The Influence of Heel Height on Strain Variation of Plantar Fascia During High Heel Shoes Walking-Combined Musculoskeletal Modeling and Finite Element Analysis

The therapeutic benefit of high heel shoes (HHS) for plantar fasciitis treatment is controversial. It has been suggested that plantar fascia strain can be decreased by heel elevation of shoes which helps in body weight redistribution throughout the length of the foot. Yet it is a fact that the repetitive tension caused by HHS wearing resulting in plantar fasciitis is a high-risk disease in HHS individuals who suffer heel and plantar pain. To explore the biomechanical function on plantar fascia under HHS conditions, in this study, musculoskeletal modeling (MsM) and finite element method (FEM) were used to investigate the effect of heel height on strain distribution of plantar fascia. Three-dimensional (3D) and one-dimensional (1D) finite element models of plantar fascia were generated to analyze the computed strain variation in 3-, 5-, and 7-cm heel heights. For validation, the computed foot contact pressure was compared with experimental measurement, and the strain value on 1D fascia was compared with previous studies. Results showed that the peak strain of plantar fascia was progressively increased on both 3D and 1D plantar fascia as heel elevated from 3 to 7 cm, and the maximum strain of plantar fascia occurs near the heel pain site at second peak stance. The 3D fascia model predicted a higher strain magnitude than that of 1D and provided a more reliable strain distribution on the plantar fascia. It is concluded that HHS with narrow heel support could pose a high risk on plantar fasciitis development, rather than reducing symptoms. Therefore, the heel elevation as a treatment recommendation for plantar fasciitis is questionable. Further studies of different heel support structures of shoes to quantify the effectiveness of heel elevation on the load-bearing mechanism of plantar fascia are recommended.

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Effectiveness of Low Level Laser Therapy Versus Ultrasound Therapy with Plantar Fascia Streching in Subjects with Plantar Fasciitis

Indian Journal of Public Health Research & Development ◽

10.37506/v11/i1/2020/ijphrd/193792 ◽

2020 ◽

Vol 11 (1) ◽

pp. 92

Author(s):

K. Koteeswaran ◽

K. Ramya ◽

Anon Rajeshwari ◽

Manikumar Muthiah ◽

Sankara Kumaran Pandian

Keyword(s):

Laser Therapy ◽

Plantar Fasciitis ◽

Plantar Fascia ◽

Low Level Laser Therapy ◽

Ultrasound Therapy ◽

Low Level ◽

Low Level Laser ◽

Level Laser

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Effectiveness of Calf Stretching Exercises Versus Plantar Fascia Stretching Exercises in Plantar Fasciitis: An Experimental Study

Indian Journal of Public Health Research & Development ◽

10.37506/v11/i2/2020/ijphrd/194927 ◽

2020 ◽

Vol 11 (2) ◽

pp. 890

Author(s):

Jasneet S. Chawla ◽

Manjeet Singh ◽

Ashwani Ummat ◽

Manu Goyal ◽

Harsimarjit Kaur ◽

...

Keyword(s):

Experimental Study ◽

Plantar Fasciitis ◽

Plantar Fascia ◽

Stretching Exercises

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Ultrasound-Guided Injection of Dextrose Versus Corticosteroid in Chronic Plantar Fasciitis Management: A Randomized, Double-Blind Clinical Trial

Foot & Ankle Specialist ◽

10.1177/1938640020980924 ◽

2021 ◽

pp. 193864002098092

Author(s):

Gholamreza Raissi ◽

Amin Arbabi ◽

Maryam Rafiei ◽

Bijan Forogh ◽

Arash Babaei-Ghazani ◽

...

Keyword(s):

Clinical Trial ◽

Plantar Fasciitis ◽

Rating Scale ◽

Corticosteroid Injection ◽

Treatment Options ◽

Plantar Fascia ◽

Numeric Rating Scale ◽

Therapeutic Effects ◽

Ultrasound Guided ◽

Double Blind

Design Chronic plantar fasciitis (PF) is a common cause of chronic heel pain, with different conventional treatment options. In this randomized clinical trial, the effect of ultrasound-guided injection of dextrose versus corticosteroid in chronic PF was evaluated and compared. Methods A total of 44 patients suffering from chronic PF who visited the physical medicine and rehabilitation clinic were enrolled in the study. Two table-randomized groups were formed. They received an ultrasonography-guided, single injection of either 40 mg methylprednisolone or 20% dextrose. Numeric Rating Scale (NRS), Foot and Ankle Ability Measure questionnaire with 2 subscales, Activities of Daily Living (FAAM-A) and Sports (FAAM-S), along with ultrasonographic parameters were evaluated before and at 2 and 12 weeks after the injection. Results. A total of 40 participants completed the study. Both interventions significantly improved pain and function at 2 and 12 weeks postinjection. After 2 weeks, compared with the dextrose prolotherapy, the corticosteroid group had significantly lower daytime and morning NRS scores (2.55 vs 4.1, P = .012, and 2.75 vs 4.65, P = .004), higher FAAM-S (66.84 vs 54.19; P = .047), and lower plantar fascia thickness at insertion and 1 cm distal to the insertion zone (3.89 vs 4.29 mm, P = .004, and 3.13 vs 3.48 mm, P = .002), whereas FAAM-A was similar in both groups ( P = .219). After 12 weeks, all study variables were statistically similar between corticosteroid and dextrose prolotherapy groups. No injection-related side effects were recorded in either group. Conclusion Both methods are effective. Compared with dextrose prolotherapy, our results show that corticosteroid injection may have superior therapeutic effects early after injection, accompanied by a similar outcome at 12 weeks postinjection. Levels of Evidence: Level II

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Study on Stress and Strain of Anchorage Using Finite Element Method

Applied Mechanics and Materials ◽

10.4028/www.scientific.net/amm.325-326.1314 ◽

2013 ◽

Vol 325-326 ◽

pp. 1314-1317

Author(s):

Cong Sheng Chen ◽

Ping He ◽

Cheng Yong Wang ◽

Xue Hui Chen ◽

Lei Huang ◽

...

Keyword(s):

Finite Element ◽

Strain Distribution ◽

Maximum Stress ◽

Mechanical Response ◽

Three Dimensional ◽

Integrated Modeling ◽

Stress And Strain ◽

Steel Strand ◽

Prestressed State ◽

Stress And Strain Distribution

Three-dimensional integrated modeling method and the numerical simulation of elastoplastic finite element are adopted in the paper. The mechanical response of the five holes anchorage is analyzed in certain prestressed state. The stress and strain distribution information of the anchor ring, clip and steel strand is obtained respectively, and the structure safety is discussed by investigating on the maximum stress and strain.

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Does femoral strain distribution coincide with the occurrence of cervical versus trochanteric hip fractures? An experimental finite element study

Medical & Biological Engineering & Computing ◽

10.1007/s11517-010-0622-1 ◽

2010 ◽

Vol 48 (7) ◽

pp. 711-717 ◽

Cited By ~ 15

Author(s):

Janne E. M. Koivumäki ◽

Jérôme Thevenot ◽

Pasi Pulkkinen ◽

Jukka A. Salmi ◽

Volker Kuhn ◽

...

Keyword(s):

Finite Element ◽

Hip Fractures ◽

Strain Distribution ◽

Finite Element Study ◽

Element Study

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

Foot & Ankle International ◽

10.1177/1071100718811631 ◽

2018 ◽

Vol 40 (4) ◽

pp. 439-446 ◽

Cited By ~ 1

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.

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Consequences of Partial and Total Plantar Fascia Release: A Finite Element Study

Foot & Ankle International ◽

10.1177/107110070602700210 ◽

2006 ◽

Vol 27 (2) ◽

pp. 125-132 ◽

Cited By ~ 66

Author(s):

Jason Tak-Man Cheung ◽

Kai-Nan An ◽

Ming Zhang

Keyword(s):

Finite Element ◽

Plantar Fascia ◽

Finite Element Study ◽

Plantar Fascia Release ◽

Element Study

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Is 2D SWE sufficient as clinical diagnosis in patients with plantar fasciitis?

Acta Radiologica ◽

10.1177/02841851211058928 ◽

2021 ◽

pp. 028418512110589

Author(s):

Engin Beydoğan ◽

Atilla Yalçın

Keyword(s):

Plantar Fasciitis ◽

Shear Wave Elastography ◽

Plantar Fascia ◽

Thickness Measurement ◽

Clinical Findings ◽

Imaging Method ◽

Control Groups ◽

Measurement Results ◽

Healthy Control ◽

Foot Function

Background The use of shear wave elastography (SWE) seems to be an important imaging method in the diagnosis of plantar fasciitis (PF). Purpose To compare patients diagnosed with PF with similar and young healthy control groups in terms of B-mode ultrasound (US) and SWE results and to evaluate the elasticity of the plantar fascia. Material and Methods A total of 140 feet of 70 participants were evaluated, including 30 patients and 40 healthy individuals as the control. Clinical, B-mode US, and SWE evaluations were performed for each patient. In addition, American Orthopedic Foot and Ankle Score (AOFAS) was calculated to evaluate pain and foot function in both groups. Results Of the patients in the PF group, 40 (88%) were women and the healthy control groups had similar sex distributions ( P = 0.23). The AOFAS score was lower in feet with PF compared to the other groups ( P < 0.001). Of 30 patients with PF, 15 (50%) had bilateral PF and 15 (50%) unilateral PF. In addition, ≥4 mm thickness measurement, which was used as a diagnostic criterion for PF as a US finding, could be shown in 11 (73.3%) patients with unilateral PF and 6 (40%) patients with bilateral PF. Conclusion In conclusion, the evaluation of the diagnosis of PF with clinical findings and regular follow-up of measurements with SWE can provide measurement results with higher sensitivity in the diagnosis of PF.

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The Effect of Dry Needling on Pain, Range of Motion of Ankle Joint, and Ultrasonographic Changes of Plantar Fascia in Patients With Plantar Fasciitis

Journal of Sport Rehabilitation ◽

10.1123/jsr.2021-0156 ◽

2021 ◽

pp. 1-6

Author(s):

Afsaneh Moosaei Saein ◽

Ziaeddin Safavi-Farokhi ◽

Atefeh Aminianfar ◽

Marzieh Mortezanejad

Keyword(s):

Range Of Motion ◽

Ankle Joint ◽

Visual Analog Scale ◽

Plantar Fasciitis ◽

Plantar Flexion ◽

Plantar Fascia ◽

Trigger Points ◽

Dry Needling ◽

Analog Scale ◽

Significant Difference

Context: Plantar fasciitis (PF) is a common and devastating disease. Despite different treatments, there is no clear evidence for the effect of these treatments on PF. One of the therapy methods used in physiotherapy is dry needling (DN). So the purpose of this study is to investigate the effect of DN on the pain and range of motion of the ankle joint and plantar fascia thickness in subjects with PF who are suffering from the trigger points of the gastrocnemius and soleus muscles. Methods: In this study, 20 volunteer females with PF were randomly assigned into DN treatment and control groups. Measurements were range of motion in dorsiflexion and plantar flexion, plantar fascia thickness, and visual analog scale measured before, immediately, and 1 month after the end of the intervention in both groups. Results: There were significant differences in the plantar fascia thickness and visual analog scale between the 2 groups. Plantar fascia thickness (P = .016) and visual analog scale (P = .03) significantly decreased in the treatment group. However, there was no significant difference in plantar flexion (P = .582) and dorsiflexion range of motion (P = .173) between groups. Conclusion: The result of this study showed that DN can reduce pain and plantar fascia thickness in women with PF who are suffering from trigger points of the gastrocnemius and soleus muscles. Level of evidence: Level 1, randomized controlled trial.

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