A colleague recently asked whether prefabricated orthoses for plantar fasciitis require a plantar fascia groove.
A plantar fascia groove is used to decrease pressure on a very prominent plantar fascia. I find this accommodation is rarely needed, even when making a custom orthosis. In fact, there are 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, the clinician should add it after the patient receives the orthosis.
There are rare occasions in which 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 who is not likely a good candidate for prefabricated orthoses and should instead receive custom devices.
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 a very prominent plantar fascia. Those patients should receive custom orthoses.
Editor’s note: This blog was originally published at http://www.prolaborthotics.com/Blog/tabid/90/EntryID/491/Default.aspx  and has been adapted with permission from Lawrence Huppin, DPM, and ProLab Orthotics. For more information, visit www.prolaborthotics.com  .