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How do you fix plantar fasciitis long term :Use footwear that allows the toe flexor muscles to work properly and so take load off of the plantar fascia during later stance ?

 

By way of explanation of the above the following is worth considering .

It has been demonstrated that by switching from "normal" shoes to more minimal shoes for everyday tasks, toe flexor strength can be increased by, on average, 57% . It can be reasonably concluded then that some aspect or aspects of modern shoes design causes the toe flexor muscles to be used less than would be the case in a natural, barefoot, condition.

It has further been demonstrated that the toe flexor muscles become active as the heel clears the ground during gait and also that this is the time of peak stress in the plantar fascia.

Given the above it surely makes sense that toe flexor muscle activity can reduce stress in the plantar fascia during gait and that the more active these muscles are the greater the stress reduction.

One of the keys therefore, to reducing load on the PF during gait, is increasing toe flexor activity not merely increase toe flexor strength.

IMO then, clinicians wishing to help patients with plantar fasciitis should consider not just toe flexor strengthening but also toe flexor utilization during gait . Since modern shoes seem to utilize the toe flexors a lot less than more minimal shoes this must be an area of concern .

Again in my opinion, features like medial arch supports or cushioning will not affect toe flexor activity at toe off but toe springs and sole flexibility will .

For greater toe flexor activity during heel off and thus greater assistance to load management in the PF ,clinicians might consider toe flexor strengthening and shoes with reduced toe springs more flexible soles, where possible/advisable .

Thoughts ?