New Research Shows Collaborative Care for Plantar Heel Pain Leads to Long-Term Savings and Better Outcomes

WEST DES MOINES, IA (11/17/2025) A multi-year study led by Shane McClinton, P.T., D.P.T., Ph.D., shows that combining physical therapy with standard podiatry care for plantar heel pain improves patients' quality of life while also cutting long-term health care costs. McClinton is a physical therapist at Des Moines University Clinic - Physical Therapy and also teaches at Des Moines University Medicine and Health Sciences.

The research project, "Cost Effectiveness of Physical Therapist Treatment in Addition to Usual Podiatry Management of Plantar Heel Pain," followed 95 participants over a three-year period to assess the direct and indirect costs associated with different treatment protocols. The study was published in PTJ: Physical Therapy & Rehabilitation Journal.

McClinton, the lead researcher on the project, notes that while initial costs were slightly higher for the combination treatment due to additional PT visits, these costs were quickly offset by downstream savings.

"Our findings suggest that by the one-year mark, the collaborative approach - podiatry care plus physical therapy - becomes more cost-effective," McClinton says. "Patients experienced better overall outcomes, were more productive at work and had fewer instances of seeking additional care for their condition or other conditions, in general."

Key takeaways included:

• The majority of data simulations showed the combined care protocol fell into the "costs less and you get more" quadrant of economic evaluation, indicating it is the preferred choice for both patients and the health care system.

• The combination group showed better health-related quality of life, which is a key metric in economic evaluations, valuing the patient's time spent in a better health state.

• Patients receiving physical therapy needed fewer medications to manage their pain and were less likely to seek additional, outside treatment from other providers (such as chiropractors or orthopedic surgeons).

• Data indicated that participants who failed to complete their assigned physical therapy program did not fare as well. When looking at trends for persons who ultimately required more expensive and invasive surgeries related to their heel pain, two that had plantar fascia surgery and two that had weight-loss surgery did not receive or complete physical therapy treatment.

• The PT component focused on manual treatment and addressing contributing factors "up the chain"- in the knee, hip and back - as well as strengthening the intrinsic muscles of the foot to reduce long-term reliance on orthotics.

The study speaks to the power of collaboration across disciplines in health care. McClinton stresses that the results do not replace the value of podiatry, but rather reinforce the need for a combined, comprehensive approach.

"We know both podiatry and physical therapy treatments work, but this study helped to demonstrate that when we work together, we can have even better improvements," McClinton says.

McClinton hopes the results will inform conversations between providers - including family practice physicians, osteopaths and podiatrists - and patients, leading to increased referrals for physical therapy and ultimately reducing the burden of chronic heel pain and related health care costs.

"This study represents a significant step forward in demonstrating the impact and value of physical therapy within an integrated health care model and recognizing the roles of each health care provider and how we can enhance the care and outcomes of the patient when PT is a part of the team," says Kari Smith, P.T., D.P.T., DMU clinic manager and a professor in the Department of Physical Therapy. "It's consistent with other conditions like lower back pain and the reduced health care costs when utilizing PT."

To read the study in its entirety, visit PTJ: Physical Therapy & Rehabilitation Journal.

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