Biomechanical Consequences of Sequential Plantar Fascia Release

Murphy, G. Andrew; Pneumaticos, Spiros G.; Kamaric, Emir; Noble, Phil; Trevino, Saul G.; Baxter, Donald E.

doi:10.1177/107110079801900306

Cited by 87 publications

(43 citation statements)

References 12 publications

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“…It has been proposed that a factor of low MLA was related to plantar aponeurosis [26]. In addition Low FTA was related to plantar aponeurosis [27]. However MLA in this study showed standard range.…”

Section: Discussioncontrasting

confidence: 49%

Association between Height of the Forefoot Transverse Arch and Kinetics or Kinematics of Ankle Joint during Gait

Matsushita¹,

Tashiro²,

Suzuki³

et al. 2017

Clin Res Foot Ankle

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Objective: Most studies on arch biomechanics focus on the medial longitudinal arch (MLA) and its function; however, there are fewer studies on the forefoot transverse arch (FTA) biomechanics and its function is not well understood. This study aimed at investigating the function of FTA on foot kinetics and kinematics during gait. Methods:Nineteen healthy participants (10 men, 9 women) with a mean age of 25.8 years were recruited. Each measurement was performed with the participants' dominant foot. For evaluating FTA, transverse arch index (TAI) was measured using ultrasonic diagnostic equipment, which represented the relative height of FTA. Measurements were performed in a two-stance condition: 90% of weight bearing (90% WB), and 10% of weight bearing (10% WB). For evaluating MLA, arch height ratio (AHR) were measured with a ruler. A three-dimensional motion analysis system was used to capture and analyze foot kinetics and kinematics. Participants were instructed to walk barefoot along a 7 m walkway at regular walking pace (110 steps/minute). To examine the function of FTA, spearman's correlation coefficients were calculated for non-parametric variables (TAI at 10% WB with foot kinetics and kinematics), to examine the relationship between MLA and FTA, (TAI at 10% WB with AHR), to examine flexibility of FTA, (the difference between TAI in 90% and 10% WB with vertical ground reaction force (GRFV)in the terminal stance).Results: A significant positive correlation was observed between TAI and max GRFV in the terminal stance (r=0.50, P=0.03). There was no significant difference between TAI at 10% WB and AHR, A significant negative correlation was observed between the difference in TAI at 90% and 10% WB and, max GRFV in the terminal stance (r=-0.64, P=0.003). Conclusions:The present study showed that GRFV in the terminal stance was positively correlated with the height of FTA, and that flexibility of FTA has relative to GRFV in the terminal stance during gait. It is important to measure flexibility of FTA as well as height of FTA so as to predict the risk of forefoot injury.

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Section: Discussioncontrasting

confidence: 49%

Association between Height of the Forefoot Transverse Arch and Kinetics or Kinematics of Ankle Joint during Gait

Matsushita¹,

Tashiro²,

Suzuki³

et al. 2017

Clin Res Foot Ankle

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“…In a biomechanical study the effect of the plantar release on the medial and lateral column and the plantar was presented [34]. A complete release led to a significant flattening of the structures.…”

Section: Discussionmentioning

confidence: 99%

Indication, surgical technique and results of endoscopic fascial release in plantar fasciitis (EFRPF)

Jerosch

Schunck

Liebsch

et al. 2004

Knee Surg Sports Traumatol Arthrosc

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The purpose of the present study is to present the surgical technique for, and review our indications and results after, endoscopic fascial release in patients with plantar fasciitis. In five thiel-embalmed human specimens, a biportal technique for endoscopic release of the plantar fascia was established. The aim was here to evaluate the relation between the plantar fascia and the heel spur and to perform a release that would not exceed 50-70% of the diameter of the calcaneoplantar fascia. The endoscopic technique was performed within the last 5 years in ten male and seven female patients. All patients with the clinical entity of plantar fasciitis underwent conservative treatment for at least 6 months. The average age at surgery was 35 years (24-56 years). In the first five patients, surgery was performed under c-arm control. In all patients the operation could be finished endoscopically. The endoscopic portals healed without complications. The time for surgery during the learning curve ranged between 21 and 74 min (average 41 min) and was still longer compared to the open technique. The clinical follow-up ranged between 4 and 48 months (average 18.5 months). Out of 17 patients, 13 improved clinically, and they would choose the treatment option again. In the Ogilvie-Harris score, seven patients showed good and six excellent results. In two patients, the initial results were not satisfactory, because of a bony stress reaction of the calcaneus. This complication was treated by 6 weeks of partial weight bearing, without any further problems. Two other patients developed secondary pain in the lateral column. In spite of the minimal invasive approach it seems to be important to be careful in increasing the weight bearing in early rehabilitation. The technique of the endoscopic plantar fascia release (E FRPF) can be performed in a standardised and reproducible procedure. The follow-up examination showed good midterm results, but a loss of stability of the plantar arch has to be strictly avoided.

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“…Excision of the medial third fascia is the recommended option because total fascia release impairs the biomechanics of the foot. 33 …”

Section: Discussionmentioning

confidence: 97%

Plantar heel pain and its 3-mode 4-stage treatment

et al. 2005

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The most common cause for heel pain is plantar fasciitis. The diagnosis can usually be made by clinical examination, but sometimes ENMG (electroneuromyography), ultrasound, and magnetic resonance imaging examinations are helpful. Other reasons for heel pain, e.g., nerve entrapments, atherosclerosis/ischemia, and fat pad degeneration, should be excluded. Plantar fasciitis can also present a symptom of chronic seronegative spondyloarthropathies or reactive arthritis. In the case of common plantar fasciitis, three different modes of treatment can be administered, namely, (1) anti-inflammatory and analgesic treatment, (2) rest and diminution of the strain at the insertion, and (3) maintenance of the tension and flexibility of the soft tissues. A simple four-step treatment plan algorithm, based on symptoms, their duration, and response to treatment, is presented. Operative treatment is seldom needed if the algorithm is correctly followed. Operative treatment is recommended only when the pain remains resistant to conservative treatment after more than 1 year. For operative treatment, partial release of the fascia close to insertion to avoid flat foot and secondary strain on the calcaneocuboid and midtarsal (Lisfranc) joints is our preferred option.

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Biomechanical Consequences of Sequential Plantar Fascia Release

Cited by 87 publications

References 12 publications

Association between Height of the Forefoot Transverse Arch and Kinetics or Kinematics of Ankle Joint during Gait

Association between Height of the Forefoot Transverse Arch and Kinetics or Kinematics of Ankle Joint during Gait

Indication, surgical technique and results of endoscopic fascial release in plantar fasciitis (EFRPF)

Plantar heel pain and its 3-mode 4-stage treatment

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