Plantar fasciitis

Abstract

Ann R Coll Surg Engl 2013; 95: 228-229We read with interest the review on plantar fasciitis (PF) by Cutts et al. While this was an excellent account of the pathology and management of the condition, it was disappointing that management using a gastrocnemius release was totally excluded, especially as the authors had recognised reduced ankle dorsiflexion and tightness of the Achilles tendon as risk factors for PF. In fact, a number of modern series reported in the literature have used this technique in preference to local surgery on the plantar fascia.Riddle et al found that individuals with ≤0º of dorsiflexion are 23 times more likely to get PF compared with the group of individuals who had >10º of ankle dorsiflexion. 1 Cheung et al showed a relationship between the PF and equinus. 2 Achilles tendon loading has twice the amount of straining effect on the plantar fascia than body weight. They conclud-ed that lengthening of the Achilles tendon may benefit PF. Patel and DiGiovanni found that 83% of 254 patients with PF had limited dorsiflexion and 57% of 254 had an isolated gastrocnemius contracture. 3 Maskill et al performed gastrocnemius recession on 25 patients with PF who had failed 6 months of conservative therapy. 4 The average visual analogue scale score improved from 8.1 to 1.9 at 19.5 months.We reported on proximal gastrocnemius lengthening on 21 heels with chronic PF. 5 At follow-up, 81% had reported total or significant pain relief following the surgery. Local surgery on the plantar fascia has a poorer outcome and longer recovery with problems associated with lateral column dysfunction and arch collapse. We believe that a gastrocnemius release is a simple way of treating a patient with PF who has failed to respond to conservative management and that it should be considered before plantar fascia release when surgical intervention is contemplated. References 1. Riddle DL, Pulisic M, Pidcoe P, Johnson RE. Risk factors for plantar fasciitis: a matched case-control study.

Study the efficacy of platelet rich plasma and local corticosteroid injection for treatment of chronic plantar fasciitis

“…8 Treatment consists of various methods such as rest, nonsteroidal antiinflammatory drugs, night splints, foot orthosis, stretching protocols and extra corporeal shock wave therapy. 9 Though corticosteroid (CS) injections are considered a popular method of treatment, but provide short term relief and have a high frequency of relapse and recurrences. 1 Platelet-rich plasma (PRP) is an ideal autologous biological blood-derived product, a concentrate of platelets prepared by ultracentrifugation of the whole blood sample from the patient.…”

The Correlation between Hamstring Tightness and Plantar Fasciitis

“…The Correlation between Hamstring Tightness & Plantar Fasciitis modalities, acupuncture and taping [3] , extracorporeal shock wave therapy can be used if failed non surgical treatment for 6 months [14] , medication; corticosteroid injection [15] and oral NSAIDs [16] and surgical intervention; partial plantar fasciotomy is rarely indicated [3] .…”