Typical clinical presentation of Plantar Fascia pain is when there is pain after periods of rest - so it's fair to say rest doesn't fix the problem!
Prolonged rest can cause a cascade of events. More rest means less strength, this leads to less endurance, poorer stability, movement compensations patterns, gait changes. Pain can continue without ease, leading to more chronic forms of pain. This is not want you want!
This spirals on to less time on feet, avoidance of exercise, weight gain and other less desirable outcomes.
The best evidence is behind strength training - which is the opposite to rest!
High-load strength training has shown to provide superior results to stretching exercises (unilateral single leg calf raises performed every second day) (Rathleff et al. 2014). High-load resistance training has been shown to have a reduction in pain and improvements in function (Huffer et al 2017)
The plantar fascia is also supported by;
- Flexibility of the big toe
- Flexibility of the ankle and achilles
- Strength of the foot, legs and hips
Plantar Fasciitis is NOT caused by flat feet
When it comes to Plantar Fasciitis (acute/short term) or Plantar Fasciopathy (chronic/long term) the evidence shows that pain is due to overuse of the Plantar Fascia, this is why pain is felt along the arch and heel. It is not always directly at the site of the spur.
Heel Spurs (also called Calcaneal spurs or Plantar Spurs) develop as a response due to an inability of the Plantar Fascia to tolerate load. Our body can't cope with what we are asking from it, and to protect the soft tissue the bone grows! The overuse causes calcium deposits to form on the heel bone.
The research shows that heel spurs are more commonly associated with heel pain. We are blaming a symptom (spur) rather than the culprit (expecting more from our feet than what their capacity is)!
Plantar fasciopathy is the PRIMARY cause of pain
- Spurs are strongly associated plantar heel pain but do not CAUSE pain
- HOWEVER spurs are the victim not the culprit (McMillan et. al 2009)
- Spurs are in those with and without heel pain (Kullar et al 2014)
- 52 people had painful heels (39 of these had spurs)
- 38 had non-painful heels (24 of these had spurs)
Treatment For Plantar Fasciitis/ Plantar Fasciopathy
- Shockwave Therapy (Schmitz et al. 2013)
- Dry Needling (Cotchett et al 2014)
- Manual Therapies (Fraser et al. 2017)
- Custom Foot Orthotics (Lee et al. 2009)
- High-load Training (Rathleff et al. 2014)
THE SECRET = RELEASE & STRENGTHEN!
We treat Plantar Fasciitis daily with excellent results and offer all of these treatments, tailored to your individual needs.
Plantar Fasciitis can we very frustrating and debilitating but we are here to help!
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