Title: Plantar Fascia – Specific Stretching Exercise Improves Outcomes in Patients with Chronic Plantar Fasciitis. A Prospective Clinical Trial with Two–Year Follow Up.
Authors: Jodi Siegel, MD and Paul Tornetta, III, MD
Source: The Journal of Bone and Joint Surgery (American). 2007; 89:276-281.
PODIATRIC RELEVANCE:
Plantar fasciitis is one of the most common foot ailments seen in podiatric offices. Benefits of posterior muscle group stretching and/or plantar fascia stretching as part of a treatment regimen have been shown. An initial 8 week study (phase one) comparing the effectiveness of these two stretching protocols showed superior results regarding pain, function, and overall satisfaction in the group performing a plantar fascia-specific stretch. The specific plantar fascia stretch used was a non-weight bearing stretch. The current study looked at the long term benefits of plantar fascial stretching over two years.
METHODS:
In a previous investigation, eighty-two patients with chronic proximal plantar fasciitis for a duration of more than ten months completed a randomized, prospective clinical trial. The patients were divided into two groups with one using a plantar fascia-specific stretching protocol (Group A) and the second managed with an Achilles tendon-stretching protocol (Group B). At the conclusion of phase one, both groups were then asked to continue with the plantar fascia-specific protocol for at least 8 more weeks. At the two-year follow-up evaluation, a questionnaire consisting of the pain subscale of the Foot Function Index and an outcome survey related to pain, function, and satisfaction with treatment was mailed to the eighty-two subjects who had completed the initial clinical trial.
RESULTS:
At the two-year follow-up evaluation, complete data sets were obtained from sixty-six patients (thirty-nine from Group A and twenty-seven from Group B). Following implementation of the plantar fascia-stretching program in all patients at eight weeks, significant improvement in the pain score was noted (p < 0.0001). The trend of improvement continued and at the two-year follow-up, both groups had similar amounts of overall pain reduction compared with the initial baseline pain. In contrast to the results at the eight-week follow-up, at two years there was no significant difference between the two groups.
COMMENTS:
The outcome for patients with acute plantar fasciitis is favorable. There are excellent protocols for conservative treatment and patients usually do well. However, patients having chronic plantar fasciitis (10 months or more) have much less favorable long term results using traditional treatment protocols which include posterior muscle group stretching. This study emphasized the use of a non-weight bearing plantar fascia-specific stretch for 16 weeks showing excellent long term benefits over a 2 year period.
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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.