Plantar stretching for Plantar fasciitis

Despite some thinking there is nothing that could be done for plantar fasciitis, combination of fascia exercises (prior post) and plantar stretches combined with high dose arthritis pills (often combined with an ulcer pill) can lead to satisfactory relief.  Regular plantar stretches by self can lead to over 50% improvement.

DiGiovanni, B. F., et al.
Tissue-specific plantar fascia-stretching exercise enhances outcomes in patients with chronic heel pain. A prospective, randomized study.
The Journal of Bone and Joint surgery. American Volume 85.7 (2003): 1270-1277.
https://pubmed.ncbi.nlm.nih.gov/12851352/

  • 46 cases in plantar fascia stretches versus 36 in calf stretch group
  • [they]were instructed to hold each stretch for a count of ten and to repeat it ten times. They were asked to perform the stretching program three times per day… the first stretch was to be done before taking the first step in the morning.”
  • In 8 weeks, 52.2% of plantar fascia cases were “all or much better” versus 22.2% of calf stretching

“Plantar Fascia-Specific Self-Stretching
In sitting, patients crossed the affected foot over the contralateral thigh. The patient placed his/her fingers over the base of the toes, grasped the base of the toes and pulled the toes back towards the shin, until a stretch was felt in the plantar fascia. Patients were instructed to start gently at first then work more aggressively as tolerated.”

At the same time, the tension of the plantar fascia can be monitored:

Exciting discovery was the finding stretching that tight found band by thumping it sideways through you thumb with an activator

Results of Plantar stretches:

Comments:

What helps further is to electrically stimulate any tender skin spots and then apply topical anti-inflammatory like Voltaren EXTRA STRENGTH (skip usual stretch). The tender spots have low impedance (probe will sing louder)

J Foot Ankle Surg. 2017 Jul – Aug;56(4):768-772. doi: 10.1053/j.jfas.2017.02.015.
Treatment of Chronic Plantar Fasciitis with Noninvasive Interactive
Neurostimulation: A Prospective Randomized Controlled Study.
Razzano C et al

https://www.ncbi.nlm.nih.gov/pubmed/28633774

Stimulate for 10 minutes three times a week. I have a pointer plus that can do that:

They found it more effective than 3 round of extracorporeal shock wave therapy.

People who take Vit D 4000 units or more and Methyl version of B12 1000 – 3000 mg/day will also notice benefits.

 

Odd finding is that over 60% of plantar fasciitis cases have HIGH arches (pes cavus). Know a  pharmacist with high arched plantar fasciitis who notice he was actually more comfortable in firm workboots than his soft orthotic shoes – might be worth looking into. Another relative I know does well with the plantar fascia exercises and the plantar stretches combined with NSAID/arthritis pill meloxicam  15 mg. That dose will irritate 20% of healthy volunteers

Fleischmann, Roy, Imran Iqbal, and Gleb Slobodin. “Meloxicam.” Expert opinion on pharmacotherapy 3.10 (2002): 1501-1512.

https://www.tandfonline.com/doi/abs/10.1517/14656566.3.10.1501

so normal subjects would do better with a PPI ulcer pill (Nexium over the counter once a day would do)

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