Research Supports Role of Massage in Plantar Fasciitis Treatment

Are your clients seeking relief from heel pain? There are several conditions that can bring on a sore heel, including Achilles tendonitis, bursitis, and bone spur. However, the most common cause of heel pain is plantar fasciitis. The pain and stiffness in the heel and bottom of the foot, which are characteristic of plantar fasciitis, can significantly affect day-to-day activities.

 

Plantar fasciitis or plantar heel pain occurs when the fascia, the connective tissues that runs along the bottom of the foot (plantar surface) to absorb the impact of standing, running, and walking becomes overloaded or stretched. This results in tears or stretches that become inflamed, especially in the fascia that meets the heel bone.

 

While the painful heel condition can develop in anybody, it often is the result of high impact sports that involve running and jumping, such as volleyball and tennis. Other plantar heel pain causes are:

 

·         Being overweight or obese

·         Age is significant among plantar heel causes. Plantar fasciitis is especially common among adults 50 and over[1]

·         Have foot and ankle arthritis, flat feet, or high arches

·         Spend a lot of time standing on hard surfaces, including concrete floors

·         Shoes do not fit properly, lacking arch support and/or cushioning

·         Certain medical conditions such as arthritis

·         Wearing high heels often

 

Plantar fasciitis symptoms

 

The most common plantar fasciitis symptoms are:

 

·         Heel pain, especially taking the first steps in the morning or after periods of rest.

·         Stiffness

·         Swelling around the heel

·         Pain the arch of the foot

·         A tight Achilles tendon

 

Another symptom very characteristic of plantar fasciitis is that pain decreases with activity but returns after prolonged sitting or standing.

 

Plantar fasciitis treatment

 

Common plantar heel pain treatment includes options for at home care:

 

·         Rest and ice: Give the plantar fascia time to heal by taking time off from activities that cause the pain. Ice applied to the affected area helps reduce inflammation and alleviate pain.

 

·         Stretching: Exercises, such as foot flexes and calf stretches, can lengthen tightened muscles in the feet and calves that brought on plantar fasciitis. Lengthening these muscles helps reduce tension on the plantar fascia.

 

·         Night splints: Worn while sleeping, the devices stretch the plantar fascia.

 

·         Supportive shoes: Wearing supportive shoes and using orthotics, which include cushioned inserts and heel supports, can help reduce plantar fasciitis pain.

 

·         Physical therapy: A physical therapist can help stretch the muscles, which will improve range of motion, reduce pain and aid healing.

 

·         NSAIDs: Nonsteroidal anti-inflammatory drugs (NSAIDS) to reduce pain and inflammation used for a limited timed under the direction of a health care practitioner.

 

 

Medical plantar heel treatments include cortisone, anti-inflammatory injections (limited in use to minimize side effects) and shockwave therapy, which is nonsurgical and may stimulate healing. Research continues to determine its efficacy, however. Surgery is another option, which takes the plantar fascia off the heel bone. It is a last resort if other treatments do not work.

 

Role of massage in plantar fasciitis treatment

 

Massage therapy also can help in reducing plantar heel pain by aiding in stretching the plantar fascia and increasing blood flow to the area to aid healing. Research to support the use of massage therapy for plantar heel pain finds the following:

 

Research conducted in 2013 compared the use of deep massage therapy to posterior calf muscles and neural mobilization with a self-stretch exercise program (DMS) to ultrasound therapy applied to the painful heel area with the same self-stretch exercises (USS). The research included sixty-nine patients in the trial of which 35 received DMS and 33 received USS. Participants received eight treatments over a period of 4-6 weeks in a single blind randomized trial. Results indicated that both protocols resulted in an overall short-term improvement, however, DMS treatment was significantly more effective in treating plantar heel pain syndrome than USS. [2]

 

Another research study published in 2021 aimed to determine the effectiveness of massage, including proximal Triger point release for plantar fasciitis, for pain and functional limitations in a patient with plantar fasciitis. A student massage therapist at MacEwan University in Edmonton administered five massages over five weeks to a 46-year-old female who had plantar fasciitis. The results indicated that massage, including Trigger point release for plantar fasciitis, may decrease pain and functional impairments in patients with plantar fasciitis, although further research is necessary to confirm this massage as a treatment option. [3]

 

Massage plantar heel treatments

 

Among the types of massage for use in treating plantar heel pain, along with calf are the following:

 

Deep tissue:  By targeting the deeper layers of muscle and fascia, deep tissue massage can be highly effective in treating clients suffering from plantar fasciitis. As noted above research indicated that deep soft tissue calf massage along with stretching helped in relieving pain and improved functionality for those with plantar fasciitis.

 

Cross-friction or deep-friction massage also has shown its effectiveness in helping treat plantar fasciitis. This type of massage does not use a lubricant. The foot is dorsiflexed, which means that the toes point toward the shin. Using finger pads, the therapist massages the foot in a back-and-forth motion across the grain of the tissue, moving from the heel towards the toes. [4]  Cross-friction massage usually is performed with deep pressure to break down scar tissue and improve flexibility.

 

You can help clients suffering from plantar fasciitis through massage and by teaching them self-massage techniques for use at home to help reduce pain in between