Note: I saw this article recently and was immediately interested. Although I don’t often see patients with plantar fasciitis or treat it (I focus mainly on shoulder and knee injuries in my practice), patients often say, “Oh by the way, my heel has been hurting.” I get these comments from friends, too! The challenging aspect of plantar fasciitis is that despite the condition rarely requiring surgery, it can be difficult for active patients to overcome. While this post is in no way meant to serve as medical advice, I thought it was worthwhile to present a new approach to the treatment of plantar fasciitis.
Plantar fasciitis is thought to be the most common cause of heel pain, especially on the sole of the foot. Both active and sedentary people can develop it. Studies have suggested it can be involved in up to 8% of running injuries. Between 3.6% and 7% of the general population might have plantar fasciitis.
It can significantly limit a person’s activities. Typically treatment involves exercises to stretch the plantar fascia. Other nonoperative treatment options include wearing a night splint while sleeping that the keeps the ankle dorsiflexed (or pulled up toward the head), shoe inserts and physical therapy. While nonoperative treatment usually relieves the patient’s pain and improves activity, many people still experience symptoms two years later.
In a study recently published in the Scandinavian Journal of Medicine & Science In Sports, M.S. Rathleff and other researchers tried prescribing a regimen of regular exercises to treat patients with plantar fasciitis. They compared one group of patients randomized to receive gel shoe inserts and stretching exercises for the plantar fascia. The other group received the inserts and performed regular strengthening exercises.
Strength training exercises for plantar fasciitis
The researchers instructed the patients in the strength training group to perform one-leg heel raises on a stair or other object every other day for three months. Each patient put a rolled up towel under the toes to further dorsiflex the toes. The “up” phase lasted three seconds. The patient held the top position for two seconds. The patient then took three seconds coming down.
At first, each patient does three sets of 12 repetitions. After two weeks, she wears a backpack with books to increase resistance, at the same time moving to four sets of 10 reps. At four weeks, she goes to five sets of eight reps, adding books to the backpack as she gets stronger.
Using a questionnaire to assess each patient’s foot pain, disability and activity limitation, the authors compared the outcomes in the stretching and strength training groups:
• At three months, the patients in the high-load strength training group had significantly lower scores on the questionnaire (improved pain, disability and activity limitation) than did the stretching group.
• Strength training group reported less foot pain at three months and were more satisfied with treatment at three and 12 months.
I am not offering these results to promote them as medical advice but instead to discuss a fairly new approach that afflicted people could try. The exercises seem relatively easy to do, as they don’t require fancy equipment or training. If you have plantar fasciitis, it could be worthwhile to talk to your doctor or physical therapist about adding strength training exercises like these to your treatment regimen.
Have you ever battled heel or foot pain from plantar fasciitis? How did you overcome it? Share your thoughts and experiences below!
Rathleff MS, Mølgaard CM, Fredberg U, Kaalund S, Andersen KB, Jensen TT, Aaskov S, Olesen JL. High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up. Scand J Med Sci Sports 2014.