Engkananuwat, P., Kanlayanaphotporn, R., & Purepong, N. (2018). Effectiveness of the simultaneous stretching of the Achilles tendon and plantar fascia in individuals with plantar fasciitis. Foot & ankle international, 39(1), 75-82.
This journal review for this week looks at a study that is utilising simple techniques that make up part of the Ultimate Plantar Fascia Treatment Plan... Stretching!! We employ stretching as a part of the treatment plan and the use of the night splint is also an effective tool to stretch out the plantar fascia and Achilles tendon.
The plantar fascia and Achilles tendon do work in tandem… if the Achilles and calf muscles are tight, then the plantar fascia is placed under greater stress, and vice versa if the plantar fascia is tight then the Achilles and calf muscles will be under greater stress.
This is why you can start with an Achilles injury and end up with Plantar Fasciitis and vice versa.
This study wanted to compare stretching of the Achilles alone with stretching of both the plantar fascia along with the Achilles tendon simultaneously.
50 adults aged between 40-60 with Plantar Fasciitis present for greater than 1 month were included in this study.
They were split into two groups: 1. Stretching of Achilles alone, 2. Stretching of both the plantar fascia and stretching of the Achilles.
A review was conducted at the 4 week mark- thus making it quite the short study and something that means we can see results in the short term at home.
The authors looked at a number of variables relating to pain and function: first step pain in the morning, average pain over a 24 hour period, pressure pain threshold, visual analogue scale foot and ankle score, and range of motion in ankle dorsiflexion.
Both groups showed improvement in all of the variables though group 2- stretching of both the plantar fascia and Achilles did show better results. They had much higher pressure pain threshold and a significantly greater amount of people who reported full resolution of pain.
Overall 56% of participants in group 2- stretching of both the plantar fascia and Achilles had full resolution of pain, whilst group 1- stretching of Achilles alone reported 28%.
So these results are interesting, looking at the improvement alone 56% looks not so high, but when you think about, if you stretch both the Achilles and plantar fascia alone with no other interventions for 4 weeks you have greater than 50% chance you will be fixed! This is great news!
What happens when we combine this with other interventions, orthotics, strengthening, heat and massage? These things all help improve the rate of healing and will only increase the success!
The plantar fascia stretch band is the perfect tool for stretching both the plantar fascia and Achilles simultaneously. It provides a dorsiflexion bending moment on the big toe joint causing a stretch on the plantar fascia and dorsiflexion of the ankle joint causing a stretch on the Achilles tendon. So using the plantar fascia stretch is found to work better than standing calf muscle stretches that are utilised by many people, so why aren’t more people utilising it?
The plantar fascia night splint will also have this effect on both the plantar fascia and the Achilles allowing a great stretching for a longer period of time and as reported in the previous blog it provides great results.
This is more evidence that The Ultimate Plantar Fasciitis Treatment Plan is evidence based to get your right sooner!
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