Assessment and evaluation
Massage practitioners are likely to see clients with plantar fasciitis, so proper assessment of this condition is important. The most common complaint of a client with plantar fasciitis is sharp pain felt on the bottom of the foot. The client may indicate that the pain is localized near the anterior calcaneus where the plantar fascia attaches.

Maintaining tissues in a shortened position for long periods will often aggravate the symptoms. For example, a person with this condition will often sleep with his/her foot in plantar flexion. This position will keep the fascial tissues of the plantar flexor "sling" (including the plantar fascia) in more of a shortened position. When arising in the morning, weight is placed on the foot, providing a sudden tensile load to tissues that have been in an unloaded position all night long. Thus, clients will most commonly report the worst pain sensations as those felt first thing in the morning upon arising and just starting to walk after getting out of bed.

Plantar fasciitis is evaluated through an accurate history and physical examination. In the history, pay particular attention to descriptions of vigorous activity performed on an unyielding surface. Examples include running on pavement, aerobic dance classes on a hard floor, or walking on a hard surface all day. Also pay particular attention to the location of the key symptoms, as the client is most likely to report the primary pain on the bottom of the foot and exaggerated pain near the calcaneal attachment of the plantar fascia.

We also must consider that a bone spur may be present in the region, though we may not be able to palpate it. Although X-rays can identify the bone spur, they are not often used because they only provide information about the presence of the bone spur and not about the state of the plantar fascia. Presence of the spur may be indicative of excessive tensile loads on the calcaneus but does not necessarily mean the client has plantar fasciitis. Therefore, sound clinical judgment is considered the best tool for accurately evaluating this condition.

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