Plantar fasciitis (fasciosis) is a painful diagnosis limiting a patient's ability to stand, walk, or run. The -itis of the name is a misnomer because very few cases of plantar heel pain involve an inflammatory process. Instead, a breakdown of soft tissue fibers and cells is noted in the plantar fascia reflecting the sequential stages of healing. Contributing factors to this diagnosis include a loss of ankle mobility, calf muscle tightness, and foot weakness. In our Boulder Physical Therapy practice we successfully treat this condition with the combination of exercise and manual therapy treatments designed to rapidly reduce and improve range of motion in the foot and ankle.
A recent review of the available literature on the utilization of manual therapy for patients with heel pain was conducted (Fraser, J. et al. J Man Manip Ther. 2018). Authors included 7 previous randomized, controlled trials on the utilization of this treatment in patients with plantar fasciitis. They reported a significant short (4 weeks) and long term (6 month) improvement in patient function when Physical Therapists included manual therapy into their treatment sessions. The authors recommended clinicians utilize both joint and soft tissue treatments, in addition to, high level exercise when treating patients with plantar fasciitis.