Plantar Fasciitis and Foot Orthotics.
The purpose of foot orthotics with a diagnosis of plantar fasciitis is to decrease the strain on the plantar fascia. Kogler, in his articles in Clinical Biomechanics, has provided evidence highlighting the effect of several variables on plantar fascia strain. Let me give you a summary:
- Heel lifts do NOT decrease the strain on the plantar fascia
- A wedge placed under the lateral aspect of the forefoot decreased the strain.
- A wedge placed under the medial forefoot increased the strain.
- Foot orthotics that raise the apex of the medial arch and prevent dorsiflexion (loading) of the first ray are the most effective in reducing plantar fascia strain.
The foot orthotic should be custom molded, fit snugly up against the navicular, and flare away from the lateral aspect of the foot. The orthotic can include a post under the lateral 4 metatarsal heads. We call this post a reverse Morton’s extension. It will allow the first ray i.e. the first metatarsal and medial cuneiform to be plantar flexed relative to the other metatarsals. As a result, we decrease the strain on the plantar fascia.
At WalkWell, biomechanical analysis is our specialty. We can fabricate custom foot orthotics as well as provide comprehensive and evidence based physical therapy.