Plantar fasciitis (PF) is a common musculoskeletal injury characterized by inflammation
and degeneration at the origin of the fascia and causing heel pain. The disease affects
individuals of different ages and activity levels and is the main cause of plantar pain
and ankle dysfunction in patients, accounting for 15% of all foot diseases. A previous
study showed that PF is more common in middle-aged and elderly people and those who love
sports. One in 10 people has their daily quality of life seriously affected by PF. In
clinical work, it was found that there was a large difference in the degree of ankle
function of PF patients at the time of consultation. The clinical symptoms of plantar
fasciitis are mainly heel pain when landing in the morning or after a long rest. The
symptoms are aggravated after standing or walking for a long time, and sometimes patients
will show a pain-reducing gait. The diagnosis is mainly based on the patient's
symptoms and signs. There are often local tenderness points when palpating along the
plantar fascia and the medial tubercle of the calcaneus. The patient's ankle
dorsiflexion range of motion may be limited. Ultrasound examination shows increased
thickness of the plantar fascia. The patient may also show bone spurs growing into the
fascia on X-rays . The cause of plantar fasciitis is still unclear. Its risk factors
include age, obesity, foot deformity, limited ankle dorsiflexion, decreased foot
proprioception, long-term weight-bearing and walking activities . These factors are
interrelated and interact with each other, and the abnormal biomechanical mechanism of
the foot is the key to the internal connection between these factors . Poor foot-ankle
force line and biomechanics will increase abnormal stress on the plantar fascia during
joint movement, leading to micro-tears of the fascia, and then thickening and tightening
of the plantar fascia, resulting in inflammation. At present, the intervention treatment
methods for plantar fasciitis are divided into two categories: surgery and conservative
treatment. Most patients are treated with conservative treatment, which mainly includes
insole adjustment, physical therapy and weight loss. Physical therapy programs generally
include stretching the plantar fascia and calf muscles, muscle strength training, taping,
the use of orthotics and night splints, etc.. Currently, the short-term effect is
acceptable, but the long-term effect is poor, and it is easy to relapse, which affects
the overall motor function and sports performance.
People have higher and higher requirements for health. In addition to paying attention to
local pain relief, patients with plantar fasciitis also have higher demands for improving
sports performance. Conventional physical therapy methods can effectively relieve the
temporary pain of patients with plantar fasciitis, but the recovery of patients'
motor function is still poor. Only relieving short-term pain symptoms can no longer fully
meet people's daily life and sports needs. For the long-term rehabilitation of
plantar fasciitis, the correction of poor foot biomechanics and the improvement of foot
and ankle function are the key to preventing and improving physical function and
improving sports performance. Ankle dorsiflexion dysfunction will reduce various sports
performances and increase the compensation of other joint functions in the body, thereby
increasing the risk and probability of sports injuries. Relevant studies have shown that
limited ankle dorsiflexion is one of the causes of plantar fasciitis. A study showed that
211 out of 254 patients had limited ankle dorsiflexion . Individuals with insufficient
ankle dorsiflexion during walking may roll their feet forward by dropping the talus and
flattening the medial longitudinal arch. The flattening of the arch may stretch the
plantar fascia, which may lead to inflammation of the plantar fascia over time . However,
the current treatment methods for plantar fasciitis have failed to systematically improve
the limited ankle dorsiflexion function of patients, and limited ankle joint function may
directly affect the long-term treatment effect of plantar fasciitis.
In summary, since the correction of poor foot force line and the recovery of ankle
dorsiflexion function play an important role in the long-term treatment effect of plantar
fasciitis, this study aims to design a randomized controlled trial to treat plantar
fasciitis in combination with conventional rehabilitation and improvement of limited
ankle dorsiflexion function, and to explore its clinical efficacy in combination with
various evaluation indicators.