Assess
& Address: Plantar
Fasciitis
by Whitney Lowe |
|
|
Traditional
methods of treatment
• Reducing tensile stress on the attachment site of
the plantar fascia is one of the first treatments for plantar
fasciitis. When tensile stress is reduced, the site of irritation
and collagen degeneration in the fascial tissue will have a chance
to heal. The best way to reduce tensile stress is to have the
client rest from any offending activities.
•
Orthotics may also help change faulty biomechanical patterns in
the foot and may take pressure off the plantar fascia and allow
time for healing. Orthotics are most useful if the patient has
either a flat foot or excessively high arch that is contributing
to the irritation of the plantar fascia.
•
Corticosteroid injections into the plantar fascia are sometimes
used to address inflammatory effects. However, there is evidence
that steroid injections into the plantar fascia may have detrimental
effects. Steroids have been shown to leak into the fat pad - that
layer of fatty tissue directly underneath the calcaneus designed
to help absorb shock - and cause the fat pad's degeneration, as
well as rupture of the plantar fascia. There is also a question
as to the reason for corticosteroid (anti-inflammatory) injections
if the primary problem is not an inflammatory condition.
•
Ice applications are also commonly used as an anti-inflammatory
treatment. Methods include placing a bag of frozen corn or peas
on the foot because these mold well to the contour of the foot.
Rolling the foot over a frozen plastic bottle of water also works
as a type of ice application. One might question why these methods
get beneficial results if the condition is not an inflammatory
problem. Quite possibly, the beneficial result occurs from some
of the other physiological effects of ice application, such as
pain reduction.
•
A device that has been used extensively to treat plantar fasciitis
with very good results is the tension night splint. This brace
is worn on the foot to maintain a position of dorsiflexion during
the night. Prolonged dorsiflexion will condition the plantar fascia
to tensile stress and prevent the aggravation of tensile forces
on the attachment site at the calcaneus.
•
Shock-wave therapy is another treatment method that is receiving
frequent mention in the rehabilitation literature. This procedure
is similar to that used to break up kidney stones. The reason
for its use in plantar fasciitis is that it may help reduce the
development of extra calcification, as with a bone spur, and therefore
reduce pain in the region. However, there are differing opinions
on the effectiveness of this approach.
References