Customized heel pads and soft orthotics to treat heel pain and plantar fasciitis.

Seligman DA, Dawson DR.

Source

Department of Occupational Therapy, Baycrest Center for Geriatric Care, Toronto, ON, Canada. james8618@rogers.com

Abstract

We describe the design of a new cost-effective, comfortable orthotic designed to treat heel pain associated with plantar fasciitis. The heel pad is fabricated from a 4 degrees Sorbothane medial wedge with a customized insertion of low-density Plastazote. The orthotic is medium-density Plastazote reinforced with cork in the medial longitudinal arch. One pair of orthotics takes less than 1 hour to make. Pilot data were collected retrospectively to evaluate the efficacy of the orthotic for reducing pain. Ten clients at a hand and foot orthotic clinic with a mean age of 71+/-9.1 years and with unilateral or bilateral heel pain associated with plantar fasciitis were provided with customized heel pads and soft, molded orthotics at their initial visit. Pain levels were recorded with verbal and Likert-type scales. After 5 weeks of heel pad and orthotic use, all patients showed a reduction in pain, with the overall reduction being highly significant (P</=.0001). Customized heel pads and soft molded orthotics are an effective first-line treatment for the heel pain and loss of function associated with plantar fasciitis.

Evaluation of combined prescription of rocker sole shoes and custom-made foot orthoses for the treatment of plantar fasciitis.

Fong DT, Pang KY, Chung MM, Hung AS, Chan KM.

Abstract

BACKGROUND:

It is a routine practice to prescribe a combination of rocker shoes and custom-made foot orthoses for patients with plantar fasciitis. Recently, there has been a debate on this practice, and studies have shown that the individual prescription of rocker shoes or custom-made foot orthoses is effective in treating plantar fasciitis. The aim of this study was to evaluate and compare the immediate therapeutic effects of individually prescribed rocker sole shoes and custom-made foot orthoses, and a combined prescription of them on plantar fasciitis.

METHODS:

This was a cross-over study. Fifteen patients with unilateral plantar fasciitis were recruited; they were from both genders and aged between 40 and 65. Subjects performed walking trials which consisted of one 'unshod' condition and four 'shod' conditions while wearing baseline shoes, rocker shoes, baseline shoes with foot orthotics, and rocker shoes with foot orthotics. The study outcome measures were the immediate heel pain intensity levels as reflected by visual analog scale pain ratings and the corresponding dynamic plantar pressure redistribution patterns as evaluated by a pressure insole system.

RESULTS:

The results showed that a combination of rocker shoes and foot orthoses produced a significantly lower visual analog scale pain score (9.7mm) than rocker shoes (30.9mm) and foot orthoses (29.5mm). With regard to baseline shoes, it also significantly reduced the greatest amount of medial heel peak pressure (-33.58%) without overloading other plantar regions when compared to rocker shoes (-7.99%) and foot orthoses (-28.82%).

DISCUSSION:

The findings indicate that a combined prescription of rocker sole shoes and custom-made foot orthoses had greater immediate therapeutic effects compared to when each treatment had been individually prescribed.

Copyright © 2012 Elsevier Ltd. All rights reserved

The impact of custom semirigid foot orthotics on pain and disability for individuals with plantar fasciitis.

Gross MT, Byers JM, Krafft JL, Lackey EJ, Melton KM.

Source

Division of Physical Therapy, Program in Human Movement Science, University of North Carolina at Chapel Hill, 27599-7135, USA. mtgross@med.unc.edu

Abstract

STUDY DESIGN:

Single-group, pre-, and postintervention repeated measures design.

OBJECTIVE:

To determine the impact of custom semirigid foot orthotics on pain and disability for individuals with plantar fasciitis.

BACKGROUND:

Few studies have examined the efficacy of foot orthotics for plantar fasciitis, and no single study has yet examined the effects of semirigid foot orthotics on an established quality-of-life instrument.

METHODS AND MEASURES:

Eight men and 7 women (mean ages 44.7 +/- 9.0 years) who reported having plantar fasciitis symptoms for an average of 21.3 +/- 23.7 months participated in the study. Subjects were timed for a 100-m walk at a self-selected speed, then they rated the pain they experienced during the walk using a 10-cm visual analog scale. Subjects also completed the pain and disability subsections of the Foot Function Index questionnaire. All measures were acquired before the fabrication of custom semirigid foot orthotics and 12 to 17 days following onset of foot orthotic use.

RESULTS:

Postorthotic 100-m walk times were not significantly different (t = 0.39, P = 0.70) than preorthotic values. Postorthotic pain ratings (mean = 0.7 +/- 0.7) for the 100-m walk were significantly less than (Wilcoxon t = 1, P <0.005) preorthotic pain ratings (mean = 3.0 +/- 1.7). Postorthotic Foot Function Index pain subsection ratings (Wilcoxon t = 0, P <0.005) were significantly less than preorthotic ratings, demonstrating a 66% reduction in pain ratings. Postorthotic Foot Function Index disability subsection ratings (Wilcoxon t = 0, P <0.005) were significantly less than preorthotic ratings, demonstrating a 75% reduction in disability ratings.

CONCLUSION:

Custom semirigid foot orthotics may significantly reduce pain experienced during walking and may reduce more global measures of pain and disability for patients with chronic plantar fasciitis.