Why Plantar Fasciitis Keeps Coming Back
(And Why the Heel Is Rarely the Real Problem)
If you’ve ever dealt with plantar fasciitis, you know the pattern.
It hurts the most when you first stand up.
It loosens up as you move.
Then it comes right back—sometimes worse than before.
Most people are told it’s an inflammation problem.
So they stretch. Ice. Rest. Maybe change shoes.
Sometimes it helps… temporarily.
But if plantar fasciitis keeps returning, something deeper is being missed.
Plantar Fasciitis Isn’t a Foot Problem
It’s a load and tissue adaptation problem
The plantar fascia is not a weak structure. It’s designed to store and release energy with every step.
When it hurts chronically, acknowledges this:
👉 The tissue has failed to adapt to the load being placed on it.
That load can come from:
Altered gait mechanics
Poor shock absorption upstream (ankle, knee, hip)
Limited movement variability
Or systemic issues that affect tissue recovery
Treating the foot alone is like blaming the smoke instead of the fire.
Why “Inflammation” Is an Incomplete Explanation
Inflammation is part of healing—but chronic plantar fasciitis often isn’t inflammatory anymore.
In long-standing cases, the tissue is more accurately described as:
Under-recovered
Poorly hydrated
Metabolically stressed
Neurologically guarded
In other words:
The tissue never fully healed or reconditioned.
That’s why symptoms improve… then return.
A Pattern I See Over and Over Again
In practice, plantar fasciitis often shows up alongside:
Reduced ankle mobility
Hip or pelvic load asymmetry
Decreased tissue resilience
Slower recovery between activity
Many patients are surprised to learn the foot is often compensating for something above it.
And in more stubborn cases, there’s another layer most people never hear about.
The Metabolic Piece No One Talks About
Healthy tissue adapts.
Stressed tissue survives.
If your internal environment is inflamed, dehydrated, insulin-resistant, or under-recovered, even “minor” mechanical stress becomes a problem.
This is something I’ve learned personally.
When I made metabolic changes—sleep, nutrition, recovery—my own joint issues began resolving more easily, not just because of better mechanics, but because my tissues could finally respond again.
Plantar fascia is no different.
Why Passive Care Alone Often Fails
Stretching, massage, orthotics, and rest can be helpful—but they don’t retrain tissue.
If the nervous system doesn’t trust the structure, it will keep guarding it.
Real resolution requires:
Restoring proper load distribution
Improving tissue communication
Supporting healing capacity—not just symptom control
That’s where newer approaches have changed what’s possible.
A Smarter Way to Look at Heel Pain
At Joint Wave Des Moines, plantar fasciitis is approached by asking better questions:
Why did this tissue stop adapting?
What loads is it compensating for?
What does this joint system need to relearn?
The goal isn’t to “calm the pain.”
The goal is to help the tissue re-integrate into normal movement again.
When that happens, symptoms don’t need to be chased—they resolve naturally.
If This Sounds Familiar…
If heel pain has limited your walking, workouts, or daily life—and especially if it keeps coming back—there may be more going on than the foot itself.
If you’ve been out of the office for a while, we’re currently offering a limited number of reactivation evaluations designed to take a fresh look at what’s actually driving the problem.
No pressure.
Just better information.
Final note
Plantar fasciitis doesn’t persist because your body is broken.
It persists because it’s adapting as best it can with the information it’s been given.
Sometimes, the right input makes all the difference.
Find Out More
If plantar fasciitis has been limiting your walking, workouts, or daily life—and especially if it keeps coming back—it may be time for a different conversation.
I take a systems-based approach to joint and tissue problems, looking beyond symptoms to understand why healing stalled and what the body needs to adapt again.
If you’ve been out of the office for a while, or if previous care never fully resolved the issue, you’re welcome to reach out and explore whether this approach is a fit for you.
Dr. Chad Rohlfsen
Spinal Tuning Chiropractic Center / Joint Wave Des Moines
📞 Call or Text: (515) 664-0667
Or Schedule a consultation today! 👉 https://calendly.com/drchad-1/spinaltuning
📍 Des Moines, IA