The list of options for the treatment for Plantar heel pain is quite extraordinary, and includes:

shockwave therapy

ESWT: Extracorporeal Shock Wave Therapy (ESWT) involves the conversion of a sound wave into a shock wave that is applied repeatedly to a specific area of the body. The technique is similar to lithotripsy, which is used to treat kidney stones. In recent years the technique has become popular in the treatment of a number of recalcitrant musculoskeletal conditions including tennis elbow, achilles tendinopathy,plantar fasciitis, and tendinitis of the shoulder. 

Meta analysis by Dizon et al (2013) concluded moderate- and high intensity ESWT were effective in the treatment of chronic plantar fasciitis. For acute heel pain, there is little or no evidence to support the use of ESWT.

STEROID INJECTIONS: The results from trials comparing steroid injections with placebo substances show

LOW DYE TAPING: A study by Radford et al (2006) was able to demonstrate that when used for the short-term treatment of plantar heel pain, low-Dye taping provides improvement in ‘first-step’ pain compared with a sham intervention after a one week.

NIGHT SPLINTS: According to Bekler et al (2007), patients without previous treatments for plantar fasciitis obtain significant relief of heel pain in the short term with the use of a night splint, however, this application does not have a significant effect on prevention of recurrences after a two-year follow-up.

Image of an orthotic insoles being fitted to a patient

CUSTOM FOOT ORTHOSES: Custom foot orthoses have been shown to be effective in both the short-term and long-term treatment of pain. Parallel improvements in function, foot-related quality of life, and a better compliance suggest that a foot orthosis is the best choice for initial treatment plantar fasciitis (Roos et al 2006)

STRETCHING:Specific stretching the plantar fascia for CPHP has been shown to be superior to traditional weight bearing GSAT (gastrocnemius soleus Achilles tendon) stretching. Three randomised controlled trials have now shown the effectiveness of plantar fascial stretching (Rompe 2010, DiGiovanni 2006, DiGiovanni 2003). It must therefore now be concluded that specific stretching of the plantar fascia is an important part of treatment.

The technique is incredibly simple, and involves pulling the hallux toward the head for a stretch count of 30. it is demonstrated in this photo.

PLATELET RICH PLASMA INFILTRATION: Once considered an experimental therapy for CPHP, platelet rich plasma (PRP) infiltration is gaining traction as a  treatment option. It remains, however, extremely controversial, and clinicians are divided in opinion as to efficacy.

Based on Evidence this is ModPod Plantar Fascial Protocol

Reference: Bartold Biomechanics

Leave a Reply

Your email address will not be published.