GSE
PLANTAR FASCIITIS - Treatment
Treatment options for plantar fasciitis
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
Benfotiamine
Speedy 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 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
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
Ã
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.
Recommended Dose :
1000mg
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
NIR Class 4 Laser Therapy
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 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 Extra-corporeal shock wave therapy (ESWT).
Pulses of high-pressure sound wavesOrthotics / Heel cups / Arch support Magnetic insoles Ultrasound Strapping/Taping Therapeutic ultrasound Chiropractic (manipulative therapy)
Soft tissue therapy / massage Heat Ice .
Anti-inflammatory effectAcupuncture
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,
Can Chiropr Assoc. 2006 June; 50 (2) : 118-133.
PubMed
