Confused on what to do with your heel pain or plantar fasciitis pain?
Well, from what I’ve read, I’m not surprised. The title above pretty much seems to sum it all up. You’ll hear or read choices to fill in the blank from toe spreaders, pads, injections to custom molded “Flexible” orthotics. Some will even attempt to sell or provide something based on “Evidence Based Medicine” research articles.
Why is this? Well, some is straight forward marketing. That is, if it helped one person, then they may try and claim it is clinically proven to help that condition. The latter is based on prior research. The problem with evidence-based information is that many of the studies are not comparing apples to apples. It may have studied only runners. Runner biomechanics vary during runs. This compared to the “Average Joe the Plumber” who may not be in the ideal shape.
Studying Joe will probably provide different results. This has been shown with heel striking. One study said it causes injury and another said it does not. Why, they had two different study groups! Further, some will quote a statement within a research article that clearly states “further research is needed”. Bottom line, one cannot take bits and pieces from one inconclusive or incomplete study to another and come up with a hard fastened answer.
Hard Orthotic VS Soft Orthotic
Another example, one article I read said a “Hard” orthotic doesn’t work any better than a “sham” orthotic. Therefore, they submitted that their flexible orthotic will do the job. First, they utilized “Evidence” from a study that has been well rebuked by those that are seriously into research articles. Reality, this “Hard” orthotic has indeed helped many people. Second, “Hard” orthotics are made probably about over 100 different ways. Finally, classifying orthotics into hard and soft, flexible and accommodative is much more complicated than is usually described. I will say though, the firmer the orthotic, the smaller the standard deviation of acceptance is, yet they typically will provide consistent support.
We are all different, we have unique situations, ultimately, treating plantar fasciitis and heel pain typically requires an individual approach- not cookie cutter treatments. A “Hard” orthotic may be indicated, a soft flexible may be as well!
Best I can tell you, seek someone to help you that has an open mind treating individually to your need(s).
David J. Sables, D.P.M., C.Ped
ArchMasters-Orthotics, Shoes & Footcare, LLC