Plantar fasciitis can be a painful and insidious condition that makes life miserable for any patient. For runners and other physically active people, it can be particularly frustrating, keeping you from doing the things you love and interfering with performance and fitness goals.
To date, treatment has mostly centered on orthotic aids, pain management and stretching. Yet even with the most aggressive treatment, plantar fasciitis has had a track record of lingering for months or even years. Now, new research offers hope for a faster, more thorough recovery from plantar fasciitis.
Building on previous research by Wearing et al. (2006) that demonstrated similarities in pathology and load response between plantar fasciitis and tendinopathy, Rathleff et al. (2017) sought to put Wearing’s theory to the test by treating plantar fasciitis like a tendinopathy, for which high-load strength training appears to be an effective treatment.
The authors wanted to see if they could induce high tensile forces across the plantar fascia in ways similar to those induced to the patellar tendon during a single leg squat. They were able to do so by dorsiflexing the toes using a rolled-up towel and executing single-leg calf raises.
The study was a randomized controlled trial using 48 patients with plantar fasciitis verified by ultrasound. The patients were randomly assigned to one of two groups: one group did plantar-specific stretching of the sort typically used to treat the condition, while the other group did progressive high-load resistance training.
Both groups of patients were evaluated at one, three, six and 12 months for foot function and reported pain. At the three-month follow up, the high-load group showed a significant reduction in pain compared to the stretching group. At six and 12 months, there was no difference between the two groups.
The authors noted that, while the final outcome was essentially the same for both groups, the three-month marker indicated that high-load training could help a patient reduce pain more quickly that simple stretching.
Since pain is the primary complaint of patients with plantar fasciitis, it stands to reason that a treatment that alleviates pain more quickly is preferable to treatments that bring about slow relief. Athletes, runners and fitness enthusiasts in particular are good candidates for high-load resistance training to treat plantar fasciitis. Combining high-load training with stretching and pain management strategies may be the best approach to treating the stubborn and slow-healing condition.
Conventional treatment for plantar fasciitis often involves uncomfortable orthotics, steroid injections and even surgery. Yet those treatments do not get at the source of pain. The foot pain specialists at NYDNRehab understand that pain in any area of the body is often associated with issues in other areas. We are dedicated to discovering the origins of your plantar fasciitis pain, so we can address them and restore your foot to optimal function.
Rathleff, Michael Skovdal, et al. “High‐load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12‐month follow‐up.” Scandinavian journal of medicine & science in sports 25.3 (2015).
Wearing, Scott C., et al. “The pathomechanics of plantar fasciitis.” Sports Medicine 36.7 (2006): 585-611.