Which Stretching Method is Superior in Plantar Fasciosis?

Plantar fasciosis is prevalent in orthopedic clinic particularly foot and ankle sections. First-line treatment includes rest, non-steroidal anti-inflammatory drugs, orthotics, and stretching. However, approximately 10-40% of patients will have persistent symptoms after 2 years. Several stretching methods have been proposed, targeting plantar fascia and calf muscle. Plantar fascia specific stretching alone showed superior result in short-term follow up only, compare to calf muscle stretching, but combine stretching effectiveness is still inconclusive. The practical conclusion is difficult to draw because foot arch type and leg flexibility are not included in those stretching studies. We believe that the possible benefit of combined stretching benefits should not be overlooked, especially in patients with a high arch or tight calf muscles. In our opinion, future studies of plantar fasciosis and stretching should include foot type and lower extremity flexibility.