Plantar fasciitis is a common condition in the foot and is typically seen in individuals between 40-60 years old. It is most prevalent among runners; however, individuals with jobs requiring a significant amount of standing and increased time weight bearing can also be impacted. Plantar fasciitis tends to come on when there is a sudden change in demands or increased stress to the plantar fascia of the foot. Some of these demand changes could include increased time on the feet, increased mileage walking or running, change in running/walking surfaces, or change in shoe type.
Plantar fascia refers to the band of tissue on the sole of the foot that helps support your arch during weight-bearing tasks such as walking, running, and jumping. This tissue spans from the heel bone (calcaneus), to the ball of your foot (metatarsals), and even attaches into the toes. Classic plantar fasciitis presents with morning heel pain, where the plantar fascia inserts on the calcaneus, with a gradual decrease of symptoms as the day goes on. The Journal of Orthopedic Sports Medicine (JOSPT) describes this condition as being on a continuum between an inflammatory condition and a degenerative condition.
Common Treatments for Plantar Fasciitis
Unfortunately, it is not uncommon for individuals to endure their symptoms for a year or more before seeking help. When it comes to plantar fasciitis and physical therapy, there are several recommended interventions to decrease symptoms and improve function.
According to JOSPT, manual therapy techniques, such as soft tissue mobilization, instrument-assisted soft tissue mobilization (IASTM), dry needling, and joint mobilizations, have strong evidence for improving overall function and decreasing plantar pain. Stretching the plantar fascia and gastrocsoleus complex, as well as high-load strengthening can help decrease pain as well. Additional techniques for heel/plantar pain include taping, night splints, or foot orthoses. A physical therapist can help determine which treatment interventions are best for you and design an individualized plan to help you return to the activities you love.
The Benefits of PRP for Plantar Fasciitis
Platelet rich plasma (PRP) injections can also provide relief of symptoms. This therapy is a regenerative treatment that uses a concentration of a patient’s own platelets to accelerate the healing of injured tendons, ligaments, muscles, and joints. PRP is derived from the patient’s blood, which is processed to increase the concentration of platelets and growth factors. PRP therapy offers a promising alternative by addressing the underlying causes of inflammation and promoting healing at the cellular level. When PRP is injected into the affected area of the plantar fascia, the concentrated growth factors accelerate the repair of damaged tissues, reduce inflammation, and enhance collagen production. This not only alleviates pain but also improves the overall functionality of the foot, allowing patients to return to their normal activities more quickly and with less discomfort.
A randomized control trial by Khurana et al. compared the results of steroid injections versus PRP injections on plantar fascia pain. PRP injections had more favorable results regarding pain relief and improved function at the 6 month mark post injection. None of the 58 participants receiving PRP required an additional injection after 6 months.
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