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How To Treat Plantar Fasciitis


Plantar fasciitis consistently makes it into the top three of the most frequently reported injuries in the sporting community. It is a notoriously stubborn condition to treat and can take several months to resolve. In this article you will find a complete list of plantar fasciitis treatment options that you can easily apply yourself.

Recent research into the condition has found that people usually wait more than 12 months before seeking treatment. This, in my opinion, may explain why the reported recovery time for plantar fasciitis is so long, since I have found that I tend to get the best results with patients who seek help immediately.

Another reason for poor recovery rates may be that a person have been misdiagnosed and that they may actually be suffering from another condition that is masquerading as plantar fasciitis. An accurate diagnosis is thus key to effective plantar fasciitis treatment and a speedy recovery.


What are the risk factors for developing plantar fasciitis?
Heel pain or plantar fasciitis  the main risk factors include:
l Tight calves
l High body mass index
l Running
l Standing/walking on hard surfaces

These risk factors contribute to you developing plantar fasciitis by increasing the load on the plantar fascia and causing it to over-strain.

Plantar Fasciitis treatment: What is the most effective?
There will never be a single treatment to cure plantar fasciitis, simply because there can be so many different reasons why you develop heel pain. The plantar fasciitis treatments below can be roughly devided into treatments that reduce tension in the plantar fascia and treatments that strengthen the plantar fascia.

The most effective physiotherapy treatments according to the research are:
l Manual therapy including joint mobilisation and massage
l Stretching
l Use foot orthotics or supportive inner soles in shoes
l Night splints
l Specific shoes or rotating which shoes you wear
l Weight loss
l Strengthening exercises

Massage for Plantar Fasciitis
It is easy to massage your plantar fascia as well as your calf using various sized balls and foam rollers. The current research suggests that foam roller massage can be just as effective as a massage from a therapist, when it comes to pain relief and increasing muscle length. Massage for plantar fasciitis should include all the muscles along the posterior chain of your body – not just the plantar fascia.

Stretching for Plantar Fasciitis
The calf muscles are connected to the plantar fascia via a fascia extension from the achilles tendon and I always find that they are tight in my patients who complain of heel pain. As with the massage, you should not only include stretches for the plantar fascia but also for the rest of the leg and back. You can find an explanation of plantar fasciitis stretches here. Word of caution – you can make the symptoms worse if you OVER-STRETCH.

Other muscles further up the leg can also contribute to tension lower down, so it is worth making sure that your whole posterior chain (back, gluteals, hamstrings, calves, plantar fascia) is flexible. It is also important to note that the lower back can sometimes refer pain into the foot which can feel very similiar to platar fasciitis.

Using foot orthosis / orthotics / supportive innersoles / braces for Plantar Fasciitis
Foot orthotics come in various shapes and levels of support. I usually prescribe a medium density off-the-shelve orthotic that provides medial arch support. By supporting the medial foot arch, you off-load the plantar fascia and give it a chance to recover. Think of it as a ‘crutch’ for the plantar fascia.

This one of the most effective treatments for plantar fasciitis in practice.

Night splints for Plantar Fasciitis
It has been suggested that the plantar fascia shortens during the night and that the sudden stretch when you stand on it in the morning causes the area to reinjure. The theory behind night splints is that they prevent the plantar fascia from shortening during the night and this reduces the pain in the morning as well as the chance of reinjury. I do find these effective in patients with persistent symptoms.

Night splints come in various shapes and range from very rigid to soft. But i prefer the ankle sock for comfort.

Shoe selection for Plantar Fasciitis
Unsupportive and inflexible shoes gives very little arch support and puts a much greater strain on the plantar fascia. Wear supportive trainers. Yes, I know they are ugly. Yes, I do mean to work as well. No, not for always – just until the symptoms settle.

Weight loss
The less you weigh, the less force is transferred through your plantar fascia when you stand/walk/run. As simple as that.

Strengthening exercises for Plantar Fasciitis
The shape of the foot is determined by a passive (bones, ligaments, plantar fascia) as well as an active (muscles and tendons) support system. The plantar fascia is put under extra strain if the muscles in the foot and lower leg are weak or not controlling the foot properly. Strengthening and proprioceptive exercises can be very effective in the treatment of plantar fasciitis, but it is important that you do them at the correct intensity for the stage of your recovery.


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source：DisuppoSport，a Sport Protection Expert
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