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Wednesday, May 16, 2018

Study Spotlight: Manual Therapy in Pain and Function w/ Plantar Fasciitis

By: Joel Luedke

Plantar fascia pain affects a lot of people throughout the year and when it does, it really does.  The treatment of it can also be extremely long and frustrating and so we took a look at a review study that tries to shine more light on interventions that could help out.

What They Did: 

This is a review study that look through a lot of studies and dwindled them down to looking at seven randomized control trials (RCTs).  From these studies the researchers took a look at what parts of these studies looking at plantar facia pain and function improved those issues with the most efficiency.


What They Found:
There were a lot of variables to look at when they broke down these studies and overall found that most interventions can be helpful when it comes to treating plantar fascia pain.  When the interventions were looked at closer they shown that the inclusion of manual therapy (MT) which included working on ankle joint motion as well as working on the soft tissue around the ankle (ex. calves, foot, etc)

What It All Means:
The great part of this study is that it shows that you can help benefit your plantar fascia pain by utilizing manual therapy.  That is good news but also comes with a lot of "it depends".  The application of the manual therapy both in the technique and the timing is extremely important when it comes the treatment of plantar fascia issues.

While it may feel good to get after the plantar surface tissue it is very easy to overdo it.  You want to be careful that when doing soft tissue work on these areas that you are actually creating 'controlled damage' to the tissue and you have to make sure that you don't over stress the tissue as you can create more problems then you're trying to solve.  It is always an option to work the soft tissue around the painful area.  That could include the other part of the foot (forefoot) or all the way up through the calf.

Bottom line: utilize manual therapy but use caution when doing so. It appears it'll help in the long run treating plantar fascia issues.

Limitations:
Due to this being a review paper is is extremely hard to control for things even if you are looking at randomized controlled trials.  That makes it so it isn't a perfect study in terms of controlling all the variables so we do have to take that into consideration.  Also it is hard to standardize manual therapy with clinicians, especially when it goes across many studies.

Source: Fraser, J. Does manual therapy improve pain and function in patients with plantar fasciitis?  A systematic review.
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