Plantar Fasciitis Treatment Options

Plantar fasciitis is extremely common affecting around 10% of the adult population at some time in life. Commonly plantar fasciitis is associated with heel spurs however on x-ray only 50% of patients with plantar fasciitis have evidence of calcification through the heel (DiMarcangelo, 1997).

Commonly plantar fasciitis symptoms start as an awareness or ache in the morning. Relief treatment can be quite simple at this time however if it is left, these symptoms will often slowly progress to pain that significantly impacts quality of life.

When targeting plantar fasciitis symptoms your practitioner will guide you through the best strategy or combination of strategies to help relieve and control your individual pain. At Body Leadership Australia we recommend a multimodal approach utilising a number of different treatment options.

Soft Tissue Release
Tightness of the muscles surrounding the foot have been found to pull hard enough on the bones that they alter the natural shape of the foot and ankle often leading to plantar fasciitis pain. Accordingly, release techniques and stretching of the lower limb muscles can have an effect on decreasing symptoms associated with plantar fasciitis.

Stretching
Strategic stretching of the calf muscles and Achilles tendon or on the plantar fascia itself can decrease pain associated with plantar fasciitis. You should get a program tailored to your individual needs.

Orthotics
Orthotics can help to relieve the effects of plantar fasciitis. Changing the weight load through the foot can allow the inflammatory response to settle by supporting the foot appropriately.

Night Splints (Strassburg Sock)
The use of a night splint can reduce recovery time compared to the same protocol utilising standing stretches through the calf.

Cortisone
Cortisone was always a last resort due to potential complications and pain post injection. Now with ultrasound guidance outcomes have improved and we see them used more effectively. Cortisone options can be discussed with your health care professional.

Surgery
A number of studies found 75% to 95% of patients had long term improvement as measured by various criteria. Up to 27% of patients still had significant pain, up to 20% had some activity restriction, and up to 12% had moderate pain that impaired function (Brown et al., 1999; Davies et al., 1999; Fishco et al., 2000). Surgical options are always a last resort.

Once your pain is treated and controlled it is important to understand your individual factors that predispose you to plantar fasciitis which can be explained by your physiotherapist. You can then be taught a home program to release tension, particularly through the calf as well as the foot to nip problems in the bud. This can also be optimised using home exercises to improve strength for better control of your biomechanics long term.

If you, your friend or family member suffer from plantar fasciitis please do not hesitate to contact one of our friendly Brisbane sports physiotherapists on 07 3847 8040. Our Brisbane sports physios can also provide treatment from our Brisbane Sports Physiotherapy practice.