Plantar Fasciitis Treatment

Plantar fasciitis (inflammation of the plantar fascia which connects the heel bone to the toes) can be debilitating and significantly interfere with an individual’s everyday activities. It usually affects those aged 40 to 60 years. It accounts for approximately 25% of foot injuries. There is a higher incidence in runners. Risk factors include and increase range of motion of plantar flexion at the ankle joint and the presence of a calcanea spur.

The plantar fascia can be exposed to increased loads due to an increase in exercise intensity, increased body weight, poor foot position (over-pronated sub-talar joint), unsupportive footwear, tight calf muscles and poor hip/pelvic control (weak gluteus medius muscle). Physiotherapy involving the provision of individualised home exercise programmes and hands-on treatment can really help.

Scott Buxton (physiospot.com 17.01.22) summarised the findings of a recent systematic review of 96 research papers published in ‘Life’ on the assessment and treatment of plantar fasciitis and concluded:-

• Proven risk factors are BMI (Body mass index) excessive plantar flexion ROM and presence of a calcaneal spur

• Corticosteroid injections should be used sparingly and will only provide very short term pain relief and functional improvement

• Evidence suggests there is no difference between PRP (Platelet-rich plasma) and corticosteroid injections

• ESWT (Extracorpeal shock wave therapy) is an effective treatment although there is disagreement about protocol however it is more effective than corticosteroid injection

• The use of insoles may be effective but pre-fabricated or custom insoles are best

• Low-dye or calcaneal taping offers around a week of pain reduction

• Acupuncture, needling, manual therapy alone and LLLT (Low level laser therapy) are ineffective treatments

• A combination of calf and plantar fascia stretches are most effective