Pin firing Plantar Fasciitis?

[Bestafter60]

I’m considering an experiment to determine whether the “pin firing” approach that Rip employs for healing epicondylitis has applicability to plantar fasciitis. I have PF now, and being the "first horse" has a certain appeal. My thought on experiment design would be to pick a regimen similar to the epicondylitis method, and a measurement system, then get started and record progress daily until the PF is gone. Something like:

Regimen: 4 bouts of 50 calf raises daily, starting with bodyweight and progressing weights incrementally.
Measurement: Walk, attempting normal gait until pain causes gait change, count and record number of steps until gait change. 1,000 steps pain free = end experiment, PF cured.

I don’t mind a little pain in the interest of science. But before I start, I want to inquire whether idea this has possibilities or is just plain dumb and likely to exacerbate the PF instead of improving it. If it has possibilities, what modifications would you make to the experiment design?

[Will Morris]

I’m considering an experiment to determine whether the “pin firing” approach that Rip employs for healing epicondylitis has applicability to plantar fasciitis. I have PF now, and being the "first horse" has a certain appeal. My thought on experiment design would be to pick a regimen similar to the epicondylitis method, and a measurement system, then get started and record progress daily until the PF is gone. Something like:

Regimen: 4 bouts of 50 calf raises daily, starting with bodyweight and progressing weights incrementally.
Measurement: Walk, attempting normal gait until pain causes gait change, count and record number of steps until gait change. 1,000 steps pain free = end experiment, PF cured.

I don’t mind a little pain in the interest of science. But before I start, I want to inquire whether idea this has possibilities or is just plain dumb and likely to exacerbate the PF instead of improving it. If it has possibilities, what modifications would you make to the experiment design?

Since plantar fasciitis is a traction-induced inflammatory response, I'd see repeated bouts of calf raises as likely compounding the issue. The best available evidence, and the current clinical practice guidelines for the treatment of PF, state the calf stretching is the treatment of choice. If I were to suggest a change, I would utilize squats with a flat shoe and more anterior knee travel than the LBBS. My main measurements would include level of pain with first steps out of bed.

[Bestafter60]

As luck would have it, my PF pain has diminished quite a bit today. It was more than bearable when I woke up. The only real intervention was to stop wearing the new shoes. I deadlifted last night, so maybe some beneficial stretching occurred. Today I'll spend quite a bit of time standing on cold concrete, which may aggravate things, but I don't think I have severe enough problem to make a worthwhile case study. I'll do the recommended calf stretches. How does stretching help PF?

[Will Morris]

Stretching helps with plantar fasciitis (one of the few things stretching is actually therapeutic for) because PF is a traction-based inflammatory response at the insertion of the plantar fascia on the calcaneus. The PF has virtually no ability to undergo tissue creep (stretching), and tight gastroc/soleus from prolonged posturing in plantarflexion start to cause the calcaneus to rotate clockwise. The PF will not stretch to accommodate, so the PF insertion starts to get disrupted (microtears) which is met with an intense inflammatory response. As the traction continues, the bone is pulled into a spur due to the constant traction.

[Bestafter60]

Thanks for such a thorough explanation, Will!
My PF must have been very mild. It's gone despite my challenging it with 8 hours on cold concrete yesterday.
This concept of healing through acute inflammation overload intrigues me. As a rule, does it generally NOT work on fascia? Does it work on other tendinopathies? (If l misused that term, what l mean is tendinitis in other locations). Does it work with arthritis?

[skid]

I had extreme PF for months where walking was always painful and I had a pronounced limp. Stair calf stretches and the spiky dog bone roller helped relieve the pain, but didn't contribute to healing as I did that for months prior to doing calf raises.

What cured it for me was calf raises. When I started I could hardly do a body weight calf raise due to pain. There was some stretching involved in the calf raises as I rested the balls of my feet on a 3 inch block, lowered my heels to the floor, and then did a calf raise up on my tip toes as high as I could go. This worked everything through a full range of motion. Despite the pain while doing the exercise, the PF felt better afterwards.

I eventually worked up to 155 pounds for 10-15 reps and haven't bothered increasing it from there since the PF has almost went away. I make sure to do weighted calf raises when I squat. When I warm up in weights I do both exercises.

[VNV]

Is squatting on one's toes, forward of mid-foot, a likely root-cause of PF, since it seems that it would produce excessive plantarflexion? I've had a few pretty bad cases of PF over the past year, and am wondering if it is related to my tendency to do this. So the long-term remedy of avoidance would be to stay over midfoot.