12/18/2013 6:49 AM
Last month, I gave a Webinar on the use of prefabricated orthotics for treatment of plantar fasciitis. In that Webinar, which is available for ProLab clients to watch online, we reviewed the most effective orthotic modifications for treatment of plantar fasciitis. These include valgus forefoot correction and the use of a medical heel skive. You can read about why those modifications help treat plantar fasciitis here.
The ProLab P3 prefabricated orthotics are the only prefabs on the market that incorporate both a medial heel skive and valgus correction forefoot in order to most effectively decrease tension on the plantar fascia.
One of the questions we received in the webinar is whether these prefabs require a plantar fascia groove.
A plantar fascia groove is used to decrease pressure on a very prominent plantar fascia. I find this is an accommodation that is rarely needed, even when making custom orthosis. In fact, there is some inherent problems with using a plantar fascia groove because it can cause the orthosis to gap excessively from the arch of the foot.
My preference is that if a plantar fascia groove is necessary to add it after the patient receives the orthosis. You can read about how to do that here.
There are rare occasions where the plantar fascia is so prominent that an intrinsic plantar fascia groove is useful. However, because this is a fairly rare foot type this is the type of patient that is not likely a good candidate for prefabricated orthosis and should instead receive custom devices.
So in summary, a plantar fascia groove should never be necessary on a prefabricated orthosis. Prefabs are designed to fit a majority of patients but not those with unusual features such as very prominent plantar fascia. Those patients should receive custom orthoses.