Treating Plantar Fasciitis with Shockwave and Orthotics Downtown Toronto

The Nature of Plantar Fasciits

If you are one of those many people who suffer from foot pain, we have solutions for you! I try my best to stay current in the recent advances in academic literature. I want to share some recent findings with you! One of the most common conditions I find in practice, is plantar fasciitis. It can be characterized as a pain in the heel or pain along the arch of the foot. Increased pain in this condition may arise from prolonged standing or activity on the feet. People tend to feel it after a period sitting or when waking up in the morning. Stretching out the band does offer some instant, temporary pain relief. Sometimes, the fascia band has been injured for some time that the healthy tissues are no longer working properly and become known as degenerative. What does that mean? It means the tissues no longer lay down healthy tissue in the manner it used to. The injury to the tissue changes the ability to repair and heal.  

My Approach to Treating Plantar Fasciitis – Extracorporeal Shockwave

How I typically treat plantar fasciitis is by the same principles of rest, support, strengthen and treating the tissue. Treating the injured area will have best benefits when one corrects the underlying issue causing the strain on the foot. This means restoring the strength and flexibility to the areas needed so that the strain on the band no longer happens. The problem about this injury is that the bottom of the foot is difficult to rest. That is why the use of an orthotic will help to lessen the strain on the tissue and offer support while standing on it. My preferred method of treatment for this is extracorporeal shockwave therapy.  

Extracorporeal shockwave therapy sends pulses into the degenerative, injured tissue to help speed up recovery. The pulses promote regeneration of healthy cells to heal the tendons and soft tissue. The treatment results in new blood vessel formation, reversal of chronic inflammation, stimulation of collagen production and loosens tissue. The treatments are usually spaced 1 week apart. I do feel the best results are when this is combined with the proper exercises so the underlying mechanism of injury is addressed. This treatment is really what helped me when I had plantar fasciitis in my earlier running years.  

Footwear and Plantar Fasciitis

Footwear can be a tricky one! Some people respond better to a lower heel drop and some respond better to a higher heel drop. I still have yet to find a holy grail which to advise people on this one. The higher heel in a shoe can alleviate the strain on tissues that don’t have flexibility. However, sometimes a higher heel in footwear can cause more focal compression on the injured tissue of the plantar fascia.  It is a bit of trial an error process. It is okay to gradually go into a little lower of a drop for those whose pain scale is quite reduced. I also implement a lot of stretching, mobility and strength work into my rehabilitation program for plantar fasciitis.  

What The Research Says for Pain Relief :

 In the academic journal Comparison of extracorporeal shock wave therapy with custom foot orthotics in plantar fasciitis treatment, it was found that both options were of benefit for those suffering with plantar fasciitis problems.  The results : Both group I and group II achieved significant improvements in our evaluation parameters (morning and evening pain) at 4, 12 and 24 weeks compared with their baseline values (P<0.001), and significant improvement observed in the group II continued at 48 weeks (P<0.05).

The study demonstrates both groups reported improvement in either scenario. Both are found to have benefit for those suffering from plantar fasciitis. I like to combine both in my practice! Orthotics can get mixed views as the person prescribing must have a sound understanding of the foot and lower limb. I am confident in my experience with my sport medicine background, that I understand the interaction of orthotics with the mechanics of the foot. Orthotics can be of great benefit when injured, to help the tissue rest and alleviate strain when recovering from an injury.