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Treatment:
This condition can be managed conservatively which can serve to be very beneficial in treating plantar fasciitis. Medical treatment should include: rest from activities that aggravate, ice, NSAIDs, shoe inserts, proper stretching with a home exercise program of the gastrocnemius, soleus, and plantar fascia.
Role of Physical Therapy
- Strength training – Your physical therapist will provide graded exercise prescription that includes high-load strength training can be effective in the treatment of plantar fasciitis. Strengthening of the gastrocnemius/soleus, foot intrinsics, quadriceps, and gluteal muscles all aid in reduction of pain.
- Stretching – Stretching of the gastrocnemius/soleus complex and stretching the toes into extension to apply stretch to plantar fascia.
- Joint mobilizations – Talocrural joint mobilizations and subtalar joint distraction manipulation can be used in hypomobile joint instances. Also subtalar and midfoot joint mobilizations.
- Night Splints – These can be worn overnight and provide constant stretch to plantar fascia as foot is held in dorsiflexion and toe extension.
- Custom foot orthotics – Foot orthotics produce short-term benefits when implemented with stretching program.
- Patient education – Patient education is perhaps the most important aspect of your rehab process. Your physical therapist can help you understand your condition more for the best course of action.
Sources:
Lemont H, Ammirati KM, Usen N. Plantar fasciitis: a degenerative process (fasciosis) without inflammation. J Am Podiatr Med Assoc. 2003;93(3):234–7.
McPoil TG, Martin RL, Cornwall MW, Wukich DK, Irrgang JJ, Godges JJ. Heel pain–plantar fasciitis: clinical practice guildelines linked to the international classification of function, disability, and health from the orthopaedic section of the American Physical Therapy
Riddle DL, Pulisic M, Pidcoe P, Johnson RE. Risk factors for Plantar fasciitis: a matched case-control study. J Bone Joint Surg Am. 2003;85-A(5):872–7
Thomas JL, Christensen JC, Kravitz SR, et al. The diagnosis and treatment of heel pain: a clinical practice guideline-revision 2010. J Foot Ankle Surg. 2010;49(3 Suppl):S1–19. doi:10.1053/j.jfas.2010.01.001
Rathleff, M.S., Mølgaard, C.M., Fredberg, U., Kaalund, S., Andersen, K.B., Jensen, T.T., Aaskov, S. and Olesen, J.L., 2015. High‐load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12‐month follow‐up. Scandinavian journal of medicine & science in sports, 25(3). DioGiovanni BF, Nawoczenski DA, Lintal ME et al. Tissue-specific plantar fascia-stretching exercise enhance outcomes in patients with chronic heel pain. Journal of Bone and Joint Surgery. 2003;85-A:1270-1277.
Anat Shashua, Shlomo Flechter, Liat Avidan, Dani Ofir, Alex Melayev, Leonid Kalichman. The Effect of Additional Ankle and Midfoot Mobilizations on Plantar Fasciitis: A Randomized Controlled Trial. Journal of Orthopaedic & Sports Physical Therapy. 2015, Vol. 45, 265–272.
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