plantar fasciitis

Your ONLY STOP for HEEL & ARCH PAIN in San Antonio & South Texas


If you suffer from heel or arch pain, then our team would love to help you overcome this often debilitating condition. Find answers to our frequently asked questions regarding Plantar Fasciitis & how we treat it at our clinic, below.

Plantar fasciitis, a condition also known as heel spur syndrome, is an inflammation of the plantar fascia—a band of tissue that runs from your heel to your toes. This inflammation is typically caused by an abnormality in the structure of the foot, such as extremely high arches or flat feet—or by an external irritation, such as non-supportive footwear over long periods of time.

The ligament supporting your arch swells and tightens on a regular, daily basis. If your ligament becomes overworked or strained, you feel pain in your heel known as plantar fasciitis. Continuing to use your foot after swelling of your ligament causes small microtears, increasing injury further.


heel spur is a bone-growth that looks like a spur at the insertion of the plantar fascia on the heel. They’re seen more frequently in people with painful heels but they are also seen quite frequently in people that have no pain. The presence or absence of a heel spur does not make the diagnosis of plantar fasciitis but does suggest the presence of the disease. The spur does not (usually) need to be removed to alleviate heel pain. Many many people live their whole lives with heel spurs with no pain in their heels.


When you get out of bed in the morning, are your feet sore and stiff? This often occurs with inflammation of the ligament in your foot directly causing plantar fasciitis. The causes of plantar fasciitis include:

  • Poor workout routines
  • Overuse injuries
  • Weight gain
  • Tight Achilles tendons
  • Low or falling arches
  • Poorly fitting shoes
  • Sudden changes in exercise

With so many reasons for your plantar fasciitis, speak with a healthcare professional about your specific cause and how you can prevent future inflammations.

About 2 million people every year receive a plantar fasciitis diagnosis. It’s the most common cause of pain in the heel, but luckily, the condition is easy to manage with correct treatment and early detection.

Your podiatrist uses different physical tests and diagnostic images when diagnosing plantar fasciitis. Plantar fasciitis is most common in long-distance runners, people who stand a lot, and overweight people.

There are several clues that help to make the diagnosis of plantar fasciitis (PF) as opposed to the other causes of heel pain.  They are not 100% but taken together they do help.

1: Location of pain:  PF usually hurts on the plantar medial aspect of the heel. This  is on the inside of the heel.  Pain can also extend into the arch.  If the whole bottom of the foot is sore it may be something else. 

2: Timing of pain:  PF usually hurts more the first steps of the morning as you get out of bed. It also usually does not hurt when you get off your foot.  If you have pain after laying down that lasts for more than a few minutes it is more likely to be nerve pain. 

3: Relief with a few steps.  In the early stages of plantar fasciitis the pain subsides after being of the feet for a few minutes.  As the tissues get stretched and warmed up the pain decreases.  When it gets more severe the pain persists.

Short answer, yes! One of the most common childhood complaints, heel pain is often caused by Sever’s disease. Sever’s disease is the result of the growth plates in the heel growing faster than the Achilles tendon, which causes irritation and pain as the tendon and other muscles tighten. Dr. Silvester can help treat symptoms effectively and economically with shoe inserts and therapy.

Learn more:Sever’s Disease and Heel Pain

Children suffer from many other foot conditions, if your child complains about their feet “being tired” or hurting, please visit our Pediatric Foot Care page to learn more.  

As with all conditions, heel pain is much easier to treat when it is caught early.  If you have had pain for 4-6 weeks  get an appointment with a good foot doctor (we like us) :).  Most of our heel pain patients are 80% improved in one week after seeing us.  They might not be cured but they sure feel better.  Healing the damaged tissue takes time.  If you have had heel pain for  one year it is going to take more effort than if you have had it for one month.   

If you have had heel pain that won’t go away  for 3-6 months then surgery is a consideration. There are other considerations of course. These include the severity of the pain, contributing factors, associated diagnoses and  the overall health of the patient, social factors etc.

Heel pain surgery fails for two reasons most of the time:

  1. Failure to make the correct diagnosis
  2. failure to address all the problems that are causing the heel pain.

Frequently nerve pain is involved and the doctor has not even looked at that possibility.

A short Achilles tendon should also be addressed. But, if these factors are addressed during the surgery the success rate is usually very high.

Of course, there can be other reasons for failure but these are the most common.    

1:  Get some good running shoes with a thick heel cushion. Try and wear them most of the time.  Avoid barefoot on hard surfaces.  

2: Get good arch supports if you have a normal foot. (We sell some great ones at our office for heel pain).  Don’t spend  more than 50 dollars. STAY AWAY FROM RETAIL “ORTHOTICS” THAT ARE JUST OVER THE COUNTER ARCH SUPPORTS AND COST HUNDREDS OF DOLLARS.  

3: Stretch your achilles tendon gently 2 minutes three or four times a day for 2 minutes. There are lots of ways to do this.  Look on line. Plantar Fasciitis Specialist

4:  Stretch your plantar fascia frequently. Don’t over do this. You can aggravate the problem with too aggressive stretching. 

Plantar Fasciitis Specialist

Plantar Fasciitis

treatment options

Our specialists offer statistically successful treatment plans that can heal your Plantar Fasciitis. On your first visit, our goal is to have you 85% better in 2-5 days.

To do that, we perform several tretments all at once to resolve the issue. This approach has been highly successful for our patients as we also provide medications, injections, night splints, and nutritional supplements to help you find relief faster.


Treatments for plantar fasciitis can vary depending on the severity and nature of your inflammation. Sometimes, simple at-home options such as stretches, ice packs, and shoe modifications can help reduce irritation, and are often initially prescribed to reduce pain and symptoms. If the pain continues, more aggressive treatments such as night splints and casts, injections, or orthotics are employed.

The professional team at Next Step Foot & Ankle Center helps you determine the best way to alleviate plantar fasciitis, in the most conservative way as possible.

Most cases of plantar fasciitis go away after treatment methods such as:



Changing your shoes to more comfortable footwear and/or adding orthotic insoles to relieve the pressure on your ligament can help increase your elasticity and heal.





Click the video below to see how Dr. Silvester recommends stretches to help treat your Heel Pain. Stretching helps loosen your ligaments, increasing the elasticity and helping them heal.



Wearing a night splint or brace keeps your muscles from pulling on your bone while you sleep, assisting further in helping you heal.

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