Plantar Fascia Offloading
In this series, Dr. Doug Richie shares detailed insights into the Richie AeroSpring Plantar Fascia Offloading System.
Currently, we do not fully understand the causes of plantar fasciitis. While most clinicians use some type of arch supporting intervention, not all patients respond favorably. The Achilles is a deforming force on the plantar fascia, but stretching and heel lifts do not always provide relief of heel pain. Recent studies show that interventions, which limit the windlass mechanism, will decrease strain on the plantar fascia. That is why stiffer rocker bottom shoes have shown promise in relieving plantar heel pain.
The Role of Walking Boots
Walking boots address two of the deforming forces on the plantar fascia: the Achilles and the windlass mechanism. However, the shortcoming of the walking boot is the lack of arch support, the overall bulk and discomfort of wearing walking boots.
An Alternative to Walking Boots
After studying carbon fiber AFO braces, it became obvious to me that this device could be enhanced and modified to perfectly address the three deforming forces on the plantar fascia. It could also be more effective in the treatment of plantar heel pain compared to a walking boot.
A Biomechanical Solution
The brace decreases strain on the Achilles by limiting ankle joint dorsiflexion. This offloading could be further enhanced with the addition of a 1 cm heel wedge. The carbon fiber footplate, with toe spring, will decrease 1st MTPJ dorsiflexion and limit loading of the windlass mechanism. The incorporation of a foot orthosis, which embodies the patented Arch Lock technology, finishes off this systematic approach to offloading the plantar fascia. The Arch Lock technology is based on research published by Kogler et al., which demonstrated that a lateral forefoot wedge would predictably offload the medial-central band of the plantar fascia.
It specifically addressed all three of the loading mechanisms of the plantar fascia. This three- prong approach minimizes the mechanical strain on the plantar fascia during standing and walking. By addressing the biomechanics of foot function, we also reduce strain on the plantar fascia.
How is that accomplished?
- Having a custom balanced orthotic footbed that contours to the medial and lateral longitudinal arches.
- The wedges offload the medial-central band of the plantar fascia.
- There is no limb discrepancy as compared to traditional walking boots.