From the Research
A 41% partial tear of the plantar fascia should be treated with a combination of corticosteroid injections and controlled training, including strength training and stretching, as this approach has been shown to have a superior effect in reducing pain and improving function compared to each treatment separately. This recommendation is based on a study published in 2019 1, which found that the combination of corticosteroid injections and training had a mean difference of 40 points in the Foot Function Index (FFI) and 20 mm for VAS function pain compared to training alone, and a mean difference of 29 points in FFI and 17 mm for VAS function pain compared to corticosteroid injections alone.
Some key points to consider in the treatment of a 41% partial tear of the plantar fascia include:
- Resting the affected foot immediately and avoiding weight-bearing activities for at least 2-3 weeks to prevent further tearing
- Applying ice to the bottom of the foot for 15-20 minutes, 3-4 times daily to reduce inflammation
- Taking non-steroidal anti-inflammatory drugs like ibuprofen or naproxen for pain and inflammation for 1-2 weeks
- Wearing supportive shoes with cushioned soles and considering the use of over-the-counter arch supports or custom orthotics to reduce strain on the plantar fascia
- Beginning gentle stretching exercises for the calf muscles and plantar fascia after the acute pain subsides, typically after 1-2 weeks
- Considering physical therapy for proper rehabilitation, including ultrasound therapy and specific strengthening exercises
It's worth noting that other treatment options, such as extracorporeal shock wave therapy (ESWT) and radiofrequency thermal lesioning (RTL), may also be effective in treating chronic plantar fasciitis, as shown in a study published in 2023 2. However, the combination of corticosteroid injections and controlled training remains the recommended first-line treatment approach. Additionally, surgical options, such as plantar fascia release and decompression of the first branch of the lateral plantar nerve (Baxter's nerve), may be considered for patients with chronic plantar fasciitis who do not respond to conservative treatment, as shown in a study published in 2021 3.