The effect of three different methods of managing heel pain

INTERVENTION: Arm 1 ‐ Customised foot orthotics + new neutral athletic footwear ‐ medical devices used to relieve the stresses on pathologiccal tissues. These devices will be placed in new neutral athletic footwear and worn in both feet. Duration of the intervention period is 12 weeks. To be worn every day for as much as possible. Compliance and amount worn will be monitored as average time worn per day in an online pain diary to be completed weekly. Arm 2 ‐ New neutral athletic footwear ‐ athletic running shoe with no added medial support or midsole dual density. Duration of the intervention period is 12 weeks. Shoes to be worn every day as much as possible. Compliance and amount worn will be monitored as average time worn per day in an online pain diary to be completed weekly. CONDITION: Plantar fasciopathy PRIMARY OUTCOME: First step pain underneath the heel. Assessed as the average first step pain on a 100mm visual analogue scale. This is done weekly on an online pain diary SECONDARY OUTCOME: Average 24‐hour pain. Assessed via a 100mm VAS ; Duration and loading rate of 1st rocker period. Defined by a force platform in terms of the loading rate (rate of change) of the vertical component of the vertical ground reaction force. Duration defined as the time from initial contact to 15% of contact time ; Maximum tibiocalcaneal joint eversion angle & corresponding joint moment. Assessed using motion capture software and force platforms ; Medial longitudinal arch angle. Assessed as the angle betwene three markers placed on the calcaneus, navicular tuberosity and 1st metatarsal head tracked by a 3‐D motion capture system. ; Peak tibiocalcaneal joint flexion/extension angle & corresponding joint moment. Assessed with motion capture technology and a force platform. Thickness of the plantar fascia on ultrasound. Assessed by diagnostic ultrasound INCLUSION CRITERIA: Aged between 18 ‐ 60 years of age Heel pain in only one foot Duration of symptoms > four weeks Self‐reported heel pain > 20 mm on A 100mm VAS Report pain on palpation of the medial tubercle of the calcaneus or proximal plantar fascia