Plantar Fasciitis

To start, I think it’s important to clarify one of the biggest misnomers out there. Plantar Fasciitis should really be called Plantar Fasciosis. Evidence has shown that this condition is not an inflammatory process (as an “itis” is), but a degenerative condition (an “osis”). It’s a big distinction to make when thinking of how to treat it.

This condition is the most common cause of heel pain, and occurs when the plantar fascia (a thick band of connective tissue that runs from your heel to your toes) becomes degenerated. This pain is especially bad upon waking up in the morning, after the fascia has tightened up overnight. Although still unclear as to what exactly causes this degeneration, possible risk factors include micro-tears from overuse, improper gait mechanics, or just as a consequence of natural aging (seeing as it most commonly affects middle-aged individuals).

Plantar Fasciitis

To treat this condition, it’s again important to remember that it’s NOT an inflammatory condition but a degenerative one. As such, anti-inflammatory supplements/medications are not the way to go to directly treat this. Effective routes should be directed at countering the perceived causes.

If it’s believed to be caused by overuse, then rest and simple calf stretches might be the best way. If it’s improper gait or extreme supination / pronation that’s a clear issue, then gait training, switching shoes, or using custom orthotics could play a role in recovery. Regardless, staples of any treatment plan should also include Myofascial Release Techniques (such as rolling your foot on a lacrosse ball), Scraping Techniques (such as Graston/Smart Tools), Dry-Needling, and rehabilitation exercises. It would also be smart to consider wearing a Night Splint that stretches the tissue while you sleep. A routine encompassing all of this can simple (~5min a day), but consistency with it can help prevent its notoriously long treatment length.

Now if you are someone who has exhausted conservative treatment for treating plantar fasciosis and have been disabled due to the pain, then there’s always other non-conservative routes. Although this only applies to a small population of affected individuals, shockwave therapy, platelet-rich plasma (PRP) injections, and surgery can be used to help relief the pain. Everyone will experience this condition in a different way and respond differently, so what works for one person might not do anything for someone else. It’s worth understanding all the treatment options available and make educated decisions on what’s the best route for you!



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Written by Dr. Brandon Buchla, DC, CSCS

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