Tissue-Specific Plantar Fascia-Stretching Exercise Enhances Outcomes in Patients With Chronic Heel Pain

DiGiovanni, Benedict F.; Nawoczenski, Deborah A.; Lintal, Marc E; Moore, Elizabeth A.; Murray, Joseph C.; Wilding, Gregory E.; Baumhauer, Judith F.

doi:10.2106/00004623-200307000-00013

Cited by 299 publications

(284 citation statements)

References 14 publications

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“…In fact the lower bound estimate of the 95% CI for within-group changes in both groups excludes the MCID for the primary outcomes, supporting a clinically meaningful improvement. Our results for the individuals in the Str group are consistent with the outcomes of previous studies in which calf muscles and plantar fascia-specific stretching were effective for the management of plantar fasciitis or plantar heel pain at short-term 12,25 and long-term 13 follow-ups. Conversely, Radford et al 27 have recently reported that a self-stretching program provides no significant short-term benefits in pain and function in patients with plantar heel pain.…”

Section: Discussionsupporting

confidence: 90%

Effectiveness of Myofascial Trigger Point Manual Therapy Combined With a Self-Stretching Protocol for the Management of Plantar Heel Pain: A Randomized Controlled Trial

Renan-Ordine¹,

Alburquerque‐Sendín²,

Rodrigues-de-Souza³

et al. 2011

J Orthop Sports Phys Ther

147

149

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Plantar fasciitis or plantar heel pain is the most common foot pain condition treated by healthcare providers. 28 It has been estimated that plantar fasciitis occurs in approximately 2 million Americans annually 10 and affects as much as 10% of the general population over the course of a lifetime. 29 In fact, some authors have reported that plantar fasciitis accounts for between 8% and 15% of foot complaints in nonathletic and athletic populations. 31,37 Plantar heel pain has a negative impact on foot-specific and general health-related quality of life, 20 and shows distinct patterns of disability on different functional domains. 30 To date, there is evidence that this condition may not be characterized by inflammation but, rather, by noninflammatory degenerative changes in the plantar fascia. 21 These findings suggest that this painful T T OBJECTIVE:To investigate the effects of trigger point (TrP) manual therapy combined with a self-stretching program for the management of patients with plantar heel pain. T T BACKGROUND:Previous studies have reported that stretching of the calf musculature and the plantar fascia are effective management strategies for plantar heel pain. However, it is not known if the inclusion of soft tissue therapy can further improve the outcomes in this population. T T METHODS:Sixty patients, 15 men and 45 women (mean  SD age, 44  10 years) with a clinical diagnosis of plantar heel pain were randomly divided into 2 groups: a self-stretching (Str) group who received a stretching protocol, and a self-stretching and soft tissue TrP manual therapy (Str-ST) group who received TrP manual interventions (TrP pressure release and neuromuscular approach) in addition to the same self-stretching protocol. The primary outcomes were physical function and bodily pain domains of the quality of life SF-36 questionnaire. Additionally, pressure pain thresholds (PPT) were assessed over the affected gastrocnemii and soleus muscles, and over the calcaneus, by an assessor blinded to the treatment allocation. Outcomes of interest were captured at baseline and at a 1-month follow-up (end of treatment period). Mixed-model ANOVAs were used to examine the effects of the interventions on each outcome, with group as the between-subjects variable and time as the within-subjects variable. The primary analysis was the group-by-time interaction. T T RESULTS:The 2 × 2 mixed-model analysis of variance (ANOVA) revealed a significant groupby-time interaction for the main outcomes of the study: physical function (P = .001) and bodily pain (P = .005); patients receiving a combination of self-stretching and TrP tissue intervention experienced a greater improvement in physical function and a greater reduction in pain, as compared to those receiving the self-stretching protocol. The mixed ANOVA also revealed significant group-by-time interactions for changes in PPT over the gastrocnemii and soleus muscles, and the calcaneus (all P<.001). Patients receiving a combination of self-stretching and TrP tissue intervention showed a gre...

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Section: Discussionsupporting

confidence: 90%

Effectiveness of Myofascial Trigger Point Manual Therapy Combined With a Self-Stretching Protocol for the Management of Plantar Heel Pain: A Randomized Controlled Trial

Renan-Ordine¹,

Alburquerque‐Sendín²,

Rodrigues-de-Souza³

et al. 2011

J Orthop Sports Phys Ther

147

149

View full text Add to dashboard Cite

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“…Di Giovanni et al, assessed the role of Achilles tendon stretching versus planter fascia stretching in a randomized study of 101 patients. Both Achilles stretching groups and planter fascia stretching groups appreciated a decrease in pain upon first steps in morning as well as increased function; however, the planter stretchers appreciated a statistically significant improvement in activity function and first step pain as compared to the Achilles stretchers [11]. We noticed that the stretching exercises which we recommended were easy to understand by the patients, further many of them claimed, that because they are like yoga they are quite beneficial for them and they have been doing at home without supervision easily.…”

Section: Methodsmentioning

confidence: 87%

Comparative Study of: Non-Invasive Conservative Treatments with Local Steroid Injection in the Management of Planter Fasciitis

Narula

Iraqi

Narula

et al. 2014

JCDR

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“…The final literature search at the completion of the data collection yielded a few sources that suggested that plantar fasciitis is more of a degenerative pathology. [2][3][4][5][6][7][8] This information may have future implications on the parameters chosen in the treatment of plantar fasciitis.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7] Clinicians commonly apply local modalities, manual treatments and stretching exercises in spite of a general lack of clinical evidence to prove the effectiveness of some of these methods. Authors performing a systematic review cited, "26 conservative treatments that have been recommended for the treatment of plantar heel pain."…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Light-Emitting Diode Versus Sham in the Treatment of Plantar Fasciitis: A Randomized Trial

Higgins

Hews

Windon

et al. 2015

Journal of Chiropractic Medicine

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Objective: The purpose of this preliminary study was to compare the application of the light emitting diode (LED) to sham LED in the treatment of plantar fasciitis. Methods: Eighteen subjects met the inclusion criteria and were randomly assigned into 2 groups: light emitting diode or sham LED. The subjects received either the LED at 12 J/cm 2 or sham LED along 2 points of the plantar fascia. Subjects in both groups received a 10 minute transverse friction massage and participated in 4 plantar fascia stretching exercises. All subjects received a total of 6 treatments over 3 weeks. Progress was assessed using the lower extremity functional and analog pain scale. Results: No significant difference was found between treatment groups (P = .845). There was a significant difference in pain and outcome scores over time within both groups (P b .35). Conclusion: Among patients with plantar fasciitis, the use of LED did not result in greater improvement in function or pain compared with sham treatment. The findings suggest that manual intervention and passive stretching activities may have provided significant pain relief and improvement in functional outcome scores.

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Tissue-Specific Plantar Fascia-Stretching Exercise Enhances Outcomes in Patients With Chronic Heel Pain

Cited by 299 publications

References 14 publications

Effectiveness of Myofascial Trigger Point Manual Therapy Combined With a Self-Stretching Protocol for the Management of Plantar Heel Pain: A Randomized Controlled Trial

Effectiveness of Myofascial Trigger Point Manual Therapy Combined With a Self-Stretching Protocol for the Management of Plantar Heel Pain: A Randomized Controlled Trial

Comparative Study of: Non-Invasive Conservative Treatments with Local Steroid Injection in the Management of Planter Fasciitis

Light-Emitting Diode Versus Sham in the Treatment of Plantar Fasciitis: A Randomized Trial

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