Arguably, there is no more frustrating condition for patients or for physical therapists than plantar fasciitis. It shows up randomly at times for no reason in particular. It can make the first few steps in the morning excruciating and then nag throughout the day. Plantar fasciitis can be unremitting and can affect your quality of life.
I’ve tried everything– orthotics, stretching, taping, chiropractics, physical therapy, etc. What works?
The physical therapists at SSOR are committed to using evidence-based practice which is a combination of clinical expertise, what the research says, and what our patients value the most. The Orthopedic Section of the American Physical Therapy Association (APTA) recently released a Clinical Practice Guideline on heel pain from plantar fasciitis. Their findings showed strong evidence to support the following interventions:
- Joint and soft tissue mobilization of the calves and foot
Soft tissue mobilization of the calf using a massage stick
- Stretching of the gastrocnemius and soleus (“calf” muscles) for at least 4 weeks
Stretch of the Gastrocnemius calf muscle
Self plantar fascia stretch
- Taping for overpronation for up to 3 weeks. Elastic therapeutic tape might be used for up to a week for short-term pain relief on the calves and plantar fascia
- Orthotics, either over-the-counter or custom, for 2 weeks up to a year, especially in those that respond to taping
- Night splints should be used for 1-3 months
What doesn’t seem to work are physical agents like ultrasound, laser, or phonophoresis. There is conflicting evidence for the use of iontophoresis, and no recommendation can be made to use dry needling.
The physical therapists at SSOR would add gluteal strengthening to this list, even though it hasn’t been studied. We understand biomechanics of movement very well and plantar fasciitis is often a condition from failed shock absorption; therefore, we work the gluteals for plantar fasciitis because they are the muscles that reduce impact forces on the heel to avoid the plantar fascia dissipating that force.
Some of these interventions may not have worked for you, while some may have a little. Regardless, you should try all of these methods before accepting your outcome. We hope you’ll give us the opportunity to help you achieve your goals.