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Laser Treatment of Plantar Fasciitis

Laser Treatment of Plantarfasciitis St. John's Physiotherapy

The plantar fascia is the tough tissue that covers the bottom of the foot, supporting the arches, ligaments and muscles which are located there. This fascia is composed of dense, well-organized collagen strands, arranged in parallel alignment. The major issue with this condition is the degeneration of the collagen, often precipitated by poor foot structure (such as flat feet, overpronation); muscle imbalance (such as tight heel-cord); overweight; and aging issues (such as arthritis or heel fat pad decay). 

Heel spurs are less related to plantar fasciitis pain. Recent research indicates that heel spurs are a normal bony adaption to provide better mechanical advantage to nearby muscles and to protect the aging foot. Spurs can become painful when large enough to compress surrounding tissues, setting up an inflammatory response.

Plantar fasciitis pain is typically worse in the morning, when your feet first hit the floor. It is centered on the heel itself, but can radiate forward into the arch of the foot. It can appear to get better, then relapse; this is described as an initial acute inflammatory response which settles, and is followed by more persistent pain associated with degradation and degeneration of the collagen fibers which comprise the fascia. The resulting pain can be very persistent.

BioFlex laser is a low-level or low-intensity laser, which is most properly called photobiomodulation. Bioflex laser has been intensively researched, and continues to be so at the Meditech Laser Clinics in Toronto. Similar research efforts are on-going at universities and other research facilities throughout the world….to the benefit of all who use the laser technology. Essentially low level laser is low powered (less than 500mW); derived from energy from wavelengths of 600 to 900 nm; and absorbed by light absorbing proteins within cells for the purpose of stimulating cell activity.

This is most helpful when tissues have been injured or are inflamed, and unable to function normally…the laser stimulation provides the energy the cell needs to recover more quickly. Low level laser also has an analgesic effect, which is used to good effect, especially by those who want to reduce their use of pain medication, or who would prefer not to take medication.

Laser is an effective treatment for both plantar fasciitis and heel spurs; the former because it can repair collagen and the later because it settles inflammation. Because laser directly targets mitochondria, the effect on the damaged tissue is to increase metabolism and restore normal cell function and structure. it A recent randomized clinical trial supports the use of laser in the treatment of plantar fasciitis; and further, demonstrated that it is more effective than both shock wave therapy and ultrasound for relieving heel pain. The study follows.

Magnetic Resonance Imaging and Clinical Outcomes of Laser Therapy, Ultrasound Therapy, and Extracorporeal Shock Wave Therapy for Treatment of Plantar Fasciitis: A Randomized Controlled Trial

Plantar fasciitis can take some time to heal, often longer than other “itis’ conditions. This is because the requirement to be on our feet generally doesn’t decrease magically because our feet are sore. Rather, the constant strain of standing and walking often worsens poor mechanics, as we squirm and shift to avoid pressure on the sore area. On average, a person will require 12 to 24 treatments of 30 to 40 minutes over a course of 2 to 3 months. Depending upon your underlying health, your response to treatment can start quickly or it may take several treatments to show improvement. After that, your feedback is key as the laser energy needs to be modulated as healing occurs. It is common that pain is relieved before the tissues are sufficiently healed to support normal function. For this reason, laser treatments taper off as pain subsides but are not discontinued until function is restored.

At Avalon Laser Health, we believe that laser cannot be a stand-alone treatment for plantar fasciitis, and your best treatment will include the insight and skills of key practitioners. The repetitive strain on the foot which leads to degradation and degeneration of the plantar fascia associates very strongly with mechanical issues, such as poor foot structure or alignment; and muscle imbalances. It is essentially a pain condition created by poor mechanics.

For this reason, effective treatment plans often start with a physiotherapy assessment, and include exercise correction of misalignments or related postural issues. In addition to laser, your treatment plan may also include massage to friction or break down scar tissue and sometimes acupuncture, for additional pain management, if required. 

We work with you to design the best plan for your situation. Your actual treatment plan will be created following assessment and respect your goals and any unique circumstances. We have had good success treating plantar fasciitis at our clinic.


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