Proximal Medial Gastrocnemius Recession and Stretching Versus Stretching as Treatment of Chronic Plantar Heel Pain

Molund, Marius; Husebye, Elisabeth Ellingsen; Hellesnes, Jan; Nilsen, Fredrik; Hvaal, Kjetil

doi:10.1177/1071100718794659

Cited by 41 publications

(49 citation statements)

References 37 publications

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“…Previous studies have shown that the PF has complicated pathogenic mechanism and the etiology is also complex and multifactorial 33, 34 . Pain status was a robust predictor of treatment outcome in PF patients according to our previous and other relevant studies 21, 35–37 . In our study, patients with higher VAS had a poorer prognosis than we thought.…”

Section: Discussionsupporting

confidence: 69%

Development and Validation of a Novel Scoring System for Severity of Plantar Fasciitis

Yin

Yao

Tong

et al. 2020

Orthopaedic Surgery

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Objectives: Plantar fasciitis (PF) is the most common cause of heel pain. Though PF is self-limited, it can develop into chronic pain and thus treatment is needed. Early and accurate prognostic assessment of patients with PF is critically important for selecting the optimal treatment pathway. Nevertheless, there is no scoring system to determine the severity of PF and no prognostic model in choosing between conservative or surgical treatment. The study aimed to develop a novel scoring system to evaluate the severity of plantar fasciitis and predict the prognosis of conservative treatment. Methods: Data of consecutive patients treated from 2014 to 2018 were retrospectively collected. One hundred and eighty patients were eligible for the study. The demographics and clinical characteristics served as independent variables. The least follow-up time was 6 months. A minimal reduction of 60% in the visual analog scale (VAS) score from baseline was considered as minimal clinically important difference (MCID). Those factors significantly associated with achieving MCID in univariate analyses were further analyzed by multivariate logistic regression. A novel scoring system was developed using the best available literature and expert-opinion consensus. Inter-observer reliability and intraobserver reproducibility were evaluated. The appropriate cutoff points for the novel score system were obtained using receiver operating characteristic (ROC) curves. Results: The system score = VAS (0-3 point = 1; 3.1-7 point = 3; 7.1-10 point = 5) + duration of symptoms (<6 months = 1; ≥1 6 months = 2) + ability to walk without pain (>1 h = 1; ≤1 h = 4) + heel spur in X-ray (No = 0; Yes = 2) + high intensity zone (HIZ) in MRI (No = 0; Yes = 2). The total score was divided in four categories of severity: mild (2-4 points), moderate (5-8 points), severe (9-12 points), and critical (13-15 points). Inter-observer agreement with a value of 0.84 was considered as perfect reliability. Intra-observer reproducibility with a value of 0.92 was considered as perfect reproducibility. The optimum cutoff value was 10 points. The sensitivity of predictive factors was 86.

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Section: Discussionsupporting

confidence: 69%

Development and Validation of a Novel Scoring System for Severity of Plantar Fasciitis

Yin

Yao

Tong

et al. 2020

Orthopaedic Surgery

View full text Add to dashboard Cite

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“…The majority of studies support the contention that chronic stretching reduces pain in the neck (27)(28)(29)(30)(31)(32), shoulder (33), chest (81), lower back (34,41,42), knee (35), ankle (36)(37)(38)(39), and overall musculoskeletal system (40). While the vast majority of chronic stretching studies demonstrate pain relief, several studies have not reported a beneficial effect on pain (82)(83)(84)(85)(86).…”

Section: Effects Of Chronic Stretching On Painmentioning

confidence: 85%

“…Only one study has demonstrated positive outcomes of stretching on patellofemoral pain, in which the patients underwent three weeks of bilateral quadriceps SS exercises (holding for 30 s for 5 sets daily), revealing an improvement in reported post-intervention pain (35). Results on the effects on plantar fasciitis are mixed with some reporting positive effects even after as little as seven days of stretching (37), but others reporting no pain reduction after 12 weeks of plantar fascia, triceps surae, and hamstrings stretching (86). The studies generally focused on stretching the lower leg muscles as well as the Achilles tendon, primarily using SS techniques (36)(37)(38)(39)86).…”

Section: Effects Of Chronic Stretching On Painmentioning

confidence: 99%

Effects of Acute and Chronic Stretching on Pain Control

Behm

Kay

Trajano

et al. 2021

Journal of Clinical Exercise Physiology

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While muscle stretching has been commonly used to alleviate pain, reports of its effectiveness are conflicting. The objective of this review is to investigate the acute and chronic effects of stretching on pain, including delayed onset muscle soreness. The few studies implementing acute stretching protocols have reported small to large magnitude decreases in quadriceps and anterior knee pain as well as reductions in headache pain. Chronic stretching programs have demonstrated more consistent reductions in pain from a wide variety of joints and muscles, which has been ascribed to an increased sensory (pain) tolerance. Other mechanisms underlying acute and chronic pain reduction have been proposed to be related to gate control theory, diffuse noxious inhibitory control, myofascial meridians, and reflex-induced increases in parasympathetic nervous activity. By contrast, the acute effects of stretching on delayed onset muscle soreness are conflicting. Reports of stretch-induced reductions in delayed onset muscle soreness may be attributed to increased pain tolerance or alterations in the muscle's parallel elastic component or extracellular matrix properties providing protection against tissue damage. Further research evaluating the effect of various stretching protocols on different pain modalities is needed to clarify conflicts within the literature.

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“…Some studies, when using the VAS, define pain as the worst over the past 24 hours whereas others define it as pain an individual is currently experiencing. 15,19 Both these methods can lead to confusion for patients as pain can fluctuate throughout the day, and for chronic issues, can lead to more challenges summarizing all the fluctuations into one single number. Postoperative patients may have a more acute recollection of how their pain felt before surgery and how it compares to each postoperative visit.…”

Section: Discussionmentioning

confidence: 99%

Visual Analog Pain Scores Reported to a Nurse and a Physician in a Postoperative Setting

McBride

Wilke

Chisholm

et al. 2020

Foot & Ankle Orthopaedics

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Background: The purpose of this study was to compare postoperative foot and ankle patient-reported visual analog pain scores (VAS) to nursing staff and the treating surgeon during a single encounter. Prior literature established preoperative patients reported higher pain scores to a surgeon as compared to nursing staff. We hypothesized that there will be no differences in postoperative patients’ pain scores when reporting to nursing staff vs a surgeon. Methods: This study was a retrospective cohort of 201 consecutive postoperative foot and ankle patients with 3 follow-up encounters treated by a single surgeon. The patients were asked to rate their pain intensity using the VAS with 0 “no pain” and 10 “worst pain” at 2, 6, and 12 weeks postoperatively by a nurse and surgeon. Results: At all time intervals, the mean pain score was significantly higher when reported to the surgeon, although these were not clinically relevant. The mean scores at 2 weeks were 2.8 reported to the surgeon and 2.5 reported to the nurse ( P < .001). The mean scores at 6 weeks were 2.0 reported to the surgeon and 1.8 reported to the nurse ( P = .002). The mean scores at 12 weeks were 2.3 reported to the surgeon and 2.0 reported to the nurse ( P = .005). Conclusion: This study found that postoperative foot and ankle patients did not overemphasize their VAS pain scores to the physician vs nursing staff. These findings contrast with our 2 previous studies that found preoperative and nonoperative patients reported clinically significant higher scores to the surgeon. Level of Evidence: Level III, comparative study.

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Proximal Medial Gastrocnemius Recession and Stretching Versus Stretching as Treatment of Chronic Plantar Heel Pain

Abstract: Level 1, randomized clinical trial.

Cited by 41 publications

References 37 publications

Development and Validation of a Novel Scoring System for Severity of Plantar Fasciitis

Development and Validation of a Novel Scoring System for Severity of Plantar Fasciitis

Effects of Acute and Chronic Stretching on Pain Control

Visual Analog Pain Scores Reported to a Nurse and a Physician in a Postoperative Setting

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