vide arch support and encourage a neutral position of the foot. As this patient already has mild pronation of the foot, he is not likely to tolerate minimalistic shoes. 7. Education : This patient also needs extensive education about the benefits of research-based physical therapy treatment. He will need an explanation about why the previous therapy was not effective: it did not include strengthening, he continued running, tendinitis was not addressed, iontophoresis has lim- ited/no effectiveness, dorsiflexion has not increased despite limited stretching, indicating a need for more stretching to increase range of motion. He also only completed three visits of physical therapy previously. This patient also needs to un - derstand the amount of time recovery from plantar fasciitis as well as Achilles tendinitis can take for him to be compliant with his new program. change in training patterns, most commonly with running, are common risk factors. Therefore, the most likely way to design an effective treatment plan is to complete a thorough examination, being careful to eliminate all other possibilities. Then address the individual deficits of each patient, focusing on treatments that have been proven by research to improve outcomes for plantar fasciitis. The most effective known treatments include low-dye taping, stretching of the calf musculature and the plantar fasciitis, strengthening of the intrinsic musculature of the foot, strengthening of the gastrocnemius and soleus, orthotics for arch support, trigger point massage, and night splints.
Manual stretching in the clinic can be included as well with the goal of increasing dorsiflexion. 3. Exercise : There are multiple strength deficits in this patient’s hip, knee, as well as in the ankle. Home exercises need to include resisted hip internal and external rotation, hip abduc- tion, hamstring strengthening, and unilateral heel raises for the calf muscles. 4. Trigger point therapy : This should be combined with use of ice to help manage pain symptoms. 5. Night splints : This patient would likely benefit from these, so a conversation with him about the importance of night splints in the treatment of chronic plantar fasciitis would be indicated as well as a discussion of the types of night splints available, to ascertain what he would be most likely to comply with. 6. Shoes : He has already obtained new shoes that have helped some. The types of shoes that are most likely to help will pro- Conclusion Plantar fasciitis is a complicated condition to treat. As there is no one right way to treat this condition, many patients attempt self- treatment prior to seeking help and the patient may read or hear of a variety of different devices or treatment, many of which are ineffective to treat the pain and loss of function associated with this condition. However, the plantar fascia has multiple biomechanical functions that make it incredibly important to a normal gait pattern. If the condition is not treated appropriately, normal gait and function of the foot may never resume. The cause of this condition is not specifically known, though it is well established that increased BMI; decreased ankle dorsiflexion; pronation or supination of the foot; extensive time standing; and a recent Resources Links to Special Tests • Windlass Test : http://www.thestudentphysicaltherapist.com/windlass-test. html Abbasian, M., Baghbani, S., Barangi, S., Fairhurst, P. G., Ebrahimpour, A., Krause, F., & Hashemi, M. (2020). 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