Foot Orthoses, Taping and Heavy Slow Resistance Training

Insoles beat sham insoles only for the first four weeks, prefabricated insoles work as well as custom ones, and they work better alongside active treatment such as stretching. Henrik advises choosing for comfort. Arch taping is another short-term option. The heavy slow resistance exercise is a single leg heel raise on a step with a rolled towel under the toes to load the plantar fascia through the windlass mechanism: three seconds up, two seconds hold, three seconds down, with a backpack added until no more than about eight reps are possible. Pain during the exercise is expected and acceptable. Compared with plantar fascia stretching, it gave faster recovery at three months but no difference at six or twelve. In Henrik's trial of 70 patients, a self-dosed approach, with as many sets as possible at up to eight reps, matched a predetermined progression. There was no dose-response link, and only 4 of 70 reached an acceptable symptom state within twelve weeks.