The plantar fascia is a thick band of tissue that runs along the arch of the foot, connecting the heel bone to the toes. When this tissue becomes irritated or inflamed, it results in a condition known as plantar fasciitis. A common symptom of plantar fasciitis is sharp, stabbing pain in the heel or arch, which is typically more intense in the morning or after long periods of rest.

Several factors can contribute to inflammation of the plantar fascia. For example, excessive standing, walking, or running without adequate progression can place too much strain on the tissue, leading to irritation. Additional factors such as weight gain, tight calf muscles, and weak foot or ankle muscles can also play a role. On a broader scale, improper walking or standing mechanics caused by strength imbalances elsewhere in the leg, including the hip, can affect the foot and ankle. Even weakness or injury in the opposite leg, causing overuse of the symptomatic side, may be a contributing factor. This is why a thorough medical evaluation is essential to identify and address the root cause of the problem. 

Persistent tension in the plantar fascia can result in the formation of heel spurs on the bottom of the foot. Similarly, chronic tension in the Achilles tendon may lead to the development of a spur on the top or back of the heel. If you've been diagnosed with a heel spur, treatment for plantar fasciitis can help alleviate your symptoms.

Traditional methods include rest, ice, anti-inflammatories, physiotherapy (including stretching and strengthening), orthotics, changes in shoes, and night splints.  

When it comes to night splints, there are generally two types: (1) rigid boots and (2) soft, sock-like devices. They are designed to be worn while you sleep to help manage your condition. During sleep, the ankles naturally relax into a plantar-flexed position (see below). This downward angle can cause the tissues on the bottom of the foot to heal in a shortened state.

Dorsiflexion stretches the tissues at the bottom of the foot which is why that first step in the morning, that sudden stretch after a night of resting in a shortened position, hurts so bad. Anyone who has badly scraped a knee or elbow knows the pain of bending that joint and tearing open the scab that has healed overnight or after resting for a while. This is basically the same thing. Every time our body forms scar tissue or a scab in a shortened position and then we have to transition to a lengthened position, we reaggravate or create microtears in that area.

Night splints are designed to support tissue healing by maintaining a neutral or slightly stretched position, reducing the cycle of re-irritation and promoting faster recovery. Traditional hard boot-like splints focus solely on keeping the ankle at a 90-degree angle, without stretching the toes. On the other hand, soft sock-like devices stretch the toes but do not address the ankle. 

Since the plantar fascia connects both the heel bone and the toes, it’s essential to target both the ankle and toe positions to effectively stretch the fascia. Our device is the first on the market to combine both elements into a single night splint. Patented and developed by a physical therapist who once suffered from plantar fasciitis, it offers a comprehensive solution.

This website is not a substitute for personalized advice from a qualified physiotherapist who has conducted a thorough evaluation to tailor treatment to your specific needs. While there is a wealth of general information available online that can help most people develop a daily routine to complement their night regimen and accelerate recovery, it is always best to seek professional guidance for individualized care.

For stretching, you should incorporate: plantar fascia-specific stretches, gastrocnemius stretches, and soleus stretches. Many individuals opt to foam roll the calf and roll the bottom of the foot with different devices including, but not limited to a frozen water bottle.

For strengthening, focus on: intrinsic foot strengthening, toe yoga, ankle resistance band exercises, and hip strengthening (particularly targeting external rotation and extension).

Building strength from the foot all the way up to the hip is crucial for achieving long-term results and sustained relief.

https://pubmed.ncbi.nlm.nih.gov/12851352/

Tissue-specific plantar fascia-stretching exercise enhances outcomes in patients with chronic heel pain. A prospective, randomized study

Conclusions: A program of non-weight-bearing stretching exercises specific to the plantar fascia is superior to the standard program of weight-bearing Achilles tendon-stretching exercises for the treatment of symptoms of proximal plantar fasciitis. These findings provide an alternative option to the present standard of care in the nonoperative treatment of patients with chronic, disabling plantar heel pain.

https://pubmed.ncbi.nlm.nih.gov/16882901/

Plantar fascia-specific stretching exercise improves outcomes in patients with chronic plantar fasciitis. A prospective clinical trial with two-year follow-up

Conclusions: This study supports the use of the tissue-specific plantar fascia-stretching protocol as the key component of treatment for chronic plantar fasciitis. Long-term benefits of the stretch include a marked decrease in pain and functional limitations and a high rate of satisfaction. This approach can provide the health-care practitioner with an effective, inexpensive, and straightforward treatment protocol.

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