Barefoot Running As A Treatment For Plantar Fasciitis In The Runner: A Case Series

Abstract

PURPOSE: Plantar fasciitis is the most common running related injury associated with the foot and represents ~8% of all running injuries. The median recovery time for plantar fasciitis is ~5-months. Following the failure of conservative management for a female runner with plantar fasciitis, we trialled an alternate day treatment strategy of barefoot running on a grass surface (10 - 15 minutes). This approach was successful and was published as a medical case report. This abstract aims to describe the results of an emerging case series (n=4) using a similar approach. METHODS: Four amateur runners (2 male, 2 female, age 27-45 years) were diagnosed as having plantar fasciitis. In all cases, the failure of conservative management led to them being prescribed a barefoot running intervention on grass. Patients were instructed to complete 10-15 minutes (dependent on pain tolerance) of barefoot running every second day and record pain scores using the visual analog scale (VAS) every morning. RESULTS: Mean pain intensity (scored out of 10) at the beginning of the intervention was 5.4 ± 1.5 (range 3.5 - 7). After 6 sessions of barefoot running, mean pain intensity had reduced to 2.0 ± 1.6 (range 2.0 - 4.0). All patients demonstrated an improvement in pain intensity after 4-sessions. Three patients sustained this improvement up to session 6 and one patient reverted to their original pain score (4). The two female patients demonstrated an immediate and sustained reduction in pain. The two male patients initially remained unchanged or increased pain intensity before improving. DISCUSSION: The results of this emerging case series suggest that this intervention is at least well tolerated in runners with chronic plantar fasciitis. The fact that the intervention contains the activity known to worsen symptoms may suggest this approach has some promise. However, it is not possible to infer cause and effect from a case series and the improvements shown in this series may be due to other factors such as the passage of time or a reduction in fear avoidance behaviour.