PF is considered a self-limited condition - since >80% of cases resolve / heal within 12 months regardless of therapy
“An ounce of prevention . . .”
Best treatment is prevention. This involves being sensitive to early warning signs and using preventative exercises; after a hiatus, runners should warm up gradually to a full workout program
Prefer conservative therapies to surgery
General recommendations
Cease activities known to induce trauma / inflammatory stress on plantar fascia. Athletes will need to be patient to allow time to heal
BenfotiamineSpeedy treatment prevents further problems developing as a result of an altered gait in response to foot pain. Such problems may affect the knee, hip and/or spine and will need to be addressed to facilitate complete healing.
Plantar Fascia strengthening / Stretching Exercises. With the overall goal of stretching the tightened plantar fascia along the foot arch. There is a growing study/experience-supported opinion that a program of non-weight-bearing stretching exercises specific to the plantar fascia is superior to the standard program of weight-bearing Achilles tendon-stretching exercises
Exercises to stretch tightened plantar fascia
Other stretching / strengthening exercises may be necessary to strengthen weak muscles affecting the problem. E.g. strengthening calf muscles
Prevent sheets at the foot of the bed from putting too much pressure on the feet
Wear good arch-supportive footwear and a well-cushioned heel
Night splinting to hold ankle joint in a neutral position. Prevents foot from becoming flexed in the night
Nutritional therapy
- Connective tissue repair/ regeneration
• Vitamin C
• Antioxidant property fights inflammation
• Increase PF tensile strength - essential for building procollagen (collagen precursor).
Recommended Dose: 1 - 3 g ascorbic acid /day
• Zinc. Generally recognized for its positive effect on the immune system
• Works with C to increase PF tensile strength. Zinc insufficiency (common in high stress people or those with injuries) implicated in delayed wound healing
Recommended Dose: 15-30 mg zinc / day
• Glucosamine - foundational substrate for several compounds associated with repair and regeneration of connective tissue, including hyaluronic acid and other glycosaminoglycans (GAGs)
Recommended Dose: 500mg glucosamine sulfate 3 x /day
- Anti-inflammatories
• Vitamin C
• Bromelain - family of proteolytic enzymescommonly used for treating soft tissue injuries and treating inflammation
• Reduces swelling / pain;
• Increases fibrinolysis (promotesplasminogen à plasmin)
Taussig SJ, Batkin S. Bromelain, the enzyme complex of pineapple (Ananas comosus) and its clinical application. An update. J Ethnopharmacol 1988;22:191-203.
Recommended Dose: 500 -2000 mg/day (with enzymatic activity of at least 2,000 mcu/g)
• Omega-3 EPA and DHA. Notable anti-inflammatory fatty acids
Recommended Dose: 1000mg Neptune Krill Oil / day or 4 - 1000 mg capsule Wild Salmon Oil or eat oily fish 2-3 times / week
Also see general recommendations to counter and control inflammation found at:
Inflammation - Can't live with it, Can't live without it!
NIR Class 4 laser therapy
NIR class 4 laser therapy restores the flow of nutrients and oxygen to inflamed tissue and increases cellular waste removal, thus allowing the cells to repair themselves more quickly than when left untreated
One particular study is sometimes referenced to denounce the efficacy of laser treatment for plantar fasciitis. However, it is noted that this study used a very low power (30mW) laser, which would not penetrate tissue like the higher-powered lasers used in NIR class 4 laser therapy
Basford JR, Malanga GA, Krause DA, Harmsen WS. A randomized controlled evaluation of low-intensity laser therapy: plantar fasciitis. Arch Phys Med Rehabil.1998 Mar;79(3):249-54. PubMed
Other healing alternatives to surgery include
(without reference to their efficacy):
• Injections / Medication. For temporary relief E.g. anti-inflammatories such as steroidal corticosteroid injections and NSAIDS E.g. celecoxib, ibuprofen, naproxen
• Extra-corporeal shock wave therapy (ESWT). Pulses of high-pressure sound waves
• Orthotics / Heel cups / Arch support
• Magnetic insoles
• Ultrasound
• Strapping/Taping
• Therapeutic ultrasound
• Chiropractic (manipulative therapy)
• Soft tissue therapy / massage
• Heat
• Ice. Anti-inflammatory effect
• Acupuncture
Stuber et al reviewed the efficacy of randomized, controlled, clinical trials (published in English between1980 and 2005) involving different conservative modalities to treat plantar fasciitis.
Kent Stuber, BSc, DC,Kevyn Kristmanson, BSc, DC.Conservative therapy fpr plantar fasciitis: a narrative review of randomized controlled trials J. Can Chiropr Assoc.2006 June;50(2): 118-133. PubMed
Chronic low-level inflammation (CLII) involved in almost all health problems
"The medical kit of the future"
General electrotherapy health benefits. Used systemically and/or locally at specific problem areas of the body, its effective application has many benefits:
Detoxification | Wellness / Healthy aging | Pain relief |
Relief from insomnia | Immune system restoral | Anti-Inflammatory |
Maximizes cellular energy production | Accelerated tissue /bone /scar healing |
Stress Reduction |
Muscle relaxation / rehabilitation | Increased blood oxygen / circulation |
+++ |
There are several reasonably affordable electrotherapy devices available for personal use. The following electrotherapies are those that have received a significant amount of positive feedback:
Pulsed Electromagnetic Field (PEMF) therapy |
Beck Protocol |
Rife therapy |
Ozone therapy |
Near Infrared (NIR) class 4 laser therapy |
Cranial Electrotherapy Stimulation (CES) applies specific frequency patterns to the head area, with the following benefits:
Balances neurotransmitters | Relieves pain | Treats depression |
Substance abuse withdrawal | Relieves insomnia | Relieve stress / anxiety |
Anti-Inflammatory | Fibromyalgia | +++ |