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‘Load me up, Scotty’: mechanotherapy for plantar fasciopathy (formerly known as plantar fasciitis)
  1. M S Rathleff1,2,
  2. K Thorborg3,4
  1. 1Department of Health Science and Technology, Faculty of Medicine, Center for Sensory-Motor Interaction (SMI), Aalborg University, Aalborg, Denmark
  2. 2Department of Occupational and Physiotherapy, Aalborg University Hospital, Aalborg, Denmark
  3. 3Sports Orthopaedic Research Center—Copenhagen, Arthroscopic Centre Amager, Copenhagen University Hospital, Amager-Hvidovre, Denmark
  4. 4Physical Medicine & Rehabilitation Research—Copenhagen (PMR-C), Department of Occupational and Physical Therapy, and Department of Orthopaedic Surgery, and Clinical Research Center, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
  1. Correspondence to Dr M S Rathleff, Department of Health Science and Technology, Faculty of Medicine, Center for Sensory-Motor Interaction (SMI), Aalborg University, Soendre Skovvej 15, Aalborg 9000, Denmark; michaelrathleff{at}gmail.com

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Plantar heel pain is often caused by plantar fasciitis (fasciopathy) and treatment has traditionally included stretching, gel heel inserts and injections. However, in line with the increased clinical focus and evidence regarding mechanotherapy, as re-introduced by Khan and Scott,1 a novel approach was recently taken by Rathleff et al2 using exercise and load (mechanotransduction) to treat the injured plantar fascia. The rationale for applying mechanotherapy was that plantar fascia consists of type 1 collagen and exhibits tendinopathy traits, including degenerative changes, deterioration of collagen fibres, increased secretion of ground substance proteins, focal areas of fibroblast proliferation and increased vascularity.3 ,4

A new ‘fascial’ treatment

The new treatment of plantar fasciopathy consists of slow, high-load strength training and is comparable to plantar fascia-specific stretching among patients with plantar fasciopathy.2 The patients performed heel-raises using a towel underneath the toes to increase dorsiflexion of the metatarsophalangeal joints. Slow high-load strength training in addition to heel …

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