In a previous post we have written extensively about the diagnosis and management of plantar fasciopathy. Our literature review regarding conservative management showed modest improvements with the use of calcaneal taping, low level laser therapy, stretching, changing footwear, and others. In many of the controlled trial studies we read, both groups demonstrate improvement (intervention and control) and/or the study has severe limitations. It appears as if time and lifestyle modification are more important than the physical intervention performed. If the literature is consistently lacking, this tells us one of two things: our understanding of the pathology is limited OR we understand the pathology yet are still poorly managing it.
In the video below, podiatrist Dr. Ray McClanahan poses some interesting arguments regarding the management of Plantar Fasciosis. For example, he discusses the negative effects of stretching the foot into dorsiflexion, which lengthens the plantar fascia. Dr. Ray states it is more important to stretch the toe extensors into flexion to take tension off the plantar fascia. Additionally he performs soft tissue work to the ADDuctor hallucis muscle in attempt to relax the lengthened and taut ABductor hallucis. His rational: when the ABductor hallucis is taut, the muscle blunts the blood supply to the plantar fascia and dorsal surface of the foot. Check out the video below and let us know what you think!
James Heafner PT, DPT, OCS:
Owner and lead physical therapist at Heafner Health, cash-based physical therapy in Boulder, CO. Areas of expertise include orthopedic and manual therapy, functional movement, pain science, and movement science.
In May 2013, I earned my Doctorate in Physical Therapy from Saint Louis University. After graduating from the Harris Health Systems Orthopedic Residency in October 2014, I moved to Boulder, CO. Since living in Boulder, I have started my own cash-based PT practice, earned my OCS certification, and teach for the OPTIM Fellowship and COMT program in Houston TX and Scottsdale, AZ.
Chris Fox PT, DPT, OCS: Physical therapist at Foothills Sports Medicine & Physical Therapy in Scottsdale, AZ and regularly lectures at the Phoenix Campus for NAU's DPT program and for Optim Manual Therapy's COMT program. Completed multiple advanced manual therapy courses implementing aspects of biomechanical analysis. He received his DPT from Saint Louis University in 2013. Completed Scottsdale Healthcare's Orthopaedic Residency (now Honor Health) in July 2014. He became a Board Certified Orthopaedic Specialist in 2015. Level I Expert in FMS and SFMA , Kinetacore FDN Level 1 certification, and IASTM Technique course completion. He would like to pursue further education in McKenzie Technique, Dry Needling, Strength & Conditioning, Orthopaedic and Manual Therapy.
Brian Schwabe PT, DPT, SCS, CSCS:
- Board Certified Sports Physical Therapist (SCS) at Elite OrthoSport in Santa Monica, CA which specializes in treating collegiate/professional athletes and clientele from the Beverly Hills, Hollywood, and Santa Monica areas.
- USC Sports Residency Trained Physical Therapist (<1% of all PT's residency trained)
- DPT from Saint Louis University
- Future plans/interest include:
1. USAW, SFMA & Catapult Systems technology for NBA teams
2. Pursuing a position as a sports physical therapist &/or Strength coach for a Division 1 athletic medicine department or professional sport team.
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