High-load strength training for plantar fasciitis
Plantar fasciitis (PF) is a reported as one of the most common injuries and ailments of runners. Often, the treatment plan consists of steroids injections, splinting, massage or stretching.
The authors of this article estimate, however, that even with these approaches up to 40% of patients continue to have symptoms after 2 years.
A new exercise regimen called high-load strength training is proposed, and the objective is to stimulate load in a way that encourages collagen production and speedy recovery of PF.
The exercise programme is simple:
Standing on a step, with the edge of the step being the mid-point of the foot and a rolled up t-shirt (instead of a towel, as the authors note the thickness of a towel is too much for most people) under the toes, the patient raises up on his/ her toes for the count of 5 seconds.
When at full plantarflexion and heel raised above the step, the patient holds for 3 seconds, then slowly eccentrically loads down until the foot is level with the step. This exercise can be done initially with the help of the unaffected leg for balance, in single-leg stance, or bilaterally if the other leg is affected too.
The exercise has to be done once daily for 10 repetitions on weeks 1-4. Following week 4, the patient can increase loading; either by adding a weighted backpack, or by increasing the load with single-leg stance if the exercise was initially done with assistance of the other leg.
While concentric and eccentric loading exercises are often used in tendon injuries, it is less commonly given with the treatment of PF. This article, however, refers to the debate that PF may not be solely and inflammatory disorder, but could instead be a degenerative disorder. The authors note that this could be why more frequent modes of treatment such as steroid injections often do not work.
This article provides an exercise that may be used in the treatment of PF, but, due to the loading and the nature of this exercise this may not be well tolerated in initial stages of PF. Nevertheless, it is worth considering that treatment goals may need to address a wider scope than just mitigating inflammation.
> From: Caratun et al., Can Fam Physician 64 (2018-03-01 06:49:21) 44-46. All rights reserved to the College of Family Physicians of Canada. Click here for the online summary.
