Title: Plantar fascia-specific stretching exercise improves outcomes in patients with chronic plantar fasciitis. A prospective clinical trial with two-year follow-up.
Authors: Digiovanni BF, Nawoczenski DA, Malay DP, Graci PA, Williams TT, Wilding GE, Baumhauer JF
Source: J Bone Joint Surg Am. 2006 Aug;88(8):1775-81
PODIATRIC RELEVANCE:
Plantar fasciitis is one of the most common conditions dealt with by podiatric physicians and it is important that the treatment given to patients is in accordance with the latest research.
METHODS:
This article represents the data from phase two of a two-part study. In part one, 101 patients with proximal plantar fasciitis for at least 10 months duration were randomly selected to be instructed in either an Achilles tendon stretching protocol or a plantar fascia stretching protocol. After 8 weeks, the plantar fascia group showed more remarkable improvements than the Achilles group. These results were published previously. After 8 weeks, all patients were instructed in the plantar fascia stretch protocol and then followed-up with 2 years later. They were questioned regarding 1) pain at its worst and 2) pain with first step in the morning.
RESULTS:
Complete data were obtained for 66 patients. Both groups of patients showed continued decrease in both pain categories 2 years later. Total satisfaction or satisfaction with minor reservations was achieved in 92% of patients. Although there was a significant difference in the pain scores at 8 weeks, there was no significant difference in the improvement of pain after 2 years between the two groups.
COMMENTS:
Given the number of patients treated for plantar fasciitis by podiatrists, the concept of plantar-fascia specific stretching is an important concept to consider while instructing patients. Also of importance, the instructions given to patients were perhaps more specific and the regimen more intensive than what is often explained to patients: Hold the stretch for a count of 10, repeated 10 times. Perform these 10 stretches 3 times daily, with the first stretch before the first step in the morning, for a minimum of 8 weeks.
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Disclaimer:
Scientific Abstract Monthly postings are submitted by podiatric surgical residents. The ideas presented are not the opinions of the American College of Foot and Ankle Surgeons (ACFAS), nor are they presented as facts. ACFAS presents this information without any warranty of any kind, expressed or implied, and is not liable for its accuracy nor for any loss or damage caused by the user's reliance on information obtained in these areas.