Phelix’s Painful Cooking Tale

Phelix has worked as a cook in a restaurant kitchen for 5 years. He has gradually gained about 25 pounds over those years. He began to develop pain in both his heels about 2 months ago. He does not exercise.

Phelix asks a friend who has received physical therapy for advice. His friend suggests he see a physical therapist to find the cause of his heel pain.

Phelix’s physical therapist conducts a detailed history, asking questions about his health, lifestyle, and work, and performs a thorough evaluation. Phelix says that his heel pain is worst when he gets up in the morning. After a shower and walking around for a while, his pain diminishes. However, when he is cooking at the restaurant during the evening shift, his heel pain returns, extending to the balls of his feet. Due to food debris in the restaurant kitchen, Phelix says he wears old beat-up sneakers to work.

After conducting a physical examination, Phelix’s therapist diagnoses plantar fasciitis. She teaches Phelix several stretches to perform twice a day and designs a home exercise program that will fit his goals and lifestyle. The therapist recommends he choose a shoe with a good arch support and replace them when they are worn out. She also suggests an orthotic (shoe insert) to place into his new shoes. She instructs him to apply ice to the bottom of his feet several times throughout the day. The therapist does not prescribe a night splint at this time, because Phelix has had symptoms for less than 3 months. The therapist recommends that for his general health, Phelix begin a low-impact exercise program, including swimming and using an exercise bike. This will help him lose the excess weight he has gained without further aggravating his plantar fasciitis.

Phelix follows the advice of his physical therapist. He purchases new footwear for work and performs the stretching exercises and icing as instructed. After 2 weeks, he is 90% pain-free. Phelix keeps his follow-up visit with his physical therapist 1 month later to review his condition and adjust his home program.