‘Load me up, Scotty’: mechanotherapy for plantar fasciopathy (formerly known as plantar fasciitis)

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 al 2 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 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 …