Which of the following is NOT a nonoperative management strategy for plantar fasciitis?

• A. Surgical release of plantar fascia
• B. Night splints
• C. Shoe modifications
• D. Eccentric calf strengthening

Answer: (D)

Plantar fasciitis is usually managed nonoperatively first, focusing on reducing tension in the plantar fascia and promoting tissue healing. Night splints keep the fascia stretched overnight, which helps reduce morning pain and stiffness. Shoe modifications and orthotics help cushion and support the arch, decreasing strain on the fascia during gait. Eccentric calf strengthening addresses calf tightness and improves ankle mechanics, which lowers the load transmitted to the plantar fascia. Surgical release of the plantar fascia, on the other hand, is an invasive procedure reserved for cases that do not improve with nonoperative care. Because it involves surgery rather than a conservative approach, it is not a nonoperative management strategy.