Heel Pain / Plantar Fasciitis

Plantar Fasciitis is one of those feared diagnoses as it takes a long time to get better. Fortunately, there is quite a bit of research on heel pain.  If you have plantar fasciitis, and you are in rehabilitation, your treatment should consist of the following (based on a clinical guideline published in the Journal of Orthopedic and Sports Physical Therapy in 2014):

>Correct footwear – making sure shoes are not too old, and provide sufficient support
>This diagnosis is slow to heal and will take 3-12 months
>The problem is due to mechanical stress from an increase in activity.  If you are a runner who has developed this, you may have increased mileage too fast.  If you are overweight, you probably increased the amount of weightbearing activity too fast.

Manual Therapy:
>Joint mobilizations to improve talocrural joint mobility
>Soft Tissue mobilization should address the gastrocnemius and soleus as well as the plantar fascia.

>Stretching: stretch the plantar fascia and the gastroc / soleus.   Secondarily, address hamstrings, quadriceps, hip flexors.
>Strengthening (although not addressed specifically in the review, this was released last year): initiate plantar flexion strengthening with the great toe in extension.   Work on this every other day at an intensity of a 12 RM for 3 sets (https://www.researchgate.net/publication/264936255_High-load_strength_training_improves_outcome_in_patients_with_plantar_fasciitis_A_randomized_controlled_trial_with_12-month_follow-up_HL_strength_training_and_plantar_fasciitis)

Supportive Resources:
>Taping: support the foot into antipronation taping
>Night Splints: wear for 3 months
>Orthotics: use off the shelf orthotics for 3 months





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