a pharmacist about insoles or heel pads, and about pain relief.
Plantar fasciitis treatment in Kitchener, Waterloo and Cambridge
Kitchener
Locations: Victoria North, Fischer-Hallman, Westmount East and Deer Ridge. Services for plantar fasciitis: Physiotherapy in Kitchener, Chiropractic in Kitchener, Massage Therapy in Kitchener, Acupuncture in Kitchener and Kinesiology in Kitchener.
Waterloo
Locations: Weber North, Uptown Waterloo and Waterloo GoodLife. Services for plantar fasciitis: Physiotherapy in Waterloo, Chiropractic in Waterloo, Massage Therapy in Waterloo, Acupuncture in Waterloo and Kinesiology in Waterloo.
Cambridge
Location: Hespeler Road. Services for plantar fasciitis: Physiotherapy in Cambridge and Acupuncture in Cambridge.
The city pages linked above show the locations and practitioners for each service, with their next availability.
Common questions
How long does plantar fasciitis take to heal?
Usually several weeks to months. The British best-practice guide describes the outlook as good but slow, and says to give stretching, taping and the right advice about four to six weeks before adding another treatment. The American guideline notes that many people have had heel pain for more than a year by the time they look for help.
Do I need orthotics?
Not on their own. The guideline says orthotics should not be used alone for short-term pain relief, and may be used together with other treatment. The British best-practice guide places custom orthoses after stretching, taping and shockwave.
Where can I get plantar fasciitis treatment in Cambridge?
CARESPACE Hespeler Road has physiotherapy, which covers the assessment, stretches, taping and strengthening, and it has acupuncture. Book online or call 519-208-2273 and our Central Reception Team will find the closest location with an opening.
Can I keep running or walking for exercise?
Usually, with changes. The best-practice guide advises cutting back the running that aggravates the heel, avoiding sudden jumps in training, and breaking up long periods of standing. The NHS suggests exercise that keeps pressure off your feet, such as swimming, while the heel is sore. Your practitioner will help you set the amounts.
What is shockwave therapy, and will I need it?
Shockwave therapy applies pressure waves to the sore area. In the British best-practice guide it is the next step for people who have not improved enough with stretching, taping and education, not a first treatment. The physiotherapy guideline makes no recommendation on it.
Is it plantar fasciitis or a heel spur?
It is not always one or the other. The guideline lists heel spurs among several possible causes of pain under the heel, and says imaging is usually not needed unless treatment has not worked. An assessment of the foot is the way to find out what is going on.
Do I need a referral?
No. Book online or call 519-208-2273. You pay at each visit and receive a receipt for your extended health plan. More on fees and insurance →
Sources
- Koc TA Jr, et al. Heel Pain – Plantar Fasciitis: Revision 2023. Clinical practice guideline, Journal of Orthopaedic & Sports Physical Therapy, 2023.
- Morrissey D, et al. Management of plantar heel pain: a best practice guide informed by a systematic review, expert clinical reasoning and patient values. British Journal of Sports Medicine, 2021.
- NHS. Plantar fasciitis.
Ready to book?
Book online with a physiotherapist or chiropractor, or call 519-208-2273 and our Central Reception Team will match you with the right person and the closest location.