As a practitioner that helps people with Plantar Faciitis/ Plantar Fasciopathy on a daily basis I am sick and tired of people being misinformed about the problem!
I have created this myth buster series document to help people who are experiencing persistent pain that is not responding or is affecting their life to the point where pain is occurring daily and they are unable to do the things they want.
The evidence is clear and if people want to enter into a type of therapy with certainty of recovery, we must consider the evidence at hand.
Myth Number 1:
1. Rolling a ball under your foot and stretching your feet and legs will fix the problem!
Other than an immediate traumatic incident (Jumping on a rock) the only reason that anyone will experience plantar fasciitis/ plantar fasciopathy is that their plantar fascia is unable to tolerate the ‘load’.
The load can change based on the way we move, body weight, footwear choice and activity. A persons ‘capacity’ or ability to tolerate the load will also influence risk of injury of the plantar fascia. So if a person’s load capacity is higher than the load they will not become injured. If however a person’s capacity is lower than the load, they will experience pathology.
No amount of rolling a ball underneath a foot is going to change the capacity of a plantar fascia. Doing this can actually aggravate the injury.
Strength training including strength and conditioning programs are better at recovering from plantar fasciitis/ fasciopathy than stretching (Rathleff et al. 2014)
Strength training including strength and conditioning programs has been proven to improve pain and function in those experiencing plantar fasciitis/ plantar fasciopathy. (Huffer et al 2017)
Myth Number 2:
2. The heel spur is the cause of the pain!
Once upon a time, we believed this in the medical profession. There has been a significant amount of research and now we understand that spurs are not the cause of the problem, but in fact are the result of the problem. The spur is one way the body responds to plantar fasciitis/ fasciopathy and it does not result in reduction of pain. In fact, as someone who has experienced plantar fasciitis/ fasciopathy myself, I have seen my own heel spurs on a plain film x ray years after I had recovered from the pathology. Likely, those heel spurs will be present on my skeleton for a long period of time.
Heel spurs can be found in people that do not and do have heel pain. The heels spur is not the cause of the problem. (Kullar et al 2014)
Myth Number 3:
3. I have a flat foot and that is the cause of the pain.
There are in fact two myths to this one: The flat foot and the cause of the pain.
Again, once upon a time, having a ‘flat foot’ is something that was referred to regularly in medicine and the podiatric community as being the cause of plantar fasciitis/ plantar fasciopathy.
Although foot posture is something that can change the load on the plantar fascia, it is never the only cause of the problem. The problem is always load/ capacity issue and in some cases, foot posture is influential on load and capacity, but not the only influencing factor.
To look at it simply, a person will either have the capacity (strength) to tolerate the (load) daily activities or they will not have the capacity (strength) to tolerate the (load) daily activities.
What is the best way to recover from Plantar Fasciitis?
Clinical evidence does tell us that these strategies are effective in managing plantar fasciopathy:
Custom Foot Orthotics (Lee et al. 2009)
Strength training including strength and conditioning programs (Huffer et al 2017)
At Proactive Health & Movement, our Podiatrists are also Strength and Conditioning Coaches and individualise programs for each clients load and capacity requirements, depending on occupation, activities and what each person wants to get back to doing.
A program for a marathon runner will look very different to a junior soccer player and someone who works for 38 hours per week standing at work.
Individualising treatment is what gets the best results.
If you would like to book an in-clinic or video consultation please click here:
https://www.proactivehm.com.au/book-online/
Daniel Monteleone
Podiatrist, S+C Coach
Proactive Health and Movement
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