There is consistent evidence in a double-blind RCT testing evaluating the effect of non-conventional conservative treatments for plantar fasciitis over the long term. Two small pilot studies showed that 5 min of physical therapy, ice, and ultrasound applied over the counter with ultrasound, heat, or cold for up to 4 days was effective in relieving heel pain for most patients. More recently, in a large secondary analysis of RCT results, it was found that physical therapy alone was not effective when used alone. Adequacy of care was found to be associated with the use of conservative treatments. The majority of patients using conservative treatments showed improvement, but there was no reduction in the incidence of any secondary infections.
Causes of Heel Pain
Heel pain usually occurs first in the morning and can be worsened by standing or walking for long periods in one position. Plantar fasciitis occurs when the fascia becomes inflamed. It can result from a traumatic event, such as heel spurs from exercising, heel bone malalignment from flat feet, or genetic factors. Typical symptoms are tenderness of the heel and tightness in the arch, usually in the mornings. Heat and/or ice applied to the heel and/or foot may relieve the pain. Using arch supports while walking provides additional pain relief for plantar fasciitis sufferers.
Stretching technique
One of the most common treatments for heel pain is to apply strong stretching and exercise pressure on the extensor muscles, which run down the outside of the heel. The main reason that this is done is to stretch tight calf muscles. A further technique that some physiotherapists use is to add arch support to the treatment, putting weight on the balls of the feet and ankle and moving the feet or ankle back in a slow, deep stretch. This is known as arch-supporting therapy. A further physiotherapy treatment for fasciitis is to add ultrasound or sound into the foot to increase the strength and tighten muscles. These methods all use a similar principle.
Shockwave Therapy
One of the more unusual methods of plantar fasciitis may involve shockwave therapy. During this treatment, a therapist applies a continuous, low, pulsating sound wave to the foot and ankle. This is believed to stimulate the bones and joints and increase the flow of blood to the affected area. Over the course of about 30 minutes, the process reduces inflammation and allows healing to begin. This is particularly effective at increasing the production of synovial fluid, which helps to reduce friction between the plantar fascia and the heel spurs. Synovial fluid contains lubrication proteins that decrease friction, allowing the heel spurs to slide more readily.
Ultrasound
The other common technique used for treatment of plantar fasciitis is ultrasound. An ultrasound probe is attached to a wand like apparatus that emits sound waves. By applying pressure to the affected area, these waves break up scar tissues and reduce inflammation. Additionally, they stimulate bone remodeling, increasing bone density. In many cases, patients are able to return to work and sports shortly after the treatment. However, more chronic or severe fasciitis will continue to require more aggressive treatments to prevent relapse.
For patients that are not able to do manual therapy, physiotherapy can still be a helpful way to alleviate the symptoms of plantar fasciitis through a variety of methods. One of these methods is repetitive, slow foot movement. This involves slowly increasing the speed at which you walk, making sure to keep the heels on the ground at all times. While this may not seem especially helpful when dealing with plantar fasciitis, it is effective at helping to rebuild the Achilles tendon. Repeatedly doing this can significantly increase the strength of the Achilles tendon and can help the patient to regain a substantial amount of their walking strength.
Promote Joint Health
Finally, in order to fully treat the condition of the Plantar Fasciitis, it is important to make use of methods that promote joint health. Physiotherapists at Healthbound clinic in Hamilton makes use of therapeutic massage to relax the muscles surrounding the joints. They also use heat packs and cold compresses to reduce inflammation and promote the growth of healthy synovial fluid. If your joint pain continues despite the application of one or more of these treatments, it is important to consult your physician. The condition of the patient's joint may be too severe and should be treated right away, without delay. By treating the underlying cause of the pain, your Physiotherapy treatment for Plantar fasciitis will become more effective.