Plantar fasciitis is a painful condition caused by inflammation of the thick band of tissue that connects your heel to your toes. While most patients improve with stretching, physical therapy, orthotics, icing, or injections, some continue to struggle despite months of treatment. When that happens, we have to take a deeper look at why.
Why Standard Treatments Sometimes Fail
One commonly overlooked cause is reduced blood flow to the plantar fascia. Without proper circulation, your body cannot deliver the nutrients needed to decrease inflammation and repair damaged tissue.
A 2019 study by Jacobs et al. found that when the big toe is pushed inward—often from narrow toe-box shoes—blood flow through the lateral plantar artery decreases by approximately 22%. This is the main artery supplying the plantar fascia.
Simply put:
If the plantar fascia isn’t getting enough blood, it can’t heal properly.
How to Improve Blood Flow
✔ Wear shoes with a wide toe box
This prevents the big toe from being pushed inward and allows normal blood flow.
✔ Continue supportive treatments
Stretching, icing, and low-impact exercises reduce strain and keep your foot flexible.
Advanced Treatments at Cornerstone Foot & Ankle
If you have tried 3–6 months of standard treatments without relief, advanced regenerative therapies may be the next step. These treatments promote angiogenesis—your body’s process of forming new blood vessels.
1. Platelet-Rich Plasma (PRP) Injections
PRP uses your own platelets to stimulate healing, collagen production, and improved circulation.
“PRP isn’t a quick fix — it activates your body’s ability to heal itself.” says Dr. William Murray
2. Extracorporeal Shock Wave Therapy (ESWT)
ESWT uses sound waves to trigger growth factors and stimulate tissue repair.
“ESWT doesn’t just mask pain — it helps restore the blood supply your plantar fascia needs.”
3. MLS Laser Therapy (Multiwave Locked System)
This painless laser uses dual wavelengths to reduce inflammation, enhance cellular repair, and increase microvascular blood flow.
“MLS Laser Therapy increases blood flow without pain, needles, or downtime.”
When Is Surgery Necessary?
If 6–12 months of both standard and advanced treatments fail, Endoscopic Plantar Fasciotomy (EPF) may be appropriate. EPF is a minimally invasive procedure that releases part of the plantar fascia to reduce tension.
A 2023 review by Papathanasiou et al. reported:
-
High patient satisfaction
-
Quick return to activity
-
Minimal complications
-
Strong clinical outcomes
“EPF offers a precise release with minimal disruption and a short recovery period.”
Bottom Line
1. Address the Root Cause
✔ Wide toe-box shoes
✔ Custom orthotics to correct mechanics
2. Improve Blood Flow
✔ PRP, ESWT, and MLS Laser Therapy
3. Stimulate Natural Healing
✔ PRP can repair the plantar fascia biologically
4. Surgery Only When Needed
✔ EPF is safe and effective after conservative options are exhausted
Our Philosophy
“Heal the plantar fascia naturally whenever possible. Surgery is reserved only after blood flow and regenerative therapies have been fully explored.” says Dr. Murray.
If you’re tired of living with heel pain and ready to finally find answers, the team at Cornerstone Foot & Ankle is here to help. Our specialists will evaluate your symptoms, review your previous treatments, and design a personalized plan to get you back on your feet — comfortably and confidently. Schedule your plantar fasciitis evaluation today and take the first step toward lasting relief. BOOK NOW!
Cornerstone Foot & Ankle is a full service foot and ankle specialty office with locations in Sewell, Cherry Hill, Marlton, Mt. Holly, Glassboro and Pennsville, serving the South Jersey region. We offer a full suite of services including surgery, fracture care, fungal nail care, diabetic foot care, pediatric podiatry, custom braces and orthotics, wound care, limb salvage, and treatments for arch pain, heel pain, and sports injuries; just to name a few. If it hurts below your knee, we can help you! CALL NOW or BOOK YOUR APPOINTMENT NOW!
References
Jacobs JL et al. Passive hallux adduction decreases lateral plantar artery blood flow. J Foot Ankle Res. 2019.
Papathanasiou M et al. Endoscopic Plantar Fasciotomy as an Effective and Reliable Treatment for Plantar Fasciitis. J Am Podiatr Med Assoc. 2023.