Plantar Fasciitis Basic Recommendations

We have excellent results treating chronic plantar fasciitis with a specific systematic approach. Many patients that find their way into our office with plantar fasciitis have already been through physical therapy and podiatry. First we make sure that it is in fact plantar fasciitis as there are a few other things that can mimic plantar fasciitis. We also use diagnostic ultrasound to measure the thickness of the plantar fascia. We’re using this as an outcome measure as well as for academic purposes as we are currently investigating whether specific sonographic changes allow us to select the appropriate conservative treatment as well predict outcomes. We then walk through the normal clinical guidelines to make sure all of the appropriate first line treatments have been completed. This includes specific heel cord stretching, orthotics, shoe modification, night splints, taping, etc. Our standard treatment approach to plantar fasciitis involves specific soft tissue mobilization to the heel cord as well as the plantar fascia. This includes a technique called active release technique as well as an old school but effective specific massage technique(Cyriax). We use other manual therapy’s around the foot and ankle including joint mobilization‘s and chiropractic manipulation. Laser therapy has been a very effective modality for this condition in both reducing pain as well as reducing the overall amount of visits needed. For some recalcitrant cases we may attempt shockwave therapy as well. This is only utilized in select cases as this is fairly expensive but the scientific literature is supportive of this modality. This comprehensive treatment protocol as well as very specific individualized self-care strategies and other specific exercises up the kinetic chain give us an excellent success rate.