Heel pain is a common complaint among approximately 2 million people per year, and nearly 10% of the population over a lifetime. 1 The diagnosis for pain in the heel or arch of the foot is called plantar fasciitis. I’m always impressed when folks have indicated that their problem took a year to heal. Muscle and connective tissue usually heals much more quickly than that. Are there other factors that are stimulating the pain?
In earlier years I asked myself, what is going on with this problem? I treated a lot of people who got better with some combination of basically flexibility exercises, proper shoes, and/or orthotics, using floor mats to cushion standing work areas, and correcting faulty biomechanics from the spine on down.
Interestingly, while some people were runners, most people had developed the problem gradually with no specific precipitating event and were not even doing a sport. How could the Plantar Fascia, the leathery-like tissue in the arch to the heel, get strained or bruised to result in so much inflammation?
What if the irritability was driven from another area? Janet Travell, MD, the doctor who cared for John F. Kennedy for his severe back muscle spasms was one of the pioneers who evaluated and mapped out painful conditions that are ‘Myofascial’ in nature, muscle and surrounding connective tissues, that were responsible for specific painful conditions. Two specific muscles in the lower leg, the gastrocnemius (see figure 1) and the soleus (see figure 2), have areas that can cause pain in the arch and the heel respectively. People who have ‘Trigger Points’ in these muscles, areas of hyper irritability, are people that can have this pain. Trigger points can be ‘latent’, that is, they are present, but not active.
It makes sense that stretching can help affect these areas of hyperirritability. The concept of latent trigger points is consistent with the history that many people have of the onset of their pain. It came on for no apparent reason. When stretching alone doesn’t eliminate the pain, effective soft tissue manipulation will resolve the effect of the trigger point pain.
There are people whose onset was associated cumulative loading of their lower leg such as a runner or dancer who were building up their training time or practice time to the point that they cross over their physiological limits. These people readily respond to relative rest, appropriate stretching, addressing any biomechanical restrictions/abnormalities from the spine down, temporary taping of the foot, and in some cases, custom orthotics.
Those who don’t, I would recommend be evaluated for trigger points.
Special Stretch: See our Video demonstration of a unique stretch that I’ve found particularly useful:
My experience here was awesome! When I first started, I could barely move my arm due to a collarbone fracture. After 12 weeks of PT I have full motion and nearly full strength in my arm. Thanks Taylor and Emily!
Cioffredi became my go-to PT provider based on the success story my wife experienced here. I underwent two successive courses of treatment. The first addressed pain in the right hip flexors, the second pain in both elbows, primarily on the right. Kate Leiser performed very thorough and revealing analysis and testing at the outset in both cases and then carefully adjusted both sets of diagnostic processes in subsequent iterations. This allowed us to fine-tune and modify stretching and strengthening exercises from session to session to accompany immediate and ongoing improvements. I stress here that it allowed us to make these adjustments, because Kate permitted and encouraged my own analysis and input throughout, as well as inquiring about my physical activities outside of PT sessions, so as to be able to incorporate or provide instructions for me to modify the execution of those activities. All of this led to a highly successful treatment that caused rapid and thorough improvement in both conditions.I have been highly physically active throughout my entire life, including athletically. The effects of aging, including apparent arthritis, seemed to have caused a significant reduction in my ability to maintain a satisfactory level of my former activities. Both the physical intervention of the treatment and the discussions of the principles behind that intervention have enabled me to modify my approach to my activities in a way that has led to ongoing improvements and my realization that these improvements are sustainable for the foreseeable future.Thank you, Kate! It clearly pays to seek out a thoroughly trained, professional, and motivated PT practitioner, who constantly invests in her curiosity to generate effective treatment.
I struggled for over a year with neck and shoulder pain on and off. During a very painful period I decided to do PT and it was the best decision I made. I am doing a lot better and will continue recommendations to move forward and get back to doing activities I love. Thank you!
I can’t thank Kate enough for helping me with resolving a long-standing issue. She was persistent, flexible, and determined to find and root out the vestiges of pain and tightness. She modified strengthening and stretching at each visit to keep my daily routine from becoming too long or complicated and her positive attitude whenever I came in, combined with an exhaustive toolbox of stretches and tweaks to address the pain/tightness with more and more specificity, kept me feeling positive. Additionally, her responsiveness to email between sessions meant that I could continue to make progress throughout the long recovery process.
I came to Cioffredi after suffering with plantar fasciitis for many, many months. Marissa worked to improve my foot strength. We determined I also had a nerve problem which I continue to work on. The care and attention received at Cioffredi was great! Marissa was so helpful, patient, kind and knowledgeable. She not only helped to improve my condition, but offered suggestions related to footwear and when it was appropriate to engage again with a foot doctor. I cannot adequately express my sincere appreciation for her help. She is awesome.
I was frustrated with some persistent lower back/lower glute soreness and wondered what was the best way to remedy it. Finally my doctor suggested therapy (PT). I was lucky to meet Justin who heard me out completely and determined I was probably experiencing some nerve compression due to a year old injury (slipping on black ice). Not only did this feel plausible, but the steps we took and treatment he recommended led to physical improvement after 7 visits. I appreciated his care, attention, and advice and feel ready to continue my recovery on my own. Thanks J!
I am so grateful to Justin. After hurting my shoulder in September, I was barely able to lift my arm and had never been in that much pain. Little every day tasks like getting dressed were now an exhausting endeavor. After months of therapy, I am able to lift my arm without pain and have gotten my life back. The team at Cioffredi excel at what they do and it shows.
Adam has been an amazing trainer! He is very consistant with positive feedback! This was so important to me! Feeling like I could never work out again – he made me realize I had a life ahead – friendly, kind, well trained gentleman – my highest recommendation to Adam!
This success story has taught me that I need to get on the bandwagon and stay there. Taylor tried to lead this old donkey to the water and I did take a sip. Exercise works if you do it and be religious with it. Thank you Taylor Daily. You are very patient and worked with me to achieve my very best. I can now do what I could not before. Yea!Esther
I was referred to Cioffredi for a neck and shoulder injury sustained during yoga and 10 sessions with Marsha and the electrical stim machine brought me totally back to normal. Marsha is a miracle-worker as far as I’m concerned! So competent with neck manipulation and really thorough in explaining her treatment to me at the onset. Everyone on staff was friendly and gave me a sense of professionalism. It was a delight to come in for my treatments and I was so pleased with the flexibility when I needed to change an appointment. I would not hesitate a moment in coming back for future needed treatments.
When I first began therapy on my right ankle tendons, I was feeling discouraged and envisioning the end of hiking, skiing, and even moving through life fluidly. Therapy with Kate Leiser has been a wonderful education and has equipped me with many means of helping keep myself mobile and pain free. Her encouragement, inspiration, clear instructions, and expertise have brought me to a whole new understanding of how to navigate life with arthritis and the immutable fact of aging. I am now stronger and pain free from my toe to my hip. Thank you so much, Kate!
I had good success with Cioffredi previously when I had total hip replacement followed by infection and another total hip on the same side. It seemed like my new hip made my leg lengths discrepant and I soon began to have knee pain in the opposite leg. Terrified that I might need a knee replacement, I went to my orthopedist and we decided on a trial of PT. I had been less active for at least 18 months due to knee pain when I came to Cioffredi. I had weakness in my core muscles as well as hips and knees and my balance was off. In just 8 weeks, with a complete PT program and a lot of encouragement from Taylor, my knee pain is gone, balance is better and leg length is dealt with using a small lift. Thank you!
I just had my last session with Emily and I feel 100% better. Thank you for all the info and tools that helped me get through the busy season at work without being in pain every day. I would recommend your office of highly educated and extremely nice PT professionals to anyone in need of services.
How do I begin… I injured my shoulder this winter while traveling. When I came home for the summer I asked my doctor about the shoulder pain. We both thought it may need surgery, I was not happy about the possibility. She sent a referral for a scan, my insurance denied it. That was the best thing that happened to me. I came in and started therapy with Zac – Kyle came on board later. They were both amazing. Yes, the therapy was fun, yes fun! The work was hard but not impossible. I am very active, but it was time to slow down, heal and work through it. Zac and Kyle answered y questions, were patient, thorough, very thoughtful, and pushed me through. I am thrilled to get back on the road again and my shoulder feels amazing. Filled with gratitude. Thank you.
After two months of shoulder pain and arm weakness, I turned to Cioffredi & Associates for help. Justin quickly diagnosed the problem and provided a set of exercises to stretch and strengthen my shoulder/scapula area. In 4 weeks, I was back to my usual gym routine.Justin’s exercises, supplemented by Richie’s personal training and more exercises, are keeping me on track to prevent a relapse.
I began working with Adam in the transition program to help gain strength & reduce pain in my shoulder after finishing PT. Adam also helped target other areas I needed to work on to improve my goals and ability to enjoy my activities, such as golf, hiking, kayaking, etc. After 7 weeks I find my legs are much stronger, I have improved balance, less pain in my shoulder (as well as improved strength). Also, I enjoyed learning the correct form in which to be more successful. The tips on where to ski, golf, hike & fish were frosting on the cake.
For the first time in a very long time, I can now look over my left shoulder. I was stopped at a stop sign, looked to my left and suddenly realized… hey! I can look to my left without stiffness & pain. Did anybody see that?!
I was very concerned that my back pain would be a chronic condition, but with the exercises and encouragement I received from Marissa and Emily, I am pain-free today and have regained my strength. I am very grateful that they knew how to help me.
I read about alleviating pain in pregnancy through an article from Cioffredi & Associates and called out of curiosity. I had been experiencing pain that I thought was normal. I set up an initial consultation appointment with Anna. She was very helpful and knowledgeable. She helped me do some stretches and identified some issues that I had. We set up a treatment plan with visits and also at home exercises. I noticed a dramatic decrease in pain within a week! It was very transformative, as I was just about to accept the pain. I highly recommend PT in everyday life. It will open your eyes to what feeling good is about. Thank you.
Probably the best PT team I've worked with. I came because of pain from an ankle injury that spread throughout my whole leg, and Kate helped me not only strengthen my ankle, but also have a better understanding of my body, the cause for my pain and different ways I could work on it in the future to be able to get back into running. Very nice and helpful staff, and great facilities. Totally recommended!
I feel that Marissa did a good job of listening to my story, asking insightful questions and performing an initial exam. I felt very confident of her diagnosis of my pain. Throughout the process of therapy, she was attentive to my progress and limitations and continued to work with me until I felt that my rehab was complete. I would recommend physical therapy with Marissa at Cioffredi & Assoc.
I walked into Cioffredi with a real pain in my foot and knee - through advice and PT and exercise I was able to complete my two long hikes, one in Scotland and one in England! I remain pain free now - and to my normal hiking and walking - thanks! Very practical advice combined with very expert assessment. Marissa was a thorough pro, and I thank her for her help!
Both Emily Milbank and Richie Hackett did a wonderful job at helping me recover from my hip replacement. I worked with Emily directly after my surgery to regain my mobility and then transitioned to Ritchie in order to work on getting back the last of my range of motion. I was in very capable hands in both cases. In a period of 8 months, I was able to recover and get back to leading a full and active life. Thank you.
Before PT, I was in almost constant pain and could not lift anything with the affected arm. I had pain with everyday activities like opening doors and the pain in my elbow would wake me up at night. After working with Marissa for a couple of months, I am now pain-free, have regained strength in my arm and am looking forward to getting back into racket sports.Marissa did a wonderful job resolving my tennis elbow and equipped me with a great set of exercises to prevent re-injury. I could not be happier with my treatment and will be back if I ever have a need for PT again.
I have been to Cioffredi & Associates many times for PT. My most recent was a right shoulder injury. As usual, I received exceptional care with all the associates from checking in at the desk to going through my PT programI will recommend anyone to come to Cioffredi for PT. It is a very caring place to everyone who walks through the doorI want to say thank you Emily for your kind and caring care that you have given me. You are a great person and Physical Therapist. I will miss our Thursday morning visits.
To my dismay after knee surgery I was told my recovery would be longer than expected. Not putting weight on my knee for 6 weeks and to expect 3 months for recovery.When I arrived at my first appointment, Becca greeted me with a smile and from then on her support, guidance and encouragement was what helped me through my recovery. I then walked into spring and will soon be running into summer.Thank you so much, Becca!!
I came in with a bewilderingly sore knee, and after 4 weeks could feel a new sense of balance & strength in my legs (& even in my feet.). This experience has encouraged me to workout at home with the expectation of good results. My therapist, Katy Barnes, is professional, smart, and careful - she paced the therapy perfectly. Thank you all!
I had a team (2 PT's) who coordinated care seamlessly; each was 100% informed of my last services before I arrived. Clearly the had 'case conferences' & together developed plan of treatment!My treatments have made a remarkable difference, allowing me to return to regular daily and recreational activities.I truly thought I was not going to be able to stay in my job when I first came here for help. The nurses and docs I work with have commented on how much better I am doing - no more limping!!
I had the great good fortune to be one of Sadie's "guinea pigs" when she was attending massage therapy school. Even at that point, I was very impressed with her ability: she provided one of the best massages that I had ever had! I have continued to have massages by Sadie and, if possible, the quality of her treatment continues to grow. When I have a massage, I know that I will leave Cioffredi's feeling refreshed and rejuvenated! Sadie is amazing!
I have been very happy with the skill, graciousness and professionalism of Emily Milbank during my treatment at Cioffredi. I am much improved. Thank you, Emily! The support staff is friendly, caring & efficient. I’m continuing to strengthen through the Cioffredi personal training program which was coordinated with my physical therapy assessment. Excellent follow up!
I came to your facility with low back pain. It was difficult to stand for longer than 10 minutes without pain. Marissa was very thorough & quick to come up with a plan for exercises & proper movement to decrease my pain & ultimately eliminate. She was incredibly knowledgeable and made the experience very comfortable. I appreciate her time and expertise. She has made a difference.
Anna recognized that my strength and flexibility were disproportionate in my lower back. I was abnormally flexible, but not as strong in my lower back. After completing the treatment plan Anna created for me, my pain is so much better! Plus, my whole posture has improved!
When I came to Cioffredi's I couldn't even look down at my feet from a work injury. Anna worked very hard to educate me continuously throughout my treatment so I always understood what was happening with my body. Anna always catered to my current pain and discomfort to enable my recovery. She knows everything about ergonomics and was extremely helpful assessing my work positions and what I could be doing to better help myself. I would not have healed the way I did or gained the knowledge I did without Cioffredi's and Anna. - Thank you all so much.
I am 100% pleased with the outcome of my Physical Therapy & Personal Training sessions.I was very discouraged before my consultations & training program. My right shoulder was causing a tremendous amount of pain & discomfort. I had decreased range of motion & was fearful of the possibility of surgery. A quick consultation & examination uncovered a postural issue with my shoulder.Richie was able to work with me over the course of the last three months to build strength in my core & arms. I have no pain & increased strength. I credit the thorough exam & application of strengthening exercises toward this end. Keep up the great work! 🙂
Zac and his student were very compassionate regarding my needs for relief of hip and back pain. They were very informed as to what was the best plan for my recovery and helped me a lot. Thank yo so much for your assistance and your sense of humor! 🙂
I have been working with Adam for several weeks. For over a year I had constant back pain because of an issue with my sacrum . Now I've been sleeping better, less back pain and an overall improvement in my strength & flexibility. My back pain has decreased significantly! I couldn't be happier.
Physical Therapy at Cioffredi has allowed me to resume my daily running routine after a significant ankle sprain. I am so thankful for the expertise and advise I've gained here and most of all the improvement I've made in just 3 weeks! Staff are professional, facility is top notch and environment is ideal for the services offered here. Thank you so much!
It was indeed a success story, and from the very first session with Anna Hinman, I knew that I was in good hands. Within 2 weeks, I was able to put aside the crutches, then the boot soon afterwards. Now, exactly 3 months after breaking my food and 2 months after beginning therapy, I am back to normal and can walk as fast and as easily as ever. It was not only the competence of the treatment that impressed me, but the intelligence and the friendliness and encouragement that characterized Anna's manner during the sessions (qualities likewise evident when she worked with her student Emily). Thank you!
I came to Cioffredi with ankle pain from a past surgery. Katy helped me understand what was causing my pain and how to improve it. Now, I have the exercises and tools to strengthen my ankle and address my pain anytime I feel it. I can comfortably run and perform all my normal activities.
Zac was GREAT! He understood the concerns with rehabbing for special needs where full use is a must. Working in construction limited motion after surgery was not an option. Zac worked with me to get me back to the point I was at before injury. Thanks all - Todd
My experience here has been amazing. Everyone at Cioffredi was friendly and more than willing to help make my recovery a success. Kate has been the best PT I have ever seen. I really appreciate her willingness to try different things to get to the root of the problem. Thank you all for getting me back on my feet.
When I came to start therapy I was having aching, and burning pain frequently in my lower back, and numbness in my foot, which made it very difficult to walk. This impacted on my ability to get exercise and enjoy time with my dog on daily walks. It was also hard to stand and sometimes to sit without experiencing pain. I was starting to rely on taking Alleve in high doses and thought I would just have to get used to it. I am pleasantly surprised that the problem has resolved! I only occasionally feel pain or numbness when I've done some heavy lifting or cleaning and this goes away quickly. All this despite the degeneration/osteoarthritis in my spine. I also feel much stronger in general. Thanks Zac (my PT) and all at Cioffredi!
My experience with Cioffredi and Associates was outstanding. The three PTs that worked with me before and after my shoulder surgery were all excellent.Kate, who worked with me to stretch and strengthen my shoulder prior to surgery, was friendly, and knowledgeable. She was particularly adept at explaining the root causes to my shoulder issues and the path she was prescribing to help remedy them. The results that were achieved from our sessions were great. The pain and shoulder tightness I had experienced prior to our visits were significantly reduced, so much so that I even considered cancelling my surgery. Her work allowed me to continue with sports and everyday life until I ultimately decided to proceed with the procedure and it could be fit into my schedule. Becca and Amanda worked with me through the rehabilitation process post-surgery. Each of them was friendly, funny, personable, knowledgeable and encouraging. Because of them, I truly looked forward to each visit, without exception. The results they helped provide are better than I expected. I am pain free and have recovered nearly all my shoulder strength. I’m confident that my strength will recover 100% (or more) with the exercises and techniques they have shown me. I am also confident that without their guidance, my healing would have traveled a longer, circuitous path to a less desirable end-result.A side note:Amanda had just started on her 11 or 12 week clinical assignment as I started therapy, post-surgery. Initially, Becca did most of the "heavy lifting" of defining and executing my rehabilitation. It was interesting for me to watch Amanda as she gradually took more responsibility and transitioned from a quiet observer into the “leader” during the latter weeks of my sessions. I’m certain that Amanda’s training, combined with her exceptional personality and professional manners, will be the foundation she will build on to achieve any personal and professional goals she sets. I wish her the absolute best as she moves on to complete her studies, begins her next assignment and ultimately her career. Lastly, I appreciated Becca’s nomination and Cindy’s invite to participate as a judge in Cioffredi’s annual pie baking contest. It was a fun event that made me feel like I was “part of the family” rather than just a “regular” client. Thanks so much to all.
I had bilateral knee replacements 7 months ago. While I had a much better than average recovery experience, I was still having some pain sitting cross-legged and leg strength was still an issue. Anna evaluated me and gave me easy to follow exercises to do at home as well as in therapy. After 6 weeks of physical therapy, I have gained increased strength that is quite noticeable. The pain in my IT band has decreased with use of the foam roller. I now have the tools and the information to continue my year long recovery from my surgery. Thanks, Anna!
This was a wonderful experience! Personal interactions were excellent, always encouraging and building on successes. Lots of humor in our sessions. This helped greatly. Free of judgement and fixed expectations. I felt I was free to do what I could during each session.Thanks to Becca & Amanda for their patience and expertise AND gentle persistence. I feel I have my leg back and frankly, didn't expect this as an outcome. With much gratitude & appreciation to you both.
I had the good fortune to work under the very knowledgeable eye of Richie. My specific health issues made the normal training regiment a little more difficult to navigate. Richie was keenly sensitive to my limitations and totally supported and encouraged my efforts. His professionalism and friendly nature made coming in for each session enjoyable. Armed with the materials and instruction Richie provided, I now feel there is a light at the end of the tunnel. I would also like to thank Billy for the moral support and attentive ear, it was all very assuring and positive. Thanks Billy, Richie, the fantastic ladies up front, and the rest of the friendly, professional staff at Cioffredi's.