scholarly journals The effectiveness of combined shockwave therapy and plantar fascia stretching interventions in treating plantar heel pain

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ian Burton ◽  
Kay Cooper ◽  
Lyndsay Alexander ◽  
Paul Alan Swinton
Keyword(s):  
Plantar Fascia ◽  
Heel Pain ◽  
Shockwave Therapy ◽  
Plantar Heel Pain

scholarly journals Plantar fasciitis

2012 ◽  
Vol 94 (8) ◽  
pp. 539-542 ◽  
Author(s):  
S Cutts ◽  
N Obi ◽  
C Pasapula ◽  
W Chan
Keyword(s):  
Plantar Fasciitis ◽  
Plantar Fascia ◽  
Heel Pain ◽  
Management Options ◽  
Heel Spur ◽  
New Techniques ◽  
Extracorporeal Shockwave Therapy ◽  
Shockwave Therapy ◽  
Plantar Heel Pain ◽  
History Of

INTRODUCTION In this article we look at the aetiology of plantar fasciitis, the other common differentials for heel pain and the evidence available to support each of the major management options. We also review the literature and discuss the condition. METHODS A literature search was performed using PubMed and MEDLINE®. The following keywords were used, singly or in combination: ‘plantar fasciitis’, ‘plantar heel pain’, ‘heel spur’. To maximise the search, backward chaining of reference lists from retrieved papers was also undertaken. FINDINGS Plantar fasciitis is a common and often disabling condition. Because the natural history of plantar fasciitis is not understood, it is difficult to distinguish between those patients who recover spontaneously and those who respond to formal treatment. Surgical release of the plantar fascia is effective in the small proportion of patients who do not respond to conservative measures. New techniques such as endoscopic plantar release and extracorporeal shockwave therapy may have a role but the limited availability of equipment and skills means that most patients will continue to be treated by more traditional techniques.

scholarly journals Shockwave therapy for plantar heel pain (plantar fasciitis)

2019 ◽  
Author(s):  
Rebecca L Jessup ◽  
Matthew J Oates ◽  
Renea V Johnston ◽  
Rachelle Buchbinder
Keyword(s):  
Plantar Fasciitis ◽  
Heel Pain ◽  
Shockwave Therapy ◽  
Plantar Heel Pain

scholarly journals Effect of a Toe-Walking Protocol in Plantar Heel Pain: A Proof of Concept

2021 ◽  
Author(s):  
Dean Huffer ◽  
Wayne Hing ◽  
John Charles ◽  
Richard Newton ◽  
Mike Clair ◽  
...  
Keyword(s):  
Plantar Fascia ◽  
Primary Outcome Measure ◽  
Heel Pain ◽  
Cortical Inhibition ◽  
Secondary Outcome ◽  
Patient Reports ◽  
Plantar Heel Pain ◽  
Pain Disability ◽  
Foot Function ◽  
Toe Walking

Abstract Background: Plantar heel pain (PHP) is one of most common disorders of the foot treated in primary care. It affects athletic and sedentary populations, with patient reports of activity-limiting pain and reduced quality of life. Recently, atrophy of the forefoot plantar intrinsic musculature was identified in patients with PHP. Therefore, the purpose of this study was to assess whether loading the plantar fascia strengthens the intrinsic foot musculature (IFM) and decreases symptoms in subjects with PHP Methods: A within-subjects experimental design assessed foot function, foot pain, disability, and activity limitation in 12 subjects with PHP prior to and at the end of a six-week toe-walking program. The primary outcome measure was the Foot Function Index (FFI). IFM strength (both hallux flexion and lesser toe flexion) was measured as a secondary outcome. Results: After six weeks of treatment, the mean (SD) FFI score significantly decreased from 73.2 (32.4) to 43.3 (22.8) points (p = 0.010, ES=1.1). HHD measures: Both great toe flexion and lesser toes flexion strength measures demonstrated significant force increases from 21.8N to 29.6N (+7.8N) 95%CI [1.3, 14.4] (p=0.024, ES=1.0) and from 21.4N to 28.4N (+6.6N) 95%CI [1.8, 11.4] (p=0.010, ES=0.9), respectively. Conclusion: Results suggest that toe-walking may reduce PHP symptoms and increase IFM strength. There was no identified correlation between the IFM and FFI changes. Symptom reduction may be due to a reduction in cortical inhibition rather than IFM strength changes. Findings provide foundation for future larger and more controlled studies, to further validate the effectiveness of toe-walking in reducing symptoms of PHP patients. Trial registration: Bond University Ethics Committee (BUHREC Protocol No. 1908)

scholarly journals Online questionnaire, clinical and biomechanical measurements for outcome prediction of plantar heel pain: feasibility for a cohort study

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Halime Gulle ◽  
Trevor Prior ◽  
Stuart Miller ◽  
Aleksandra V. Birn-Jeffery ◽  
Dylan Morrissey
Keyword(s):  
Cohort Study ◽  
Plantar Fascia ◽  
Step Length ◽  
Order Effect ◽  
Heel Pain ◽  
Future Research ◽  
Online Questionnaire ◽  
Level Of Evidence ◽  
Face To Face ◽  
Plantar Heel Pain

Abstract Background Plantar heel pain (PHP) accounts for 11–15% of foot symptoms requiring professional care in adults. Recovery is variable, with no robust prognostic guides for sufferers, clinicians or researchers. Therefore, we aimed to determine the validity, reliability and feasibility of questionnaire, clinical and biomechanical measures selected to generate a prognostic model in a subsequent cohort study. Methods Thirty-six people (19 females & 17 males; 20–63 years) were recruited with equal numbers in each of three groups: people with PHP (PwPHP), other foot pain (PwOP) and healthy (H) controls. Eighteen people performed a questionnaire battery twice in a randomised order to determine online and face-to-face agreement. The remaining 18 completed the online questionnaire once, plus clinical measurements including strength and range of motion, mid-foot mobility, palpation and ultrasound assessment of plantar fascia. Nine of the same people underwent biomechanical assessment in the form of a graded loaded challenge augmenting walking with added external weight and amended step length on two occasions. Outcome measures were (1) feasibility of the data collection procedure, measurement time and other feedback; (2) establishing equivalence to usual procedures for the questionnaire battery; known-group validity for clinical and imaging measures; and initial validation and reliability of biomechanical measures. Results There were no systematic differences between online and face-to-face administration of questionnaires (p-values all > .05) nor an administration order effect (d = − 0.31–0.25). Questionnaire reliability was good or excellent (ICC2,1_absolute)(ICC 0.86–0.99), except for two subscales. Full completion of the survey took 29 ± 14 min. Clinically, PwPHP had significantly less ankle-dorsiflexion and hip internal-rotation compared to healthy controls [mean (±SD) for PwPHP-PwOP-H = 14°(±6)-18°(±8)-28°(±10); 43°(±4)- 45°(±9)-57°(±12) respectively; p < .02 for both]. Plantar fascia thickness was significantly higher in PwPHP (3.6(0.4) mm vs 2.9(0.4) mm, p = .01) than the other groups. The graded loading challenge demonstrated progressively increasing ground reaction forces. Conclusion Online questionnaire administration was valid therefore facilitating large cohort recruitment and being relevant to remote service evaluation and research. The physical and ultrasound examination revealed the expected differences between groups, while the graded loaded challenge progressively increases load and warrants future research. Clinician and researchers can be confident about these methodological approaches and the cohort study, from which useful clinical tools should result, is feasible. Level of evidence IV

scholarly journals Autoregulated Heavy Slow Resistance Training Combined with Radial Shockwave Therapy for Plantar Heel Pain: Protocol for a Mixed Methods Pilot Randomised Controlled Trial

2020 ◽  
Author(s):  
Ian Burton
Keyword(s):  
Mixed Methods ◽  
Randomised Controlled Trial ◽  
Resistance Training ◽  
Controlled Trial ◽  
Treatment Protocol ◽  
Heel Pain ◽  
Shockwave Therapy ◽  
Plantar Heel Pain ◽  
Pilot Rct ◽  
Randomised Controlled

Background: Plantar heel pain (PHP) is considered a tendinopathy and it affects up to 10% of the population. Both heavy slow resistance training (HSRT) and extracorporeal shockwave therapy (ESWT) have shown effectiveness for treating PHP in isolation. However more comprehensive exercise protocols and progression methods are needed due to poor long-term outcomes, and better standardization of ESWT protocols are required. Autoregulation of resistance training involves self-selecting exercise dosage based on individual factors. Although autoregulation has proven effective for strength gains in athletes, it has not been investigated in tendinopathy. It is recommended that PHP not be treated by one treatment in isolation, with there being a need to investigate feasibility and effectiveness of combined treatments in PHP. Currently, no studies have investigated autoregulated HSRT combined with ESWT, despite their individual efficacy. The optimal treatment protocol for PHP is unknown, and there is a need to ascertain whether the addition of ESWT to autoregulated HSRT leads to better outcomes compared to either alone. Methods: A three-arm randomised controlled trial (RCT) comparing these groups would be the ideal way to investigate this question, with a pilot RCT testing trial procedures and process evaluation required prior to a definitive RCT. Patients expectations, feasibility and acceptability of combined ESWT and exercise for PHP also remain unknown. Therefore, the addition of qualitative interviews in a mixed methods pilot RCT would help ascertain acceptability and help explain the intervention outcomes.

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