Introduction Plantar fasciitis, or more appropriately called fasciopathy in its more common chronic state, is the most common cause of heel pain in adults.
Plantar fasciitis, or more appropriately called fasciopathy in its more common chronic state, is the most common cause of heel pain in adults. It occurs due to repetitive microtrauma of the plantar fascia as it inserts into the calcaneus. Symptoms are famously worse in the morning when first getting out of bed and tend to improve with activity.
Diagnosis is primarily clinical and the vast majority of patients will have improvement or resolution of symptoms by 12 months with conservative management only. Here we review some of the treatment options and the evidence behind them.
Illustration of Plantar Fasciitis First Line Therapy Initially, all cases of plantar fasciitis can be treated similarly. Most patients will start with discontinuing any provocative activities such as running or sports, using NSAIDS and acetaminophen to treat pain, initiating a home stretching plan and using ice. Commonly, a frozen water bottle is used to roll along the arch of the foot.
Physical Therapy Physical therapy is a first line treatment modality and the primary treatment for plantar fasciitis. Emphasis should be on stretching the plantar fascia, the Achilles tendon, calf and posterior chain. Tissue-specific plantar fascia-stretching exercise enhances outcomes in patients with chronic heel pain: a prospective, randomized study.
J Bone Joint Surg Am 2003;85:1270โ1277.[/ref] All patients will benefit from trengthening extrinsic and intrinsic foot muscles, strengthening abductor and lateral rotator hip muscles, and stretching.[ref]Cheung RT, Sze LK, Mok MW, Ng GY. Intrinsic foot muscle volume in experienced runners with and without chronic plantar fasciitis. Although helpful, its not clear whether custom orthotics are needed.
If you are experiencing symptoms that may be related to treatment options for plantar fasciitis, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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