Martin, R. L., Davenport, T. E., Reischl, S. F., McPoil, T. G., Matheson, J. W., Wukich, D. K., ... & Godges, J. J. (2014). Heel pain—plantar fasciitis: revision 2014. Journal of Orthopaedic & Sports Physical Therapy, 44(11), A1-A33.
This weeks review is not the most recent article but it is a great overall article of plantar fasciitis with informational collated from 100 articles.
What I am keen to focus on with this review, is the treatment we advised and offer.
That is: Massage, Stretching, Orthotics, Strengthening and Night Splint.
The joy of this article is it utilises a scale on how strong the evidence in the studies used to put this article together.
Please see the below table.
And how strong the recommendation is to use certain treatments based on the strength of the evidence of the studies that were utilised.
So as we can see, Level I evidence is the strongest and Grade A recommendation is the most supported.
Below is the list of treatments that we include in The Ultimate Plantar Fasciitis Treatment Plan.
Manual Therapy: Grade: A: ‘Clinicians should use manual therapy, consisting of joint and soft tissue mobilization, procedures to treat relevant lower extremity joint mobility deficits and to decrease pain and improve function in individuals with heel pain/plantar fasciitis.
3 articles were reviewed for this finding.
Stretching: Grade A: ‘Clinicians should use plantar fascia-specific and gastrocnemius/soleus stretching to provide short-term (1 week to 4 months) pain relief for individuals with heel pain/plantar fasciitis. Heel pads may be used to increase the benefits of stretching.’
5 articles were reviewed
Orthotics: Grade A: ‘Clinicians should use foot orthoses, either prefabricated or custom fabricated/fitted, to support the medial longitudinal arch and cushion the heel in individuals with heel pain/plantar fasciitis to reduce pain and improve function for short- (2 weeks) to long-term (1 year) periods.’
22 articles were reviewed for this finding.
Night Sprints: Grade A: ‘Clinicians should prescribe a 1- to 3-month program of night splints for individuals with heel pain/plantar fasciitis who consistently have pain with the first step in the morning.’
Six articles were reviewed for this finding.
Strengthening: Grade F: ‘Clinicians may prescribe strengthening exercises and movement training for muscles that control pronation and attenuate forces during weight-bearing activities.’
This is quite an interesting grade for strengthening or as the authors called it. ‘Therapeutic Exercise and Neuromuscular re-education’. Upon review there were only two articles looked at for this recommendation and both were not plantar fascia specific. One article looked at Women with tibialis posterior tendon dysfunction and it evaluated strength in the hip and ankle region, so this can not be judged directly with healing for plantar fasciitis. The second article was looking at resistance training and its affects in lower limb biomechanics during running. So once again, this is not directly looking at the effectiveness of strengthening of the plantar fascia for treatment of plantar fasciitis nor the prevention of reinjury.
The one other interesting treatment option that had a Grade A recommendation was that of taping! We may look at doing some videos with the taping technique in the next few weeks.
It is good to see how so many steps of The Ultimate Treatment Plan have strong evidence behind the use and recommendation of them as a treatment option.
As you can see from the article what we provide is based on research to help you get better faster.
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