Plantar fasciitis affects more than one million people each year and is one of the most common causes of heel pain in adults (Goff & Crawford, 2011). Plantar fasciitis pain is usually localized and felt at the medial tuberosity/tubercle of the calcaneus where the origin of the plantar fascia is located. People with plantar fasciitis generally report pain with their first steps in the morning or after a long period of inactivity; this pain tends to dissipate with a gradual increase in activity and return near the end of the day. Plantar fasciitis is often multifactorial; however, the most common belief is that excessive pronation, prolonged standing, or improper footwear can contribute to its onset (Buchbinder, 2004).
-Sudden increase in running volume or intensity
-Running on hard surfaces
-Gastrocnemius, Soleus, or Achilles tendon tightness
There is limited research on single treatment modalities for plantar fasciitis, so it is recommended to try a variety of methods.
RICE: Rest, ice, compression, elevation, and nonsteroidal anti-inflammatories (NSAlDs) can all aid in reducing pain contributed to plantar fasciitis in the short-term; long-term relief and recovery from plantar fasciitis often requires a more active treatment. A treatment program consisting of several different modalities has proven to be more effective at reducing plantar fasciitis pain than a single method alone (Donley, Moore, Sferra, Gozdanovic, & Smith, 2007).
Stretching and self-massage: Stretching the plantar fascia prior to the first steps taken after prolonged rest can reduce micro trauma to the plantar fascia and aid in healing (DiGiovanni et al., 2003). Since a tight gastrocnemius or soleus may contribute to the onset of plantar fasciitis, stretching these muscles may also be beneficial (Garrett & Neibert, 2013). Deep myofascial massage of the plantar fascia can stimulate healing by increasing blood flow to the area (Goff & Crawford, 2011).
Orthotics & Insoles: Custom-made orthotics and prefabricated insoles have both been shown to be effective in controlling over pronation and reducing forces on the plantar fascia; however, neither was proven to reduce foot pain more than the other in a Cochrane review (Hawke, Bums, Radford, du Toit, 2008). Used alone, orthotics or insoles can help reduce pain by preventing the plantar fascia from being overstretched and creating a more biomechanically effective gait; greater decreases in pain have been seen in those who use an orthotic or insole in conjunction with a night splint. (Lee et al., 2012).
Night splints: Sleeping with your foot in a neutral 90-degree angle has shown to decrease plantar fasciitis pain, especially pain felt with the first steps in the morning. Tight calves can cause excessive pronation, which increases the loads on the plantar fascia; sleeping in a neutral or dorsiflexed position has been shown to reduce calf tightness and pain in the plantar fascia (Lee et al., 2012). A night splint such as the Strassburg sock is beneficial because it allows the user to adjust the angle to compensate for any discomfort.
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Buchbinder, R. (2004). Plantar fasciitis. The New England Journal of Medicine, 350(21), 2159-2166.
DiGiovanni, B. F., Nawoczenski, D. A., Lintal, M. E., Moore, E. A., Murray, J. C., Wilding, G. E., & Baumhauer, J. F. (2003). Tissue-specific plantar fascia-stretching exercise enhances outcomes in patients with chronic heel pain A prospective, randomized study. The Journal of Bone & Joint Surgery, 85(7), 1270-1277.
Doniey, B. G., Moore, T., Sferra, J., Gozdanovic, J., & Smith, R. (2007). The efficacy of oral nonsteroidal anti-inflammatory medication (NSAlD) in the treatment of plantar fasciitis: A randomized, prospective, placebo-controlled study. Foot & Ankle International, 28(1), 20-23.
Garrett, T. R., & Neibert, P. J. (2013). The effectiveness of a gastrocnemius-soleus stretching program as a therapeutic treatment of plantar fasciitis. Journal of Sport Rehabilitation, 22(4), 308.
Goff, J. D.. & Crawford, R. (2011). Diagnosis and treatment of plantar fasciitis. American Family Physician, 84(6), 676.
Hawke, F., Burns, J., Radford, J. A, & du Toit, V. (2008). Custom-made foot orthoses for the treatment of foot pain. The Cochrane Database of Systematic Reviews, (3), CD006801.
Lee, W. C. C., Wong, W. Y., Kung, E., & Leung, A. K. L. (2012;2013;). Effectiveness of adjustable dorsiflexion night splint in combination with accommodative foot orthosis on plantar fasciitis. Journal of Rehabilitation Research and Development, 49(10), 1557-1564.