TREATMENT PROCESS

This is my current treatment process for patients with plantar fasciitis, please watch the video for full details. Here is my current treatment sheet for patients.

• 1st Visit - Evaluate your condition, review x-rays, and perform a walking evaluation to determine the cause of your condition. Start working to reduce inflammation, reduce tightness and reduce stress through your plantar fascia. You will start the daily ritual.

• Daily Rituals (Video Explanation Included) - These are the daily rituals that can be used with other office-based treatments.
  
  1.When you wake up do a towel stretch before getting out of bed (30-second stretch 3 repetitions) to loosen up the calf region.
  
  2. Put on supportive sandals such as Oofos. 
  
  3. I recommend starting your coffee pot and that gives you about 5 minutes to work on foam rolling (5 minutes 2x a day)
  
  4. At the end of day foam roll for another 5 minutes and then wear the night splint for up to 3 hours. If you have pain loosen the sides of the night splint or remove the wedge under your toes. Don't walk with the night splint. Some people can sleep with it but the majority can not. 

• Icing or contrast baths - You can either ice (10 minutes 2x a day) or take two buckets of water (one ice water and the other hot water) and alternate 5 minutes ice water, 5 minutes hot water and 5 minutes ice water to help your body to reduce swelling and pain.

• Shoe recommendations - For most of the patients with heel pain I recommend a stable running shoe even if you are not a runner. Wear that for now until the pain goes down and at home I recommend wearing a supportive sandal such as an Oofo sandal.

• 2nd Visit - Will evaluate the initial treatments and if indicated perform an ultrasound examination to evaluate the thickness of the plantar fascia to help guide further treatments. 
• Shockwave and Amnio Injection - Most of my patients benefit from a series of 3-6 sessions of shockwave therapy to improve blood flow and recovery of the plantar fascia. After these sessions then patients go through a course of 6 weeks of physical therapy. At times to help speed up the healing an Amniotic injection is beneficial. 
• Orthotics - Orthotics are useful to stabilize the heel position, help with posture and reduce excess movement of the foot that can increase stress in the area of the plantar fascia. 
• Physical Therapy - After these sessions of shockwave then patients go through a course of 6 weeks of physical therapy twice a week and then follow up in the office. 
• Cortisone Injection - Rarely do I use cortisone injections to reduce the inflammation in the plantar fascial if you are limping due to the amount of pain all day long. 
• Brace - At times I recommend an off-loading brace to reduce pressure on the plantar fascia and move the pressure to the lower leg region. 

COMMON QUESTIONS

• What if my night splint is painful or causes numbness? Start with taking out a wedge in the device or reduce the tension of the device. If is not getting better please call or send me a message so I can help.  

RESOURCES 

• Shockwave (EPAT) - Information about shockwave therapy to promote the natural healing of your own body. 

• Amnio Injection - More information about Amnio injections to speed up healing. 

• Orthotics -  Explanation of how and why orthotics help foot pain.

• Icing and Contrast Bath Instructions - Here is information on how to ice your foot. 

• Foam Rolling Exercises - Instructional video for foam rolling. 

• Shoe Recommendations - Here are my shoe recommendations and shoe-related resources.

• Short Foot Exercises - Exercises to help with strengthening your feet. 

• Aerospring Brace - This carbon fiber brace can offload the plantar fascia. 

AMAZON RESOURCES

• Walk Hero Insert - Effective temporary over-the-counter insert to reduce pressure on the heel.

• Oofos - Recovery sandals to wear at home for more support.

• Night Splint - Good to reduce morning pain wear for 2-3 hours per day. 
• Foam Roller - Recommended to loosen calf. 

ONLINE COURSE

I have put together an online course you might enjoy for those who want to learn more. Using these resources can save you one visit on average to the office. There is an opportunity to ask questions and comment, and I will respond via this online learning tool. This course is called 2 Weeks to Pain-Free Plantar Fasciitis. 

Click HERE to learn more about the course.