How to treat plantar heel pain

...a practical guideline for patients and physiotherapists

Plantar heel pain (PHP) accounts for around eight percent of running related injuries. It is characterised by pain during weight-bearing tasks, especially after a period of rest.

Published literature is dominated by low-quality trials resulting in clinical practice guidelines that do not recommend any specific treatment for PHP. Therefore, the authors of this study combined findings from randomised controlled trials, experts’ opinions and patients’ input to develop a best practice guideline.

According to the developed best practice guideline, the clinician should take each patient’s treatment history and experience into consideration. It is also recommended to develop locally audit, monitoring and checklist tools to support implementation of this best practice guideline.

Finally it should be noted that, though this guideline aims to inform and guide patient care, further work is required to update the treatment approach.

> From: Morrissey et al., Br J Sports Med (2021) (Epub ahead of print). All rights reserved to The Author(s). Click here for the online summary.

Expert opinion

The authors of this study tried to address the problem of existing guidelines that lack clear recommendations for patients with PHP. The combination of a meta-analysis with expert opinions is a great way for this. On top of this, it is fantastic to see that the authors integrated the patient’s perspective, which is unfortunately rarely considered in research.

The authors applied a structured way to analyse and summarise the expert opinion and patients’ views. However, both remain subjective and there is a risk of distortion of current evidence. So, this article should be seen as a first step in the development of a practice guideline for PHP. Hopefully future high-quality studies in the field of PHP will enable the development of a high-quality practical recommendation.

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