Beating Plantar Faciitis

Beating Plantar Faciitis

As a Certified Pedorthist over the years, I’ve seen hundreds, if not thousands of cases of plantar fasciitis.  For the most part, plantar fasciitis can be overcome with a diligent well-rounded conservative treatment plan, which includes: good footwear, proper support of the medial longitudinal arch, regular stretching, physiotherapy, daily icing, and a night splint.

Unfortunately, research shows that about 10% of cases become chronic, particularly if their daily activities require long hours of standing.  Due to the nature of the job, I have found some of the trickiest cases of plantar fasciitis related to the following professions: nurses, teachers, postal carriers, flight attendants.

Since we see so many cases of plantar fasciitis, I’m always interested in learning the newest research in the area.  An article in the March 2011 issue of the Journal of Foot and Ankle Surgery caught my eye.  It is a paper by Hafner et al. from the Yale New Haven Hospital.

The study examined 100 specimens of plantar fascia removed from patients with chronic cases on plantar fasciitis (“recalcitrant plantar fasciitis”).  The specimens were collected over the course of 14 years – that amount of time commitment to the study really impressed me.  This study has two main results:

1. No evidence of inflammation in 54% of the samples
2. Fibromas seen in 25% of the samples

The fact that more than half of the specimens did not exhibit inflammation is interesting.  It is commonly believed that plantar fasciitis is defined as the inflammation of the plantar fasciat, thus, the suffix“-itis” of plantar fasciitis.  Other studies in the past have also demonstrated this misnomer, and some have suggested that we use the term plantar fasciosis instead of plantar fasciitis.

This study also sheds light on why some individuals have such difficulty with plantar fasciitis.  The 25% frequency of fibromas (a benign nodule or neoplasm) with plantar faciitis is a novel finding – it has never been reported previously.  While I have observed soft tissue masses in the plantar fascia through visual and manual investigation, I would have never thought that it would be such a high occurrence.

As a pedorthist, there are ways to make accommodations in orthotics to provide more specific comfort for nodules and fibromas.  We can provide cushioning and shape the orthotic accordingly so that the orthoses does not end up providing a high pressure point.  I will endeavour to look more closely at patients for this possibility.

Reference Link: doi:10.1053/j.jfas.2010.12.016

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2 Comments
  • Rita Punchak

    May 6, 2014 at 11:08 pm

    Thank you Conny for helping me find a runner for me/ I was rather apprehensive when I first arrived but was made most comfortable by Conny & the other staff. I am elderly & have had two operations for a bunion & one toe fused. The first operation was ineffective & I had to have it redone. Getting any kind of footwear has been very difficult. Conny made me feel relaxed & took as much time as I needed with many options to fit my orthotics I received from Dr. Mathews, a Podiatrist in New Westminster that are only six months old. Conny suggested a Saucony Progrid Integrity ST 2 runner to try at home for comfort & suitability. I am hoping my feet will feel good & I will be happy to have shoes that will give me comfort. Thanks Conny for being patient with me. Rita

  • Rita Punchak

    May 6, 2014 at 11:12 pm

    Thank you Conny for helping me find a runner. I was rather apprehensive when I first arrived but was made most comfortable by Conny & the other staff. I am elderly & have had two operations for a bunion & one toe fused. The first operation was ineffective & I had to have it redone. Getting any kind of footwear has been very difficult. Conny made me feel relaxed & took as much time as I needed with many options to fit my orthotics I received from Dr. Mathews, a Podiatrist in New Westminster that are only six months old. Conny suggested a Saucony Progrid Integrity ST 2 runner to try at home for comfort & suitability. I am hoping my feet will feel good & I will be happy to have shoes that will give me comfort. Thanks Conny for being patient with me. Rita

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