Physical Therapy News

Plantar Fasciitis Stretches, Causes and Treatments

If you’re experiencing heel pain, especially after walking all day or running long distances, you may have plantar fasciitis. It’s a common condition characterized by pain and inflammation of a thick band of tissue, called the plantar fascia, which is similar to a bowstring. The plantar fascia runs across the bottom of your foot and connects your heel bone to your toes.

Many times plantar fasciitis develops due to chronic poor posturing of the foot during weight-bearing activities, such as walking for long periods, or standing all day at work. It’s also common in runners and people who are overweight.

Most people experience a sharp, stabbing pain in their heel. This often occurs when you first get out of bed and take a few steps in the morning, or when you get up after long periods of sitting. When sleeping or sitting, the plantar fascia becomes tight. Once you get up and start walking around, the plantar fascia loosens and the pain typically decreases.

Other notable symptoms include pain in the arch of the foot, pain that increases over a period of months, and swelling on the bottom of the heel.

If you suffer from plantar fasciitis or foot pain, give these stretches a try next time you feel a flare up coming on.

What causes plantar fasciitis?

Causes of plantar fasciitis vary but there are risk factors that can increase your chances of developing the condition:

  • Improper foot mechanics, being flat-footed, having a high arch or even having an abnormal pattern of walking
  • Occupations that require walking or standing on hard surfaces, including teachers, factory workers, carpenters and nurses
  • Faulty footwear can affect the way weight is distributed when you’re standing and put added stress on the plantar fascia
  • Overuse or increase or change in activity
  • Weight fluctuation and obesity
  • Age as plantar fasciitis is most common in women and men between the ages of 40 and 60
  • Certain types of exercise including long-distance running, jumping, ballet, and high-intensity training

If tension on the plantar fascia becomes too great, it can create small tears in the fascia. Repetitive stretching and tearing can cause the fascia to become irritated or inflamed. Ignoring the symptoms of plantar fasciitis may result in chronic heel pain. If left untreated, it can lead to foot, knee, hip or back problems from overcompensating.

Treatment options for plantar fasciitis

Plantar fasciitis usually goes away after several months, but it is best to visit your doctor for an official diagnosis and rule out other injuries. There are a variety of lifestyle changes and treatment options that can help, along with education and physical therapy.

  • Stretching exercises. Stretching out the calf muscles can help ease pain and assist with recovery.
  • Limit activities. Give your heel a rest by reducing physical activities.
  • Good shoes. Invest in supportive shoes that have good arch support and a slightly raised heel.
  • Ice. Using an ice pack on your heel for 20 minutes a day can reduce inflammation. Do not apply ice directly to the skin.
  • Avoid going barefoot. When you walk without shoes, you put undue strain and stress on your plantar fascia.
  • Medications. Oral non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can help reduce pain and inflammation.

Minimally invasive procedures include extracorporeal shock wave therapy (ESWT) and radioablation (Topaz). Few people need surgery to detach the plantar fascia from the heel bone. It’s generally an option only when the pain is severe and all else fails. Side effects include a weakening of the arch in your foot.

Dry needling is also a great treatment for plantar fasciitis. In part 2 of our video series we’re demonstrating how and why it works. Dry needling the calf not only reduces tightness throughout the lower leg, but also aides in reducing foot pain.

Physical therapy can help plantar fasciitis

If at-home treatments don’t relieve your symptoms, physical therapy is a good option for foot pain and plantar fasciitis. A good way to think of rehabilitation is in two phases: first, control the symptoms and aggravating factors; second, prevent future flare-ups or reoccurrences.

Phase one of physical therapy may include treatments such as hot/cold packs, electrical stimulation, or ultrasound. Gentle non-weight bearing stretching and range of motion (ROM) activities are often recommended.

Manual therapy techniques include joint mobilizations and soft tissue mobilizations. The Graston Technique, a form of instrument-assisted soft tissue mobilization, is a specific type of manual therapy provided by certified physical therapists and is an effective complement to stretching and strengthening.

Physical therapists also focus on education, such as wearing proper footwear and using ice packs at home, to prevent and change daily habits that may be triggering symptoms. The goal is to help control and eliminate symptoms such as pain and inflammation.

Phase two is designed to prevent reoccurrence by eliminating the source of the fasciitis. Re-establishing correct foot mechanics, the way in which the foot impacts the floor throughout gait, is critical in preventing future symptoms. Routinely orthotics or proper-fitting shoes are recommended to support unstable or high arches.

Additionally, strengthening and balance training activities are beneficial to ensure proper force transfer through the foot during stance and minimizing stress through the plantar fascia. As part of the Ivy Rehab Network, we also offer a special Running Analysis Program.

Don’t go another day with a throbbing heel or chronic foot pain, especially if you have been diagnosed with plantar fasciitis. Contact your nearest Northern Physical Therapy clinic for an assessment or to talk to a physical therapist about your symptoms and how they can help.

Rotator Cuff Exercises to Prevent Shoulder Pain & Rotator Cuff Injuries

rotator cuff injuries

You may not realize how often you use your shoulder until you begin feeling pain. When simple tasks like reaching up into a cupboard, brushing your hair, or reaching over to fasten your seat belt cause you pain, it begins to affect your daily life. And for athletes, the pain can put a quick stop to your training program.

Issues with the rotator cuff and tissues that surround it are the most common causes of shoulder pain in people over the age of 40. Rotator cuff tendinitis occurs when a shoulder tendon (a bundle of fibers connecting muscle to bone) is irritated and becomes sore. With continued irritation, the tendon can begin to break down, causing tendinosis, which is a more chronic condition. Every time you move your shoulder you’re using your rotator cuff to stabilize and help move the joint. People who perform repetitive or overhead arm movements, such as weight lifters, athletes, and manual laborers, are most at risk for developing issues within their rotator cuff.

How does it feel to have tendonitis in your rotator cuff?

Typically you’ll experience shoulder pain that can occur gradually over time or start quite suddenly. The pain occurs in the shoulder area and can radiate into your upper arm. It doesn’t usually go past the elbow region, however, in some cases it can. You may not experience any pain or discomfort when you’re at rest, but once you move the arm the pain can be moderate to severe. Reaching behind your body or doing overhead activities, such as throwing, swimming, reaching into a cabinet, or combing your hair can be very painful. The pain can get worse at night, especially when rolling over or sleeping on the painful side. If the condition is left untreated, it could get worse and the pain could move to other parts of the body, such as your neck.

Doing proper exercises can help to avoid a rotator cuff injury because it’s possible for your shoulder to become inflamed pretty quickly. Many people with rotator cuff issues can manage their symptoms and return to daily activities with physical therapy exercises that improve flexibility and strength of the muscles surrounding the shoulder joint.

Our team has put together a series of rotator cuff exercises that you can do a few times each week to strengthen the shoulder region and avoid pain and injury.

How is a rotator cuff injury diagnosed?

A physical therapist can assess your pain by performing an evaluation (you may even be eligible for a free consultation, call and ask for details), which may include strength and motion tests on your shoulder. They’ll talk about your job duties and hobbies, evaluate your posture, and check for any muscle imbalances and weakness that can occur in the shoulder region. Your physical therapist will then gently touch your shoulder in specific areas to determine which tendon(s) are inflamed, and may perform other special tests to detect rotator cuff tendinopathy. Generally, a physical examination is all that’s needed to diagnose rotator cuff tendinopathy. If the symptoms do not resolve with physical therapy, imaging (eg, MRI) may be considered, to help determine any possible underlying condition that could be affecting the shoulder.

How can a physical therapist help with rotator cuff pain?

It’s important to get proper treatment for tendinitis as soon as it occurs because over time, a degenerated tendon that is not treated can begin to tear, leading to a more serious condition. Physical therapy can be very successful in treating rotator cuff tendinitis, tendinosis, and shoulder impingement syndrome. Depending on your specific condition and goals, your personal treatment program may include:

Pain management. Your physical therapist will help you identify and avoid painful movements to allow the inflamed tendon to heal. Ice, massage, or moist heat may be applied for pain management.

Patient education. Posture education is an important part of rehabilitation. For example, if you sit at a computer all day you may have a tendency to roll your shoulders forward, causing the tendons in the front of the shoulder to become pinched. We may suggest adjustments to your workstation and work habits to reduce the discomfort. We may also go over certain sitting, standing, and sleeping positions to help alleviate symptoms. Finally, your physical therapist may suggest different ways to perform currently painful activities and show you movements to avoid while you’re experiencing shoulder pain.

Manual therapy. Your physical therapist may use manual techniques, such as gentle joint movements, soft-tissue massage, and shoulder stretches, to get your shoulder moving in a manner which is pain-free.

Range-of-motion exercises. You will learn exercises and stretches to help your shoulder and shoulder blade move properly, so you can return to reaching and lifting without pain.

Strengthening exercises. Your physical therapist will determine which strengthening exercises are right for you, depending on your specific condition. You may use weights, medicine balls, resistance bands, and other types of resistance training to challenge your weaker muscles. You will receive a home-exercise program, so you can continue rotator-cuff and shoulder-blade strengthening long after you have completed your formal physical therapy.

Functional training. As your symptoms improve, your physical therapist will help you return to your previous level of function, which may include household chores, job duties, and sports-related activities. Functional training can include working on lifting a glass into a cupboard or throwing a ball using proper shoulder mechanics. Speak with your physical therapist so they know what your goals are, and can get you back to your prior level of functioning as soon as possible.

Can a rotator cuff injury be prevented?

The likelihood of developing rotator cuff tendinopathy can be reduced by:

  • Being aware of repetitive movements that may lead to pain—especially over your head, across your body, or behind your back—and modifying your activity if there are any symptoms of discomfort.
  • Maintaining ideal shoulder and spinal posture during daily activities, including sitting at a computer. This can be accomplished by performing daily stretches to the shoulder and upper back to maintain normal movement. Tightness in the upper back, or a rounded shoulder posture will decrease the ability to move your torso, and that makes the shoulder have to work harder to perform everyday activities, such as reaching for objects.
  • Keeping your upper body strong, including the upper back and shoulder-blade muscles, will help prevent tendinitis. Many people work the muscles in their chest, arms, and shoulders, but it is also important to work the muscles around the shoulder blade and upper back. These muscles provide a strong foundation for your shoulder function. Without a strong foundation, muscle imbalances occur and put the shoulder at risk for injury.


If you have any questions about a rotator cuff injury or shoulder pain, feel free to contact us. You may be eligible for a free consultation where you’ll meet one-on-one with a physical therapist to discuss your concerns.


Northern Physical Therapy is part of the Ivy Rehab Network, learn more at

Tips for doing yard work with less pain :: An interview on eightWest

Yard work and back pain

After a long winter, we’re all ready to spend some time outdoors – and this time of year there’s plenty to do. At the first sign of a warm day many people head to the yard and spend all afternoon raking stray leaves, pulling weeds, and trimming the hedges. But, all that yard work can often lead to a sore back or cause pain in your legs and knees. It’s easy to overdo it as we put extra strain on our bodies. Gina Otterbein, Regional Director at Ivy Rehab in West Michigan, talked with the WOOD TV  eight West studios and shared her tips for reducing aches and pain while getting the yard ready for the warmer months ahead.

Yard Work Tips

  • Change your position often. Every 20-30 minutes you need to get up, stretch and change your position. This simple tip is going to prevent a lot of the common aches that we see after a long day doing yard work.
  • Avoid bending over and deep squatting when you’re pulling weeds. To ease the stress on your back and knees try using a knee pad and a stool or 5 gallon bucket to sit on so you don’t have to bend, reach, or twist as far.
  • When raking or using a weed trimmer, avoid twisting your spine, which can lead to back pain. Instead, walk with the rake or weed trimmer, engage your core, and use your feet so you’re not twisting.
  • Wear a pair of gloves when using power trimmers. The constant vibrations of the trimmer can lead to discomfort in your elbows, wrists, and hands. Gloves will reduce the vibrations, making your hands feel better the next day.

Feeling sore?
Yard work really can be a rewarding process, but the last thing you want is to spend the rest of the weekend indoors because of unnecessary muscle aches and pains. If you do happen to experience low back pain, or any other discomfort, give us a call! With a quick Telehealth session, we can assess the source of your pain and give you some exercises and a treatment plan to get you feeling good again in no time. We can also review what caused the pain in the first place and talk about how to avoid it next time you’re out moving around and doing yard work.

We’re now offering more options than ever for receiving therapy. Plus, you can see us with or without a referral from your physician. As part of the Ivy Rehab Network, there are three convenient ways to receive therapy treatment from us:

  • Telehealth sessions connect patients to their licensed therapists through a secure, HIPAA-compliant, fully encrypted, two-way video-call system. Patients can do therapy from the comfort of their home through a desktop computer, laptop, smartphone, iPad or tablet. Learn more about Telehealth here.
  • Therapy at home allows both new and existing patients to receive in-person therapy services. This includes one-on-one evaluations and treatment sessions in the comfort and safety of their home. Learn more about an in-home therapy session.
  • Therapy in our clinic: We are here to serve you. Schedule an appointment today.


View Our Previous Physical Therapy Segments on eightWest
If you missed any of our previous WOOD TV eightWest segments, you can view them at the following links. We’ve talked about various topics: Tips for comfortably working from home, Couch to 5k Training Programhow fitness can prevent cancertips to reduce holiday stress, reducing your chances for a fallis physical therapy painfulpediatric constipation and bed wettingback pain in women, physical therapy vs taking prescription pain medication, the lesser known issues we treat, benefits of physical therapypain during pregnancy and when caring for a newborn, our annual step challenge, senior and elderly fitness programs, having healthy kids and teens, reducing the chances for injuries by knowing the proper form when running and stretchingwomen’s health, and direct access to physical therapy in Michigan. With multiple west Michigan locations we’re offering physical therapy in Lowell and throughout the greater Grand Rapids area!