Effect of Gender, Toe Extension Position, and Plantar Fasciitis on Plantar Fascia Thickness

2018 ◽  
Vol 40 (4) ◽  
pp. 439-446 ◽  
Author(s):  
Michael J. Granado ◽  
Everett B. Lohman ◽  
Noha S. Daher ◽  
Keith E. Gordon
Keyword(s):  
Risk Factors ◽  
Gender Differences ◽  
Plantar Fasciitis ◽  
Plantar Fascia ◽  
Case Control ◽  
Joint Position ◽  
Maximal Extension ◽  
Level Of Evidence ◽  
Males And Females ◽  
Healthy Males

Background: Ultrasound is a widely used diagnostic tool for patients with plantar fasciitis. However, the lack of standardization during the measurement for plantar fascia thickness has made it challenging to understand the etiology of plantar fasciitis, as well as identify risk factors, such as gender. The purpose of this study was to investigate gender differences regarding plantar fascia thickness while controlling for metatarsophalangeal (MTP) joint position in the healthy and those with unilateral plantar fasciitis. Methods: Forty participants (20 with unilateral plantar fasciitis and 20 controls) with plantar fascia thickness (mean age, 44.8 ± 12.2 years) participated in this study. The majority were females (n = 26, 65%). Plantar fascia thickness was measured via ultrasound 3 times at 3 different MTP joint positions: (1) at rest, (2) at 30 degrees of extension, and (3) at maximal extension. Results: When comparing gender differences, the males in the plantar fasciitis group had a significantly thicker plantar fascia than the females ( P = .048, η2 = 2.35). However, no significant differences were observed between healthy males and females. The males with unilateral plantar fasciitis also had significantly thicker asymptomatic plantar fasciae collectively compared with controls ( P < .05), whereas females with unilateral plantar fasciitis had a similar but not significant change. Conclusion: It appears that healthy males and females have similar plantar fascia thickness. However, as plantar fasciitis develops, males tend to develop thicker plantar fasciae than their female counterparts, which could have future treatment implications. Level of Evidence: Level III, case-control comparative study.

Relationship of Plantar Fascia Thickness and Preoperative Pain, Function, and Quality of Life in Recalcitrant Plantar Fasciitis

2018 ◽  
Vol 39 (8) ◽  
pp. 930-934 ◽  
Author(s):  
Carlo Gamba ◽  
Aleix Sala-Pujals ◽  
Daniel Perez-Prieto ◽  
Jesus Ares-Vidal ◽  
Alberto Solano-Lopez ◽  
...  
Keyword(s):  
Plantar Fasciitis ◽  
Case Series ◽  
Plantar Fascia ◽  
Health Perception ◽  
Functional Score ◽  
Preoperative Pain ◽  
Level Of Evidence ◽  
Sf 36 ◽  
American Orthopaedic ◽  
Relationship Of

Background: The measurement of plantar fascia thickness has been advocated as a diagnostic and prognostic instrument in patients with plantar fasciitis, but there are no data relative to it in recalcitrant plantar fasciitis. The aim of the study is to evaluate the correlation between plantar fascia thickness and pain, functional score, and health perception in patients with this condition. Methods: Thirty-eight feet were studied with ultrasound and magnetic resonance imaging to measure plantar fascia thickness. The visual analogue scale (VAS), American Orthopaedic Foot & Ankle Society Hindfoot Score (AOFAS), and SF-36 were then recorded for each patient. The relationship between the fascia and these scores was analyzed to evaluate the correlation of thickness with pain, functional level, and health perception of patients. Results: In patients with recalcitrant plantar fasciitis, plantar fascia thickness did not correlate with pain (VAS), AOFAS, or any item of the SF-36. Conclusion: The thickness of the plantar fascia in patients with recalcitrant plantar fasciitis did not correlate with its clinical impact, and thus, we believe it should not be used in treatment planning. Level of Evidence: Level IV, case series.

scholarly journals Actualización en el diagnóstico y tratamiento de la Fascitis plantar.

2020 ◽  
pp. 140-146
Author(s):  
ISABEL MIÑANO MARTINEZ
Keyword(s):  
Risk Factors ◽  
Differential Diagnosis ◽  
Plantar Fasciitis ◽  
Scientific Evidence ◽  
Plantar Fascia ◽  
Degenerative Process ◽  
Multiple Risk Factors ◽  
Nerve Entrapments ◽  
Adjacent Structures ◽  
Over Time

Plantar fasciitis is a very common pathology. Over time, some aspects of this entity have generated controversy, so our objective is to group the latest available scientific evidence. Plantar fasciitis has its origin in a degenerative process resulting from repetitive microtrauma. In addition, multiple risk factors are involved that contribute to its overload the fascia and its collagen degeneration. Its diagnosis is clinical, reserving the performance of complementary tests to perform differential diagnosis with other entities, which may originate in the plantar fascia or adjacent structures, paying special attention to nerve entrapments. There are numerous treatments that have proven effectiveness, obtaining better results by individualizing each patient and with a combination of treatments.

scholarly journals Ultrasonography features of the intrinsic foot muscles in patients with and without plantar fasciitis: A novel case-control research study

2021 ◽  
Author(s):  
Lorena Canosa-Carro ◽  
Daniel López-López ◽  
Paula García-Bermejo ◽  
Emmanuel Navarro-Flores ◽  
Carmen de Labra-Pinedo ◽  
...  
Keyword(s):  
Plantar Fasciitis ◽  
Research Study ◽  
Plantar Fascia ◽  
Case Control ◽  
Heel Pain ◽  
Cross Sectional ◽  
Healthy Group ◽  
Control Research ◽  
Intrinsic Foot Muscles ◽  
Healthy Participants

IntroductionPlantar fasciitis (PF) is the most common cause of heel pain.(1) This condition was described as a degenerative syndrome associated with pain, lack of functionality and stiffness on the plantar fascia. The aim of the present study was to compare with ultrasound imaging (USI) the thickness and cross-sectional area of the intrinsic foot muscles between individuals with and without plantar fasciitis (PF).Material and methodsA total of 64 volunteers from 18 to 55 years were recruited for the present study. The sample was divided in two groups: A group, composed of participants diagnosed by PF (n = 32) and B group, composed by healthy participants (n = 32).ResultsUSI measurements for FBH CSA (p = 0.035) was decreasing showing statistically significant differences for the PF group, while the QP CSA (p = 0.40) was increasing reporting statistically significant differences for the PF group with respect the healthy group. The rest of the IFM did not show statistically significant differences, however in FHB, FDB, QP and AHB thicknesses and FDB CSA a slightly decrease for the PF group have been observed.ConclusionsUSI measurements showed that the CSA of the FHB muscle is reduced in patients with PF while the CSA of the QP muscle is increased in patients with PF.

scholarly journals Gender, Clinical Presentation And Risk Factors in Acute Coronary Syndrome under 45 years A Comparison Study

KYAMC Journal ◽  
2017 ◽  
Vol 6 (2) ◽  
pp. 620-622
Author(s):  
Md Moniruzzaman ◽  
Fazila Tun Nesa Malik ◽  
Md Saiful Islam ◽  
Md Annaz Mus Sakib ◽  
Soumen Chakraborty
Keyword(s):  
Risk Factors ◽  
Gender Differences ◽  
Acute Coronary Syndrome ◽  
Clinical Presentation ◽  
Comparison Study ◽  
Common Risk Factor ◽  
Men And Women ◽  
Coronary Syndrome ◽  
Males And Females ◽  
The Mean

Background: Acute coronary syndrome (ACS) is a common cause of disability and death, and when it happens in young individuals, it causes more social and economic disadvantages. Gender differences have been identified in nearly every aspect of cardiovascular disease including acute coronary syndrome. Several studies reported differences between men and women in the clinical presentation & risk factors of acute coronary syndromes.Methods: In this observational analytic study a total 115 patients (75 males and 40 females) under 45 years presenting with acute coronary syndrome were enrolled to see the gender differences in clinical presentation and risk factors.Results: The mean age in males was 36.6±4.8 years and in female 39.0±3.8 years. Chest pain was the main presenting complaints in both sexes but atypical presentation was significantly higher in females. Smoking was the most common risk factor in males and hypertension & diabetes were significantly higher in females. Females mostly diagnosed as Unstable Angina and NSTEMI and males as STEMI.Conclusion: There are significant differences between males and females in respect to clinical presentation and risk factors in acute coronary syndrome under 45 years of age.KYAMC Journal Vol. 6, No.-2, Jan 2016, Page 620-622

Effectiveness of the Simultaneous Stretching of the Achilles Tendon and Plantar Fascia in Individuals With Plantar Fasciitis

2017 ◽  
Vol 39 (1) ◽  
pp. 75-82 ◽  
Author(s):  
Phoomchai Engkananuwat ◽  
Rotsalai Kanlayanaphotporn ◽  
Nithima Purepong
Keyword(s):  
Achilles Tendon ◽  
Plantar Fasciitis ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Plantar Fascia ◽  
Complete Relief ◽  
Level Of Evidence ◽  
Pressure Pain ◽  
Group 2 ◽  
Group 1

Background: Since the plantar fascia and the Achilles tendon are anatomically connected, it is plausible that stretching of both structures simultaneously will result in a better outcome for plantar fasciitis. Methods: Fifty participants aged 40 to 60 years with a history of plantar fasciitis greater than 1 month were recruited. They were prospectively randomized into 2 groups. Group 1 was instructed to stretch the Achilles tendon while group 2 simultaneously stretched the Achilles tendon and plantar fascia. Results: After 4 weeks of both stretching protocols, participants in group 2 demonstrated a significantly greater pressure pain threshold than participants in group 1 ( P = .040) with post hoc analysis. No significant differences between groups were demonstrated in other variables ( P > .05). Concerning within-group comparisons, both interventions resulted in significant reductions in pain at first step in the morning and average pain at the medial plantar calcaneal region over the past 24 hours, while there were increases in the pressure pain threshold, visual analog scale–foot and ankle score, and range of motion in ankle dorsiflexion ( P < .001). More participants in group 2 described their symptoms as being much improved to being completely improved than those in group 1. Conclusion: The simultaneous stretching of the Achilles tendon and plantar fascia for 4 weeks was a more effective intervention for plantar fasciitis. Patients who reported complete relief from symptoms at the end of the 4-week intervention in the simultaneous stretching group (n = 14; 56%) were double that of the stretching of the Achilles tendon–only group (n = 7; 28%). Level of Evidence: II, lesser quality RCT or prospective comparative study.

Ultrasonographic Evaluation of Low Energy Extracorporeal Pulse Activated Therapy (EPAT) for Chronic Plantar Fasciitis

2012 ◽  
Vol 33 (3) ◽  
pp. 202-207 ◽  
Author(s):  
Robert Gordon ◽  
Charles Wong ◽  
Eric J. Crawford
Keyword(s):  
Plantar Fasciitis ◽  
Case Series ◽  
Plantar Fascia ◽  
Ultrasound Measurement ◽  
Level Of Evidence ◽  
Pain Scores ◽  
Ultrasound Evaluation ◽  
Patient Reported ◽  
History Of ◽  
Minimum Followup

Background: Ultrasonographic measurement of the plantar fascia can be used to objectively diagnose plantar fasciitis. The purpose of this study was to determine the long-term effectiveness of Extracorporeal Pulse Activated Therapy (EPAT) for the treatment of plantar fasciitis using ultrasonographic measurement as an objective outcome measure, with a minimum followup of 12 months. Methods: Patients with chronic recalcitrant plantar fasciitis were prospectively recruited and underwent EPAT. Ultrasound measurement of the plantar fascia and patient-rated pain scores were collected before treatment and at followup (minimum of 12 months post-treatment). Twenty-five subjects (35 feet) met the inclusion criteria. The average followup time was 29.4 ± 13.1 (M ± SD; range, 12 to 54) months. Results: The average thickness of the plantar fascia of the symptomatic heels was 7.3 ± 2.0 mm before treatment and 6.0 ± 1.3 mm after treatment ( p < 0.001). The average change in thickness of the treated heels was −1.3 mm (−0.8 to −1.8 mm; 95% CI, p < 0.0001). No correlation was found between length of followup and change in ultrasound measured plantar fascia thickness ( r = −0.04, p = 0.818). Conclusion: For patients with a greater than 12-month history of heel pain, EPAT can effectively decrease plantar fascia thickness as demonstrated objectively by ultrasound evaluation and reduce patient-reported pain. No relationship between length of followup and change in plantar fascia thickness was found after 12 months. Level of Evidence: IV; Case Series

Comparison of Plantar Fasciitis Injected With Platelet-Rich Plasma vs Corticosteroids

2018 ◽  
Vol 39 (7) ◽  
pp. 780-786 ◽  
Author(s):  
Sumit Kumar Jain ◽  
Kumar Suprashant ◽  
Sanjeev Kumar ◽  
Arun Yadav ◽  
Stephen R. Kearns
Keyword(s):  
Plantar Fasciitis ◽  
Platelet Rich Plasma ◽  
Corticosteroid Injection ◽  
Plantar Fascia ◽  
Subjective Rating ◽  
Level Of Evidence ◽  
Outcome Instrument ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Plantar fasciitis is one of the most common causes of heel pain. This prospective study compared the efficacy of local injection of corticosteroids vs platelet-rich plasma (PRP) in the treatment of plantar fasciitis. Methods: Patients were randomly allocated into 2 groups of 40 each (group A and group B). Patients were treated with local corticosteroid injection in group A and autologous PRP injection in group B. Clinical assessment was done prior to the injection and at 1 month, 3 months, and 6 months following the injection, which included visual analog pain scale, subjective rating using the modified Roles and Maudsley score, functional outcome score by the Foot and Ankle Outcome Instrument (FAI) core scale, and the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale. Radiological assessment was done by measuring the thickness of the plantar fascia using ultrasonography. The mean age, sex, and body mass index of both groups were comparable. Results: Postinjection, there was significant improvement of visual analog score, modified Roles and Maudsley score, FAI core scale, AOFAS ankle-hindfoot score, and plantar fascia thickness in both the groups. However, with the numbers available, no significant difference in improvement could be detected between the above-mentioned variables in the 2 groups. Conclusion: We found that the treatment of plantar fasciitis with steroid or PRP injection was equally effective. Level of Evidence: Level II, prospective randomized comparative series.

scholarly journals Evaluation and Treatment of Chronic Plantar Fasciitis

2020 ◽  
Vol 5 (1) ◽  
pp. 247301141989676
Author(s):  
L. Daniel Latt ◽  
David Eric Jaffe ◽  
Yunting Tang ◽  
Mihra S. Taljanovic
Keyword(s):  
Minimally Invasive ◽  
Initial Treatment ◽  
Plantar Fasciitis ◽  
Platelet Rich Plasma ◽  
Plantar Fascia ◽  
Heel Pain ◽  
Invasive Treatment ◽  
Level Of Evidence ◽  
Healing Response ◽  
Atypical Presentations

Plantar fasciitis is the most common cause of chronic heel pain in adults, affecting both young active patients and older sedentary individuals. It results from repetitive stress to the plantar fascia at its origin on the medial tubercle of the calcaneus and is often associated with gastrocnemius tightness. The diagnosis can be made clinically with a focused history and physical examination; imaging is reserved for atypical presentations and those that do not respond to initial treatment. The most common presenting symptom is aching plantar heel pain, which is worst with first step in the morning or after periods of rest. Diagnosis is confirmed with point tenderness at the origin of the plantar fascia on the medial tubercle of the calcaneus. Initial treatment consists of activity modification, anti-inflammatory medication, gastrocnemius and plantar fascia stretching, and an in-shoe orthosis that lifts and cushions the heel. These nonoperative treatments lead to complete resolution of pain in 90% of patients but can take 3-6 months. Patients who remain symptomatic despite a 6-month trial of nonoperative therapy may be considered for minimally invasive treatment or surgery. Platelet-rich plasma injections and therapeutic ultrasound are among a number of minimally invasive treatments that stimulate the body’s healing response. Corticosteroid injections temporarily relieve pain, but may increase the risk of plantar fascia rupture and fat pad atrophy. Botulinum toxin injections relax the calf muscles, which decreases the stress in the plantar fascia. Operative treatments include gastrocnemius recession and medial head of gastrocnemius release, which decrease the stress on the plantar fascia and partial planter fasciotomy, which stimulates a healing response. Level of Evidence: Level V, expert opinion.

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