Plantar fasciitis is a common cause of pain in the foot. I would doubt that a day in the clinic passes without someone coming in for treatment of this condition. Due to this, we’ve done a number of blog posts on the condition in an effort to educate our regular readers and assist those who may be experiencing this type of foot pain.
The pain with plantar fasciitis occurs on the bottom of the foot, closer to the heel than the toes. There is still a lot of research being generated on this condition as there is much that we don’t know. What we do know, is that those with confirmed plantar fasciitis likely have some thickening of the plantar fascia and they likely have some tendon degeneration where the tissue inserts on the bone (which is something that is common with many tendon disorders). Interesting, a study published in the Scandinavian Journal of Medicine & Science in Sports has given us something new to ponder when treating plantar fasciitis.
This study took 48 patients and investigated whether intense strength exercises would help plantar fasciitis. I found this very interesting as I’m sure most practitioners would be apprehensive prescribing these exercises given the risk of exacerbating the pain. At the same time, this is a rather new trend in rehabilitation. For many conditions, early exercise and activation is a quicker way to recover and return to normal pain free function.
Selection of participants in the study was limited to those who had pain for at least 3 months and they had to have a thickening of the fascia of 4.0 mm or greater. This was determined through ultrasound. You also had to be older than 18 years of age and in general good health (among other things). The 48 patients were all given shoe inserts. The difference between the groups was that they were either given stretches for plantar fasciitis or they were given intense strength exercises. The strength training was basically a heel raise with a towel inserted underneath the toes. The patients did the exercises every other day with specific progressions for three months.
The interesting result of the study is that patients doing the intense strength training found less pain than the other group at three months. The theory is that intense strengthening creates a tensile force across the tendon which may assist recovery of the damaged tissue better than stretching. Unfortunately, the results didn’t hold. At six months and twelve months the pain levels were the same between the two groups. At the same time, adding intense strength training in the plantar fascia to already successful treatments (like manual therapy, laser therapy, active release, graston, acupuncture and stretching) may assist patients in their recovery from plantar fasciitis.
If you’re suffering from foot pain caused by plantar fasciitis or other reasons you can’t explain, contact us and we can help. Pain is not something you have to live with.