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!