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Plantar fasciitis and foot strengthening

Discussion in 'Biomechanics, Sports and Foot orthoses' started by scotfoot, Jul 22, 2022.

  1. scotfoot

    scotfoot Well-Known Member


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    This clinical trial has just been registered . In my opinion it is likely to be a wild goose chase.
    https://www.clinicaltrials.gov/ct2/show/NCT05462002

    Brief Summary:
    Plantar fasciitis is one of the most common musculoskeletal conditions in distance runners. 44% of patients still had the symptoms after 15 years from the first onset. The chronicity of the condition may lead to significant limitations on daily activities and even cessation of running. In the concept of foot core system, the intrinsic foot muscles work together with plantar fascia to stabilize the foot arches and provide dynamic support to the foot during functional activities. Given that the intrinsic foot muscles also play an important role as a direct sensors of foot deformation, postural control may be compromised during pathological state. Therefore, this study aim to investigate the differences in the muscle thickness and cross-sectional area of intrinsic foot muscles and postural control in runners with and without plantar fasciitis. We hypothesized that runners with plantar fasciitis demonstrate small intrinsic foot muscles sizes and poor postural control when compared with the asymptomatic counterparts.
     
  2. scotfoot

    scotfoot Well-Known Member

    Re the above, a wild goose chase because if the runners all wear modern running shoes with springy soles and toe springs, they will all have very weak toe flexors PF or not . Only 50-60 % of habitually unshod norms.

    A better study would be to take runners with PF and double their toe flexor strength and have them run in shoes without a toe spring ( cushioning and medial arch supports are unlikely to make PF any worse but may actually improve things )
     
  3. scotfoot

    scotfoot Well-Known Member

    Like a number of other structures the plantar fascia helps supports the arch of the foot . Plantar fasciitis is thought to develop when this structure is subjected to excessive loading over time, so one might expect a reduction in loading /rate of loading would help with the condition.

    Cushioning : It is known that workers who are on their feet all day are less prone to plantar fasciitis if on a rubberized floor.

    Medial arch support : It's worth a try and IMO will not cause the intrinsic foot muscles to weaken since these muscles kick in as the heel clears the ground and the arch support becomes redundant.

    Toe springs : Generally these don't hold the toes in a dorsiflexed position but do cause the toes to hang out over empty space. The toes need to have resistance under them to allow the muscles that attach to them to function properly and support the medial longitudinal arch.

    Foot tripod : In my opinion a horrible term that suggests the foot starts at the heel and finishes at the heads of the metatarsals which could not be less correct.

    From above -44% of patients still had the symptoms after 15 years from the first onset: We know that shoes weaken feet dramatically even in distance runners .We know that the toe flexors support the arch and therefore likely reduce strain on the plantar fascia. Toe flexor strength can be almost doubled in fit young male sports students in a few weeks so why not advise runners with PF to do this using resistance bands for progressive resistance training/strengthening ( Mickle at al ) .

    Based on research, a near doubling of toe flexor strength could reasonably be expected to significantly and perhaps greatly reduce strain on the plantar fascia during gait.

    " Shoes do not affect the way the foot functions or cause foot weakness " a social truth amongst some foot health care professionals but, from a scientific point of view, right up there with "the moon is made of cheese " .
     
    Last edited: Jul 23, 2022
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