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"Top 10 Ways to Manage and Alleviate Plantar Fasciitis Pain"

Have you heard that Plantar Fasciitis is not inflammation but a degeneration of the tissues? What does this mean concerning the treatment of this kind of foot pain?

It seems like lately more than ever someone is trying to sell the newest device to treat or fix plantar fascia pain. What bugs me is when they say "You don't need expensive Physical Therapy, you need this device...." I hope people see through the marketing and realize one kind of treatment usually doesn't take care of something like Plantar Fasciitis. Physical Therapy is multi-modal which means having several modes or types of treatment. You will get a comprehensive evaluation from the top down and from the foot upwards. Most diagnoses are not only related to the area of pain. A Physical Therapist will look at pelvis stabilization, hip stabilization and mobility, knee mechanics, soft tissue mobility/tightness, and more. Many patients are a bit confused when a PT is looking at their hip or knee when they are having foot pain. The body is not only comprised of many parts, but all the parts work together.

The other part that everyone should know about Physical Therapy for Plantar Fasciitis is that research has been done on the best most effective ways to treat each diagnosis. This provides a great guideline as to what kind of treatment works best. It is great that most Physical Therapists also learn from experience and can find what works best for each individual. Sometimes that means it will take a few visits to see the response to treatment options.

Plantar Fasciitis signs and symptoms are 1) First-step pain 2) Pain with prolonged weight bearing, and 3) Tenderness to palpation of medial calcaneal tubercle. Physical Therapists will rule out eight or more other possible diagnoses that will not be covered now.

Here are 10 ways to manage and alleviate Plantar Fasciitis pain:

Number One: Stretching

Plantar fascia-specific stretch and calf stretching. The American Physical Therapy Association recommends 2-3 times per day, sustained or intermittent.

Number Two: Night Splint

When symptoms are less than 6 months, this is usually one of the first treatment methods. The Metatarsal Phalangeal joint (MTP) extension is essential. Wear time is 1-3 months. The type of night splint used did not affect outcomes. One I recommend often is the Strassburg sock.

Number Three: Manual Therapy

There is not great research when it comes to manual therapy. I know from experience that what I have seen work for patients when it comes to manual therapy is not done in the articles. Manual therapy when done with exercise or before retraining movement works the best. This includes Talocural joint posterior glides, subtalar joint glides, navicular plantar glides, anterior/posterior glides of the first MTP joint, subtalar joint distraction manipulation, and soft tissue mobilization (aka massage). I could go into a long explanation of massage tools out in the market, but that will have to be another blog.

Number Four: Taping

Taping provides short-term pain relief by decreasing stress on plantar fascia. There are two main techniques: Calcaneal and Low dye taping. This also helps determine the benefit of orthotics.

Number Five: Orthotics

In the research, there appears to be no difference between custom-made and pre-fabricated in the outcomes. The more rigid the less compliant people were with using them. I have seen many good brands but I usually recommend Superfeet due to the cost and the different types for different individual needs.

Number Six: Shoewear

Most people do not look at comparing shoes, especially shoes for exercise to other brands or kinds. It is sometimes all about what is available or what looks good. Shoes are constructed with different lasts, widths, amount of control, amount of cushion, and more. It is worth going to specialty stores and learning from shoe experts who can see you in person to help you be informed to make a good choice.

Number Seven: Rest and Activity Modification

Continuous loading like running can continue to worsen pain and have a longer time to heal if not resting. When you can return to dynamic loading, it is best to do this gradually. A Physical Therapist will guide you with this. Many times training errors will need to be addressed by a gradual plan of return to specific activities such as running

Number Eight: Strengthening

Gradual Criterion-based progression is key to the best treatment of tendinopathy. In the early stages of rehab low-load isometrics then progressing to high-load isometrics, slow and heavy isotonic then eventually progress to more complex, dynamic, and sport-specific exercises. How this is done depends on each individual and their needs. Exercises to look up are called Short Foot exercises (see Naboso), toe flexor strengthing, and foot and arch stability exercises.

Number Nine: Balance Training

Balance training is not listed under the treatment of Plantar Fasciitis. I am not sure why it has not and how the nervous system and Balance systems could be overlooked. We have nerve receptors in our feet that give us a positional sense of sensation and motor control of our feet. I feel more research needs to focus on this and now using tools like Naboso sensory technology to get more input to our nervous system and how we load our feet.

Number Ten: Other Treatments

Injections have shown short-term relief but with the risk of rupture and fat pad degeneration. The effectiveness of surgery versus conservative (listed above) measures remains unproven.

It may seem like too much to do on your own or you do not know where to start. That is why you need to start with me. If you want only a few sessions to get started or need more sessions to reach your goals, contact me through my website:

#Live Inspired,

Karen Baltz Gibbs, PT, DPT, CSCS, LMT, CMP, Owner Garage Training & Rehab Gym


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