Health
Giving Heel Pain the Boot
Ouch. The sharp heel pain of plantar fasciitis is all too familiar to court-stomping superstar dunkers and pavement-pounding regular Joes alike.
Now a study by a team of foot experts provides new evidence that a simple exercise can help give that pain the boot -- potentially bringing relief to the more than 2 million Americans hobbled annually by the injury.
Plantar fasciitis is caused by a small tearing, or micro-tearing, of the plantar fascia -- a ropelike band of fibrous tissue that runs from the heel to the toes and supports the arch.
Unlike many overuse injuries caused by excessive strain, plantar fasciitis often follows relatively mild activity, such as standing, walking or jogging on a hard surface. The injury is vexing because it can take from six to nine months to recover completely. For about 10 percent of unlucky sufferers, it takes longer.
The study, led by Dr. Benedict DiGiovanni, an orthopedic surgeon and associate professor of orthopedic surgery at the University of Rochester in New York, tested a new exercise designed to stretch the plantar fascia. DiGiovanni theorized that it might be more effective than the Achilles' tendon stretch -- a common exercise for the injury.
The stretch involves curling the toes backward while flexing the ankle. In an earlier investigation published in 2003, he compared the exercise to the Achilles' tendon stretch in an eight-week clinical trial of 82 patients who had suffered from plantar fasciitis for more than 10 months.
Patients were taught protocols for either the Achilles' stretch or the plantar fascia stretch. After two months, the plantar fascia stretch group reported significantly less pain and more improvement in their condition than the Achilles' tendon group, based on their responses to questions about pain and satisfaction with treatment.
DiGiovanni's new study, published in a recent issue of the Journal of Bone & Joint Surgery, examined the progress, two years on, of 66 patients from the first study. All had been instructed in the proper way to perform the plantar fascia stretching exercise at the termination of the initial study.
Based on their responses, patients in the original Achilles' tendon group who had been taught the plantar fascia stretch showed marked improvement, essentially catching up with the plantar fascia group. In all, 92 percent of patients in both groups reported total or near-total satisfaction with the treatment, and 94 percent reported a decrease in pain.
