Plantar fasciitis: What it is and what treatment is best!
Plantar Fasciitis is commonly seen in both the general population and running community.
What is Plantar fasciitis (PF): PF is inflammation of the plantar fascia which is a thick band of tissue that runs on the bottom of the foot from the heel to the toes. The inflammation can cause stabbing and aching pain in the arch or heel. Pain is often worse in the morning or after long periods of time of standing or sitting.
What causes PF? Well it depends! There is no single cause for PF. Evaluation by a physical therapist is always a good place to start. Some potential causes can be sudden increase in activity (like running more!), weight gain, poor footwear and many other factors.
How do you fix it? Because of the wide range of possible causes, treatment can differ for everyone. I always suggest an examination of movement patterns, range of motion and strength to determine why this might have happened. We need to “load” the tissue to improve it, so rarely is complete rest the answer. It is important to know that some pain as you are recovering from PF is common and cannot be avoided. Speaking with a provider can help you understand more of what pain is okay to work through.
Here are potential treatments you may have heard of and what the research says on them:
Extracorporeal shockwave therapy has been proven to help as a possible form of treatment.
Dry needling has been shown to help both with acute and chronic episodes of PF.
Manual therapies such as joint mobilization and soft tissue mobilization can help with some symptoms.
Stretching of both the plantar fascia and calf is superior to one or the other. Clinically, I have found that low load, long duration stretching in the morning has had the best outcomes.
Taping has been found to be effective, but usually only in the short term. If taping is helpful, it is likely that you can benefit from an insole to help some of the pain while also working on remediating potential contributing factors. Research has found there is no difference in outcomes when comparing custom orthotics vs prefabricated insoles.
Night splints, like the Strassburg sock has the most effect on people who experience morning pain.
Laser therapy and ultrasound doesn’t have any definitive evidence to help with PF and therefore is not recommended.
The use of heat has been proven to help release some tension in the PF.
The best combination of treatment according to resent research (as well as what I have seen clinically) is a combination of manual therapy, patient education, neuro dynamic education, stretching and strengthening has had the best outcomes at 6 weeks and 1 year follow-ups!
Want to fix your foot pain? Contact Carbs today and get back to moving!!!
