Stretching has always been a part of the treatment regimen for plantar fasciitis, but not all stretches are equal. Research in the past few years has shown that specifically stretching the plantar fascia is more effective than general calf stretching in the short term and has also shown overall pain reduction in the long term.
Initial Study: The first of two studies published in the Journal of Bone & Joint Surgery, 101 patients with chronic plantar fasciitis were evaluated. The patients were divided into two groups. Both groups watched an educational video, were given prefabricated arch supports and instructed to take celecoxib for 3 weeks. The first group was given a plantar fascia specific stretching protocol to follow and the second group was given an Achilles tendon stretching protocol to follow. At 8 weeks the patients were reevaluated. Eighty-two patients had completed the recommended therapy regimen. The patients who completed the plantar fascia specific stretching program showed statistically significant improvement in pain and activity limitations compared with the patients who completed the Achilles tendon stretching program. The patients who completed the plantar fascia specific stretching program had overall greater improvement and patient satisfaction.
Follow-up Study: Three years after the publication of this study, the same group of researches published a follow-up study. This study evaluated the long term outcomes of the plantar fascia tissue specific stretching protocol. All patients who completed the original study were instructed in the plantar fascia specific stretching protocol. At 2 years, pain, function and satisfaction with treatment were evaluated by a mail-in questionnaire. Of the initial 82 patients, 66 responded to the questionnaire. The study found that 94% reported a decrease in their pain, 92% had total satisfaction or partial satisfaction regarding their treatment and 77% reported no limitation in their recreational activities. Twenty-four percent needed to seek additional treatment by a clinician.
Plantar Fascia Stretch: Rest your ankle on your opposite knee. Grab your heel with the opposite hand and use your other hand to pull back at the toes until you feel a stretch within the arch. Confirm the stretch by using your thumb to palpate the fascial band. Hold this stretch for 10 seconds and repeat it 10 times. Perform this stretching protocol three times a day. More of plantar fascia stretching.
DiGiovanni BF, Nawoczenski DA, Lintal ME, Moore EA, Murray JC, Wilding GE, Baumhauer JF. Tissue-specific plantar fascia-stretching exercise enhances outcomes in patients with chronic heel pain. A prospective, randomized study. J Bone Joint Surg Am. 2003 Jul;85-A(7):1270-7.
Digiovanni BF, Nawoczenski DA, Malay DP, Graci PA, Williams TT, Wilding GE, Baumhauer JF. Plantar fascia-specific stretching exercise improves outcomes in patients with chronic plantar fasciitis. A prospective clinical trial with two-year follow-up. J Bone Joint Surg Am. 2006 Aug;88(8):1775-81.
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