This blog is a sequel to last week’s blog that discussed the epidemiology of plantar fasciitis. We will touch briefly on treatments/prevention used by podiatrists and discuss treatment pearls podiatrists tend to follow when athletes and dancers present to their office with plantar fasciitis.
Alternative Physical Activity is one of the first steps to treatment. It is important to change the cardiovascular fitness routine to one that avoids high impact on the plantar fascia. This means limiting running and jumping and pursuing swimming and upper body weights as an alternative method of cardiovascular fitness. This is often called a period of “Relative Rest”
Changing footwear is another critical treatment step. Barefoot and sandals should not be worn while trying to treat this condition, instead shoes with a slightly elevated heel and a strong mid-shaft insole, should be worn inside and outside the house. We favor the use of plantar arch strapping (taping) which proves to be very successful, especially in athletes and active people who want to maintain their busy lifestyle.
Home Therapy consists of stretching the heel cord to encourage healing, and massaging the foot to increase blood flow. Night splints are also indicated for plantar fasciitis as it maintains the foot in a passive stretch position to encourage healing. This prevents unwanted re-tightening of the fascial band during the night and reset of stretch receptors that trigger pain activation.
Customized orthotics is an important long term strategy in the management of patients with this condition. Additional adjuncts to expedite recovery include: physical therapy which proves to be useful in alleviating pain associated with plantar fasciitis, and anti-inflammatory drugs which are given to control pain when appropriate for the patient.
These conservative methods typically suffice when treating plantar fasciitis in up to 90% of people with this condition, however when not successful, corticosteroid injections are considered for the more severe cases. Along with these treatments, rest and the maintenance of a healthy weight can also limit predisposal to plantar fasciitis so it is highly encouraged. If pain persists and all conservative treatments are unsuccessful, surgery may be required to release tension on the plantar fascia ligament. We are also using the Topaz radio frequency coblation technique with great success on our patients. If you suffer from plantar fasciitis or know someone who does, Drs Murray and Chang, can offer complete evaluation and tailor an appropriate treatment plan designed around the persons needs.