NEW STUDY PUBLISHED in The Scandinavian Journal of Medicine & Science in Sports
Continuing on with some more information on plantar fasciitis, this next post was sent to me by a reader yesterday who was wondering if I had come across this recent study published in the Scandinavian Journal of Medicine & Science in Sports. The study claims that by performing 8-12 repetitions calf raises as described below an improvement is seen in heel pain caused by plantar fasciitis over those who did stretching exercises for the calf muscle. I have been prescribing this to my patients now for over 3 years along with a gradual increase in time spent barefoot to increase foot strength and thereby reduce the symptoms of plantar fasciitis. Remember, this is a condition that is in every way similar to a tendonitis that is seen in the arm or shoulder which is treated with strengthening exercises. It should be treated no differently in the foot. After many years of seeing this condition progress into what could be dubbed as an epidemic, studies are now demonstrating that strengthening is needed over shoe gear modifications or support with orthotic devices placed into one’s shoes.
Plantar fasciitis, the heel pain caused by irritation of the connective tissue on the bottom of the foot, can be lingering and intractable. A recent study of novice runners found that those who developed plantar fasciitis generally required at least five months to recover, and some remained sidelined for a year or more.
Until recently, first-line treatments involved stretching and anti-inflammatory painkillers such as ibuprofen or cortisone. But many scientists now believe that anti-inflammatories are unwarranted, because the condition involves little inflammation. Stretching is still commonly recommended.
The exercise requires standing barefoot on the affected leg on a stair or box, with a rolled-up towel resting beneath the toes of the sore foot and the heel extending over the edge of the stair or box. The unaffected leg should hang free, bent slightly at the knee.
Then slowly raise and lower the affected heel to a count of three seconds up, two seconds at the top and three seconds down. In the study, once participants could complete 12 repetitions fairly easily, volunteers donned a backpack stuffed with books to add weight. The volunteers performed eight to 12 repetitions of the exercise every other day.
They study (a total of 48 volunteers) compared these volunteers to others who completed a standard plantar fasciitis stretching regimen, in which they pulled their toes toward their shins 10 times, three times a day.
After three months, those in the exercise group reported vast improvements. Their pain and disability had declined significantly.Those who did standard stretches, on the other hand, showed little improvement after three months, although, with a further nine months of stretching, most reported pain relief.
Conclusion: A simple progressive exercise protocol, performed every second day, resulted in superior self-reported outcome after 3 months compared with plantar-specific stretching. High-load strength training may aid in a quicker reduction in pain and improvements in function.
I think we will continue to see more evidence published similar to this which demonstrates orthotics and shoes are not the answer to treating plantar fasciitis.