scholarly journals Efficacy of Stretching Exercises in the Treatment of Chronic Plantar Fasciitis: A Prospective Study in Manipal Teaching Hospital, Pokhara, Nepal

2011 ◽  
Vol 2 (2) ◽  
pp. 97-101 ◽  
Author(s):  
Manoj Kumar Chakraborty ◽  
Pratendra Raj Onta ◽  
Brijesh Sathian

Objective: Chronic plantar fasciitis developed in ten percent of cases with poor response. Specific plantar stretching exercises alone improves the patient with better outcome. It is self limited process with resolution of symptoms within one year but five percent cases may require surgical intervention in intractable cases. The purpose of this study was to evaluate the long term outcomes of the plantar fascia specific stretching exercise only for chronic plantar fasciitis. Material & Methods: 50 patients with chronic plantar fasciitis for more than three month duration were enrolled in our study for post treatment follow up with effect from Jan 2010 to Jan 2011 in Department of Orthopedics of Manipal College of Medical Sciences. All patients received plantar specific stretching exercise protocol for twelve months interval of one week, three week, two months, six months and twelve months. Results: Out of 50 patients, 36(72%) were female and 14 (28%) were male. 36(72%) were left sided and 14 (28%) were right. Mean age of patients were 46.12±SD7.11 years. The pre treatment mean visual analogue scale score for all patients is significantly higher than every follow up (p=0.0001). Conclusion: This stretching of the plantar fascia is a modification of the traditional stretch weight bearing to tissue specific plantar fascia stretching protocol to optimize tissue tension through a controlled stretch of plantar fascia by recreation of windlass mechanism with high rate of satisfaction in regards to decrease of pain and functional limitations. Key Words: Chronic plantar fasciitis; stretching; windlass mechanism DOI: http://dx.doi.org/10.3126/ajms.v2i2.4218 Asian Journal of Medical Sciences 2 (2011) 97-101

2015 ◽  
Vol 3 (2) ◽  
pp. 84-88
Author(s):  
S Shrestha ◽  
S Rai ◽  
H Limbu ◽  
S Bajracharya

Background: Plantar fasciitis is a self limiting disease, with only 10% of patient developing chronic condition even after ten months. We hypothesized that patient with chronic plantar fasciitis who are treated with standard plantar fascia stretching program can have a better functional outcome than those treated with Achilles tendon-stretching exercise.Method: Forty patients who had chronic plantar fasciitis for duration of at least ten months were randomized into one of two groups. Group A received plantar stretching exercise and Group B had Achilles tendon stretching program. All patients completed the pain subscale of Foot Function Index and a subject relevant outcome survey that incorporated generic and condition-specific outcome measures related to pain, function and satisfaction with treatment outcome.Result: The pain subscale scores of the Foot Function Index showed significantly better results at eight weeks for the patients managed with plantar fascia stretching program respect to item 1 (worst pain; p = 0.004) and item 2 (first steps in the morning; p =0.001). Similarly at ten months follow up, pain subscale score comparison was statistically significant for item 1 (p = 0.018) and item 2 (p =0.003).Conclusions: A treatment method of non-weight-bearing stretching exercises specific to plantar fascia is superior to the conventional method of weight-bearing Achilles tendon-stretching exercises for treating patients with chronic plantar fasciitis.Nepal Journal of Medical Sciences Vol.3(2) 2014: 84-88


Author(s):  
Jasneet S. Chawla ◽  
Manjeet Singh ◽  
Ashwani Ummat ◽  
Manu Goyal ◽  
Harsimarjit Kaur ◽  
...  

2020 ◽  
Vol 34 (8) ◽  
pp. 1072-1082
Author(s):  
Dovile Naruseviciute ◽  
Raimondas Kubilius

Objectives: To evaluate and compare the efficacy of high-intensity laser therapy (HILT) and low-level laser therapy (LLLT) for plantar fasciitis. Design: A participant blind randomized controlled trial with parallel group design and an active comparator with follow-up at four weeks. Settings: Outpatient, University hospital. Subjects: Unilateral plantar fasciitis participants ( n = 102) were randomly assigned into two groups. Recruitment period was from January 2017 to April 2019. Interventions: Interventions included eight sessions of laser therapy over three weeks and single session of patient education. The HILT group ( n = 51) received HILT and the LLLT group ( n = 51) received LLLT. Main measures: Primary outcomes: visual analogue scale; secondary outcomes: pressure algometry, sonography of plantar fascia thickness (time frame: baseline to three-week and four-week follow-up) and numeric rating scale (0%–100%) for opinion of participants on effect of treatment (time frame: three weeks). Data presented: mean (SD) or n (%). Results: There was no statistically significant difference between the groups according to visual analogue scale (pain in general reduction in three weeks: 2.57(3.45) vs. 2.88(3.28) cm), pressure algometry (pain threshold difference between healthy and affected heel reduction in three weeks: 1.80(6.39) vs. 1.77(2.85) kg) and sonography measurements (plantar fascia thickness difference between healthy and affected heel reduction in three weeks: 0.19(0.56) vs. 0.30(0.57) mm). There was a statistically significant difference between the groups in participants’ opinion in favor to HILT group (efficacy of treatment better than 50%: 26(51%) vs. 37(73%)). Conclusion: No statistically significant difference between groups was observed.


2015 ◽  
Vol 16 (1) ◽  
pp. 39-42 ◽  
Author(s):  
Melih Malkoc ◽  
Ozgur Korkmaz ◽  
Adnan Kara ◽  
Ismail Oltulu ◽  
Ferhat Say

ABSTRACTPlantar fasciitis is a disorder caused by inflammation of the insertion point of the plantar fascia over the medial tubercle of the calcaneus. Foot orthotics are used to treat plantar fasciitis. Heel pads medialise the centre of force, whereas medial arch supporting insoles lateralise the force. We assessed the clinical results of the treatment of plantar fasciitis with silicone heel pads and medial arch-supported silicone insoles.We retrospectively reviewed 75 patients with heel pain. A total of 35 patients in the first group were treated with medial arch supporting insoles, and 40 patients in the second group were treated with heel pads. The patients were evaluated with the Visual Analogue Scale (VAS) and the Foot and Ankle Ability Measure (FAAM) at the first and last examinations.The mean VAS score in the first group was 8.6±1,2 (6-10); the FAAM daily activity score was 66.2±16 (41.2-95.0), and the sporting activity score was 45.4±24,4 (0.1-81) before treatment. At the last follow-up in this group, the mean VAS score was 5.3±1,5 (0-9); the FAAM daily activity score was 83,0±15,1 (55,9-100), and the sporting activity score was 73,5±26,2 (25-100). The mean VAS score in the second group was 8,6±0,9 (7-10); the FAAM daily activity score was 66.4±17 (41.4-95.2), and the sporting activity score was 45.8±24,2 (0.8-81, 3) before the treatment. At the last follow-up in this group, the mean VAS score was 5.5±1,2 (0-9); the FAAM daily activity score was 83.4±14,9 (60, 2-100), and the sporting activity score was 73.8±26 (28-100).There was no significant difference in the clinical results of both groups. The force distribution by the use of silicone heel pads and medial arch-supported silicone insoles had no effect on the clinical results of the treatment of plantar fasciitis.


2019 ◽  
Vol 27 (3) ◽  
pp. 230949901987401
Author(s):  
Fasheng Wang ◽  
Tianyi David Luo ◽  
Chunyong Chen ◽  
Yun Xie ◽  
Zhangxiong Lin ◽  
...  

Purpose: The purpose of this study was to assess the outcomes in a series of patients, who underwent cerclage and figure-of-eight tension band wiring using a single titanium cable for comminuted patellar fractures. Methods: We describe a modified tension band technique using a single titanium cable to create an ellipsoidal cap structure that combines the circumferential and figure-of-eight wrapping in the fixation of closed Association for the Study of Internal Fixation/Orthopaedic Trauma Association 34C2 and 34C3 patellar fractures. We retrospectively reviewed 25 patients (16 males and 9 females, mean age 54 years) who underwent the described fixation technique between 2015 and 2017. Postoperative function was evaluated using the Böstman score. Results: At the mean follow-up of 25 months (range 17–39 months), the mean Böstman score was 27.3 ± 2.6 points (range 23–30). Eighteen patients (72%) had excellent results (score ≥28); seven patients (28%) had good results (score 20–27); and no patients had an unsatisfactory result (score < 20). All surgical incisions healed without major wound complications. Two patients reported minor complications (soft tissue irritation, cellulitis). No patients demonstrated loss of reduction or implant failure during the follow-up period. Conclusion: The modified anterior ellipsoidal cap tension band using a single titanium cable created an effective tension band structure in the treatment of comminuted patella fractures. It is a simple operative technique that produced a stable fixation construct, which allowed early functional rehabilitation and weight-bearing with a high rate of excellent outcomes at 2 years after surgery.


2007 ◽  
Vol 28 (7) ◽  
pp. 815-822 ◽  
Author(s):  
Ryan M. Flanigan ◽  
Deborah A. Nawoczenski ◽  
Linlin Chen ◽  
Hulin Wu ◽  
Benedict F. DiGiovanni

Background A recent study found nonweightbearing stretching exercises specific to the plantar fascia to be superior to the standard program of weightbearing Achilles tendon-stretching exercises in patients with chronic plantar fasciitis. The present study used a cadaver model to demonstrate the influence of foot and ankle position on stretching of the plantar fascia. Methods Twelve fresh-frozen lower-leg specimens were tested in 15 different configurations representing various combinations of ankle and metatarsophalangeal (MTP) joint dorsiflexion, midtarsal transverse plane abduction and adduction, and forefoot varus and valgus. Measurements were recorded by a differential variable reluctance transducer (DVRT) implanted into the medial band of the plantar fascia, and primary measurement was a percent deformation of the plantar fascia (stretch) with respect to a reference position (90 degrees ankle dorsiflexion, 0 degrees midtarsal and forefoot orientation, and 0 degrees MTP dorsiflexion). Results Ankle and MTP joint dorsiflexion produced a significant increase (14.91%) in stretch compared to the position of either ankle dorsiflexion alone (9.31% increase, p < 0.001) or MTP dorsiflexion alone (7.33% increase, p < 0.01). There was no significant increase in stretch with positions of abduction or varus (2.49%, p = 0.27 and 0.55%, p = 0.79). Conclusion This study provides a mechanical explanation for enhanced outcomes in recent clinical trials using plantar fascia tissue-specific stretching exercises and lends support to the use of ankle and MTP joint dorsiflexion when employing stretching protocols for nonoperative treatment in patients with chronic proximal plantar fasciitis.


2020 ◽  
Vol 110 (6) ◽  
Author(s):  
Yen-Chun Chiu ◽  
Shih-Chieh Yang ◽  
Yu-Hwan Hsieh ◽  
Yuan-Kun Tu ◽  
Shyh-Ming Kuo ◽  
...  

We present a 57-year-old female patient with iatrogenic lateral plantar nerve injury caused by endoscopic surgery for plantar fasciitis. Nerve grafting surgery was recommended, but the patient refused further surgical intervention because of personal reasons. After 1-year follow-up in outpatient clinics, she achieved only slight improvement in the lateral foot symptoms and still required oral analgesics for pain control. The purpose of this case report is to remind physicians of such a rare and serious complication that can occur after endoscopic surgery for plantar fasciitis. Good knowledge of anatomy and skilled surgical technique could decrease this type of complication.


2007 ◽  
Vol 87 (8) ◽  
pp. 1002-1008 ◽  
Author(s):  
Scott C Wearing ◽  
James E Smeathers ◽  
Patrick M Sullivan ◽  
Bede Yates ◽  
Stephen R Urry ◽  
...  

Background and Purpose: Although plantar fascial thickening is a sonographic criterion for the diagnosis of plantar fasciitis, the effect of local loading and structural factors on fascial morphology are unknown. The purposes of this study were to compare sonographic measures of fascial thickness and radiographic measures of arch shape and regional loading of the foot during gait in individuals with and without unilateral plantar fasciitis and to investigate potential relationships between these loading and structural factors and the morphology of the plantar fascia in individuals with and without heel pain. Subjects: The participants were 10 subjects with unilateral plantar fasciitis and 10 matched asymptomatic controls. Methods: Heel pain on weight bearing was measured by a visual analog scale. Fascial thickness and static arch angle were determined from bilateral sagittal sonograms and weight-bearing lateral foot roentgenograms. Regional plantar loading was estimated from a pressure plate. Results: On average, the plantar fascia of the symptomatic limb was thicker than the plantar fascia of the asymptomatic limb (6.1±1.4 mm versus 4.2±0.5 mm), which, in turn, was thicker than the fascia of the matched control limbs (3.4±0.5 mm and 3.5±0.6 mm). Pain was correlated with fascial thickness, arch angle, and midfoot loading in the symptomatic foot. Fascial thickness, in turn, was positively correlated with arch angle in symptomatic and asymptomatic feet and with peak regional loading of the midfoot in the symptomatic limb. Discussion and Conclusion: The findings indicate that fascial thickness and pain in plantar fasciitis are associated with the regional loading and static shape of the arch.


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