Heel Pain Research Articles

Outcome of Corticosteroid Injection in Reducing the Intensity of Pain in Patients with Plantar Fasciitis

Introduction: Plantar fasciitis is one of the most common causes of heel pain, accounting for about one million patient visits per year in the United States. Objectives: The main objective of the study is to find the outcome of corticosteroid injection in reducing the intensity of pain in patients with plantar fasciitis. Material and methods: This descriptive study was conducted in CMH Kharian during March 2022 to September 2022. Data was collected with the permission of ethical committee of hospital. All the data related to physical examination, BMI, age, history of diseases and socioeconomic status were collected. The injections were applied to all patients who included unilateral foot symptoms and didn't respond to conservative treatment for at least six months. Results: Data was collected from 100 patients. Most of the cases were males 63 (63.3%) and rest 36 (36.7%) were females. Age with mean standard deviation was 38.15±10.26 years and had body mass index 23.11±13.51 kg/m2. Practical implication: This study will help us to treat the plantar fasciitis treated with single injection of corticosteroid injection resulted in significant pain reduction. Conclusion: It is concluded that plantar fasciitis treated with single injection of corticosteroid injection resulted in significant pain reduction in our patients. We recommend steroid injection in patients who are refractory to 6 weeks anti-inflammatory drugs and physiotherapy treatment. Keywords: Pain, Reduction, Injection, Corticosteroid, Significant, Treated

The Impact of Petrissage on Functional Measures of High-Heeled Shoe Wearers

Background Many women enjoy wearing high heels despite knowing they can be harmful to the feet. There are many uncomfortable conditions that can originate from wearing this type of shoe leading to biomechanical changes in ankle joints. Hence the study is aimed to identify the effects of massage therapy in improving muscular flexibility among women wearing high heels Methodology Forty female participants with chronic heel pain were included in the single-blinded randomized controlled trial. Participants were divided into Group-A (Stretching and deep heat) and Group-B (petrissage and deep heat) group. The treatment was performed for four weeks, 3 sessions/ week in both groups. Foot function index and ankle dorsiflexion were recorded at baseline and after 4 weeks of intervention. Results Forty female participants with a mean age of 28.23±6.24 were recruited in the study. Both groups showed significant improvement in all three variables i.e. pain, disability, and ankle dorsiflexion. However, group B showed more significant results with mean differences of 1.80±2.22 and 4.1±6.7 (p-value <0.05) for pain and disability respectively. A similar result was observed for ankle dorsiflexion in which a mean difference of 0.95±1.08 in the left ankle and 1.25±1.12 in the right ankle was observed. Conclusion Both treatment programs are highly effective in reducing pain, reducing disability, and improving the ankle joint ROM, but petrissage massage along with deep heating was found to be superior as compared to superficial heat with static stretching for females with chronic heel pain. Keywords Ankle joint, Disability, Massage, Pain, Range of motion

A Review of Pediatric Heel Pain.

The objective of this review article is to provide orthopaedic surgeons and general practitioners a reference and guidance for the evaluation and workup of heel pain in pediatric patients. The authors performed a comprehensive literature search to review the etiologies and management of heel pain in patients <18 years of age. Relevant studies in Medline/PubMed and EMBASE were searched from inception to March 3, 2022 using medical subject headings and text words without limitations on language or study type. The initial search utilized the following Boolean operators: (children) AND (heel pain); (pediatric) AND (heel pain). Heel pain in the pediatric population is usually a benign condition. Sever's apophysitis is the most common etiology of heel pain in pediatric patients.Most causes of heel pain in the pediatric population do not require imaging or extensive workup. However, providers must maintain a high index of suspicion for symptoms that could indicate a more severe pathology.

Is There a Relationship Between Perceived Activity Performance-Satisfaction Level and Quality of Life in Activities of Daily Living in Adults with Plantar Fasciitis?

Aim: Plantar fasciitis (PF) is a disease that negatively affects quality of life (QOL) and activities of daily living and is the most common cause of heel pain. The aim of this study is to examine the relationship between QOL, perceived activity performance and satisfaction in adults with PF and to determine the activities that have problems in daily living.&#x0D; Materials and Methods: A total of 96 participants, 26 male and 70 female, aged between 18-65 years, with a mean age of 53.88±6.41 years diagnosed with PF completed the study. The Nottingham Health Profile was used to determine the QOL, the Canadian Occupational Performance Measure was used to determine the perceived activity performance and satisfaction level.&#x0D; Results: The findings show the perceived activity performance and satisfaction levels of individuals with PF are negatively related to pain and energy levels, which are sub-dimensions of QOL (p=0.001; p=0.017; p=0.001; p=0.018). Moreover, it has been determined individuals have problems in many activities, such as walking, working, going up and down stairs, housecleaning and sleeping.&#x0D; Conclusion: This study showed the QOL of individuals with PF decreases as activity performance and satisfaction level decrease. Pain is one of the most important factors affecting activity performance, and recurrent and increasing pain with activity may have limited activity participation in individuals with PF. Therefore, pain should be considered as a priority in the evaluation and intervention plans of individuals with PF. Also, activity-based intervention plans should be developed for activities where these individuals have problems in daily living.

Efficacies of extracorporeal shockwave therapy and low-level laser therapy in patients with plantar fasciitis

BackgroundVarious conservative treatment methods can be administered in the early stages of plantar fasciitis (PF). The aim of the treatment is to enable the patient to return to the physical activity as soon as possible. AimIn this study it was aimed to compare efficacies of Extracorporeal Shockwave Therapy (ESWT) and Low-Level Laser Therapy (LLLT) on patients with PF. DesignA local prospective cross-sectional study SettingDepartment of Physical Medicine and Rehabilitation Outpatient Clinic of Sakarya University, Faculty of Medicine PopulationPatients aged 18–70 years, having ongoing heel pain for at least 3 months, and not using oral and/or parenteral corticosteroids in the last 6 months. MethodsA total of 40 patients with PF included in the current study. Visual Analog Scale (VAS), Roles and Maudsley Score (RMS), American Orthopedic Foot and Ankle Association Score (AOFAS) and Foot Function Index (FFI) questionnaire were performed for all patients. ESWT and LLLT groups comprised of 22 (55%) and 18 (45%) patients, respectively. ResultsWe found significant improvements in scores based on the VAS, RMS, AOFAS, FFI in patients with PF and it was sustained for 3 months (p = 0.001, for all scores). While decrease in scores based on the VAS and FFI in LLLT group was statistically more significant compared to ESWT group (p = 0.014, p = 0.013), there was statistically less significant decrease in scores on the AOFAS in LLLT group than that of ESWT group (p = 0.032). ConclusionsThe results of this study indicated significant improvements in terms of pain, functional status and daily life activities following the administration of either of the treatments. Furthermore, LLLT was found to be significantly more effective for alleviating pain than ESWT in the treatment of PF.

An Outlook of Plantar Fasciitis with Correlation in Ayurveda as Vatakantaka

Pain is an unfavourable sensation that brings an individual to the physician due to a halt from his routine works. Heel pain is commonly found in society which experiences severe pain, tenderness and restricted movements fortunately in some of these pain subsides within short period, but unfortunately as many as these pains reoccur and may get converted in diseases like VATAKANTAKA (PLANTAR FASCIITIS). Vatakantaka can be properly compared to plantar fasciitis based on its pathophysiology and clinical presentation, and it responds quite well to ayurvedic treatment. Ayurveda defines “Vatakantaka” as being brought on by vitiated Vata at Gulfa Sandhi Pradesh, as stated by Acharya Charaka, Sushruta, and Vagbhata .Chronic plantar fascia irritation and fibrous tissue deterioration without new fibrous tissue development are the pathology of plantar fasciitis. Vatakantaka can be properly compared to plantar fasciitis based on its pathophysiology and clinical presentation, and it responds quite well to ayurvedic treatment.

Case Series to Evaluate the Efficacy of Selected Treatment Modality in the Management of Vātakantaka (Planter Fasciitis)

Heel pain is the most prevalent condition these days, and it affects 1 in 10 people at some point in their lives. Various disorders can cause heel discomfort, but one with a high prevalence rate is plantar fasciitis. Vātakantaka and Plantar Fasciitis may be connected in Ayurveda. Walking on an uneven surface and suffering repeated injuries cause Vāta Prakōpa (vitiation of humor), which develops a stinging pain similar to a thorn in the heel area and ultimately results in Vātakantaka. Adults’ heel pain is frequently brought on by plantar fasciitis. Pain that is particularly intense with the first few steps made in the morning is how the disorder typically shows. Plantar fasciitis typically resolves on its own. However, when there is less time between the onset of symptoms and the start of treatment, symptoms typically go away faster. The purpose of this study is to determine the efficacy of selected treatment modalities in the management of Vātakantaka. Four case presentations with a follow-up of one month were studied. Treatment modality, including Ēranda Saptaka Kwātha, Yōgarāja Guggulu, Dhāthri Chūrna, Navarathna Kalka, Sarshapa Thaila, Ketakēla Pattu, and Agni Karma, was advised for four weeks. Pre- and post-treatment assessments of subjective and objective criteria were made. According to the results, most of the symptoms were healed 100%, while some were reduced up to 66.66% and 33.33%. It may be concluded that the selected treatment modality is a secure and reliable treatment for Vātakantaka.

Diagnostic Accuracy of Ultrasonography in Patients with Plantar Fasciitis: A Cross-sectional Study

Introduction: Plantar Fasciitis (PFS) is the most well-known cause for plantar heel pain seen predominantly in middle aged women. Imaging findings of Magnetic Resonance Imaging (MRI) is considered to be the gold standard in the diagnosis of PFS, but MRI is expensive. Hence; there is a need to study the accuracy of Ultrasonography (USG), as USG is inexpensive, free of radiation and readily available. Aim: To evaluate the diagnostic accuracy, sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of ultrasound in comparison with MRI for the diagnosis of PFS, in patients with heel pain. Materials and Methods: The present cross-sectional study was conducted in the Department of Radiodiagnosis, SRM Medical College and Research Centre, Kattankulathur, Tamil Nadu, India, from December 2019 to July 2021. USG and MRI of foot were performed in 40 patients with heel pain. MRI protocol included three plane Proton Density Fat Saturated (PDFS), T1 sagittal, T2 axial and Short inversion Time Inversion Recovery (STIR) sagittal sequences. USG scans were done in prone position with the patient’s feet dorsiflexed. The Plantar Fascia (PF) thickness was measured in both USG and MRI and association of the ultrasound and MRI measurements of PF thickness was done using Chi-square test. Results: Mean age of the cohort was 36.83±10.08 years. Out of this subject population, majority were females 29 (72.5%). Nineteen (47.5%) females were overweight i.e., BMI from 25- 29.9 kg/m2 . The accuracy, sensitivity, specificity, PPV and NPV of plantar fascia thickness of USG as compared to MRI was found to be 80%, 60%, 82.9%, 33.3% and 93.5%, respectively. Conclusion: Despite MRI being the imaging modality of choice in diagnosing PFS, accuracy of ultrasound was comparable to that of MRI and it can be used as the initial investigation and follow-up.

A Rare Case of Chondromyxoid Fibroma of Calcaneum: A Case Report

Chondromyxoid fibroma is a rare benign Primary tumour occurring in the calcaneum. We report a case of a 23-year-old woman with 3 months history of sudden onset right heel pain with no history of trauma. Which was exacerbated by movement such as walking and standing. A radiographic examination of the right foot and ankle revealed a lesion in the posterior part of the calcaneum. The calcaneum was further evaluated using an MRI scan which revealed a lytic lesion with clearly defined borders. The lesion was treated with curettage, iliac bone grafting, and cementing. Three months after surgery, the graft was consolidated with bone cement in place. There was no sign of recurrence at the one-year follow-up, and the patient had adequate ankle range of motion. Even though the tumour is rare, there is a need for physicians to recognize its radiological features and offer appropriate treatment options. Keywords: Chondromyxoid fibroma, Lytic lesion, Benign primary tumour

Arthralgia and Soft Tissue Swelling Post Covid-19

A middle aged 50-year man contracted severe Covid 19 pneumonia. Post discharge he complained of multiple joint pains and heel pain on walking. The pain was waking him up at night and regular paracetamol wasn’t effective. Full thorough workup was done to exclude any possible causes and ultrasound was performed. It was concluded that he had post covid arthralgia and soft tissue swelling. He was prescribed paracetamol and amitryptiline with escalating dose and was referred to rehabilitation and exercise which showed significant improvement and he made a good recovery. The aim of this article is to explore the possible reasons behind these symptoms and the management in primary care setting. Key words: arthralgia, soft tissue swelling, Covid-19

The struggle to stay physically active—A qualitative study exploring experiences of individuals with persistent plantar fasciopathy

BackgroundPlantar fasciopathy is the most common cause of heel pain, and is associated with decreased physical activity level and quality of life. There has been limited research on the experiences of patients with plantar fasciopathy. This study seeks to gain more in-depth understanding and knowledge by exploring the lived experiences of people with persistent plantar fasciopathy.MethodsWe included 15 participants with longstanding plantar fasciopathy. Face-to-face, semi-structured interviews were audio recorded, transcribed verbatim and analysed using Braun and Clark’s reflexive thematic analysis. We used an inductive approach led by a phenomenological theoretical framework.ResultsWe identified three core themes and ten sub-themes. The first theme was ‘Struggling to stay active’ with sub-themes ‘Struggling with pain and how to adjust it’, ‘ Finding alternative activities’ and ‘Longing for the experience of walking’. The second main theme was ‘Emotional challenges’ with the sub-themes ‘Feelings of frustration and self-blame’ and ‘Worries of weight gain and related consequences’. The third main theme was ‘Relations to others’ with the sub-themes ‘Participation in family and social life’, ‘ Visible in new ways’, ‘ Striving to avoid sick leave’ and ‘Bothering others’.ConclusionsParticipants revealed how their heel pain led to inactivity and emotional and social challenges. Pain when walking and fear of aggravating it dominated the participants’ lives. They emphasised the importance of finding alternative ways to stay active and avoiding sick leave. Treatment should focus on holistic and individually tailored approaches.

Predicting the outcome of plantar heel pain in adults: a systematic review of prognostic factors

BackgroundPlantar Heel Pain (PHP) is a common disorder with many treatment pathways and is not self-limiting, hence prognostic information concerning recovery or recalcitrance is needed to guide practice. In this systematic review, we investigate which prognostic factors are associated with favourable or unfavourable PHP outcomes.MethodsMEDLINE, Web of Science, EMBASE, Scopus and PubMed electronic bibliographic databases were searched for studies evaluating baseline patient characteristics associated with outcomes in prospective longitudinal cohorts or after specific interventions. Cohort, clinical prediction rule derivation and single arms of randomised controlled trials were included. Risk of bias was evaluated with method-specific tools and evidence certainty with GRADE.ResultsThe review included five studies which evaluated 98 variables in 811 participants. Prognostic factors could be categorised as demographics, pain, physical and activity-related. Three factors including sex and bilateral symptoms (HR: 0.49[0.30–0.80], 0.33[0.15–0.72], respectively) were associated with a poor outcome in a single cohort study. The remaining four studies reported twenty factors associated with a favourable outcome following shockwave therapy, anti-pronation taping and orthoses. Heel spur (AUC = 0.88[0.82–0.93]), ankle plantar-flexor strength (Likelihood ratio (LR): 2.17[1.20–3.95]) and response to taping (LR = 2.17[1.19–3.90]) were the strongest factors predicting medium-term improvement. Overall, the study quality was low. A gap map analysis revealed an absence of research that included psychosocial factors.ConclusionsA limited number of biomedical factors predict favourable or unfavourable PHP outcomes. High quality, adequately powered, prospective studies are required to better understand PHP recovery and should evaluate the prognostic value of a wide range of variables, including psychosocial factors.

Haglund's Syndrome

Background: Haglund's syndrome an important cause of posterior heel pain presents with a prominent bony contour, a retrocalcaneal bursitis or achillis tendinitis these can also occur in isolation hence for the diagnosis of etiology of Haglund's disease certain radiological parameters and soft tissue parameters have been created to evaluate the anatomical variations which will assist in its exact diagnosis. Study aims to distinguish between the bony and soft tissue causes of Haglund's disease radiologically. Methodology: After Institutional ethical committee clearance an observational cross-sectional study was conducted with subjects coming to radiology OPD for X-ray foot with complains of posterior heel pain fulfilling inclusion and exclusion criteria were examined for X-ray lateral view of foot. Parameters like calcaneal inclination angle (CIA), Fowler Philip angle (FPA), parallel pitch line (PPL), Steffenson &amp; Evenson angle (SEA) measured, posterior/calcaneal spur and posterior calcaneal step were noted. The data obtained was analyzed for mean, Standard deviation, sensitivity % and false negative %. Result: Sensitivity of the parameters were analyzed to find CIA, SEA &amp;PPL to be 63.3%, 55% and 55% sensitive respectively. CIA could be assigned most sensitive but regarding soft tissue parameters none were sensitive. Conclusion: CIA, SEA &amp; PPL were found to be sensitive among bony parameters. But none of the soft tissue parameters were sensitive radiologically highlighting a need for its correlation with clinical symptom in peripheral health centers where MRI is not available. Sensitivity of bony and soft tissue parameters were analyzed to find CIA, SEA &amp; PPL to be sensitive. CIA could be assigned most sensitive among bony parameter but with regards to soft tissue parameters none were sensitive.

Effectiveness of extracorporeal shock wave therapy according to plantar calcaneal spur types

Objective: The aim of this study is to group patients with plantar heel pain and calcaneal spurs detected via lateral foot x-rays based on the angle between the spur and the calcaneus and compare the efficacy of an Extracorporeal shock wave therapy (ESWT) treatment between these groups. Materials and Methods: The patients were divided into three groups based on the measurement the angle between the plantar calcaneal spur and the calcaneus. Those with a measured angle of &lt;30° were classified as Group 1, ranging between 30–60° as Group 2, and &gt;60° as Group 3. Demographic characteristics, spur length, visual analog scale (VAS) and foot function index score (FFI), and pain and function evaluation were used as the pre-and posttreatment data in each group. Results: Out of the 170 patients, 96 (56.5%) were included in Group 1, 65 (38.2%) were in Group 2, and 9 (5.3%) in Group 3. The posttreatment VAS and FFI scores of the patients were significantly lower than the pretreatment scores (p &lt; 0,001). It was determined that the highest and lowest VAS and FFI score changes in the posttreatment period was in Group 3 and Group 1, respectively. In the correlation analysis, a positive correlation was found between the measured angle value and pretreatment VAS and FFI scores, age, and spur length. Conclusion: ESWT is an effective treatment method for calcaneal spurs, but further studies are needed on PCS classifications and the efficacy of the treatment selected based on these classifications.

Development of a foot and ankle strengthening program for the treatment of plantar heel pain: a Delphi consensus study

BackgroundPeople with plantar heel pain (PHP) have reduced foot and ankle muscle function, strength and size, which is frequently treated by muscle strengthening exercises. However, there has been little investigation of what exercises are used and there is no sound evidence base to guide practice. This study aimed to develop a consensus-driven progressive muscle strengthening program for PHP.MethodsThirty-eight experts were invited to participate in the study over three rounds. Round 1 was an open-ended questionnaire that provided the core characteristics of progressive strengthening programs designed for three different adult patient types with PHP (younger athletic, overweight middle-aged, older), which were presented as vignettes. In Round 2, experts indicated their agreement to the proposed exercises and training variables. In Round 3, experts were presented with amendments to the exercises based on responses from Round 2 and indicated their agreement to those changes. Consensus was achieved when > 70% of experts agreed.ResultsTwo experts were ineligible and 12 declined, leaving 24 (67%) who participated in Round 1. Eighteen (75%) completed all three rounds. From Round 1, progressive strengthening programs were developed for the three vignettes, which included 10 different exercises and three training variables (sets / repetitions, weight, and frequency). In Round 2, 68% (n = 17) of exercises and 96% (n = 72) of training variables reached consensus. In Round 3, only exercise changes were presented and 100% of exercises reached consensus.ConclusionsThis study provides three progressive strengthening programs agreed to by experts that can be used in future clinical trials to determine the effectiveness of muscle strengthening for PHP. In addition, clinicians could use the programs as part of a rehabilitation strategy with the caveat that they may change as more research is conducted.

Walking pain-free: A prospective study on the efficacy of surgical resection with Achilles tendon reinforcement for painful Haglund lesions

Abstract Background Haglund’s deformity is a common cause of posterior heel pain, often requiring surgical management when conservative treatment fails. Traditionally, surgery focused solely on resection of the bony prominence, yielding suboptimal outcomes. Aim This study assessed the efficacy of surgical resection of painful Haglund lesions combined with Achilles tendon reinforcement for managing insertional Achilles tendinitis. Methods Twenty patients with insertional Achilles tendinitis underwent surgical resection of Haglund lesions and Achilles tendon reinforcement with suture anchors. Functional outcomes were evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot score preoperatively and at 6 and 12 months postoperatively. Complications were recorded. Results The mean AOFAS score significantly improved from 43.5 ± 7.2 preoperatively to 79.0 ± 9.1 at 6 months and 84.5 ± 9.8 at 12 months postoperatively (P&lt;0.001). Early weight-bearing was achieved in 2 weeks. The complication rate was 25% (all minor). There were no re-ruptures or revisions during the one-year follow-up. Conclusion Surgical resection combined with Achilles tendon reinforcement is an effective treatment for Haglund’s deformity, allowing early weight-bearing while significantly improving function. It is associated with a low complication rate and no major adverse events. This technique addresses both bony and soft tissue pathologies, optimizing outcomes.

Effect of Agnikarma therapy on heel pain associated with Calcaneal Spur: A case study

Effect of Agnikarma therapy on heel pain associated with Calcaneal Spur: A case study

Ultrasound Imaging in a Woman with Lateral Heel Pain.

Ultrasound Imaging in a Woman with Lateral Heel Pain.

Comparison between Ultrasound-guided Pulsed Radiofrequency Ablation of the Medial Calcaneal Nerve and Extracorporeal Shockwave Therapy in Managing Recalcitrant Plantar Fasciitis: A Randomised Controlled Trial

Introduction: Plantar Fasciitis (PF) is one of the most common causes of heel pain, with a prevalence ranging from 3.6-7% in the general population. Approximately 90% of patients with PF respond well to conservative therapy, including rest, stretching, analgesics, physical therapy, shoe modifications, or steroid injections. However, around 10% of patients have recalcitrant cases that require invasive or surgical interventions. Pulsed Radiofrequency Ablation (PRFA) is a non neurodestructive method that provides non surgical pain relief in such cases. Aim: To compare the effectiveness of ultrasound-guided PRFA of the Medial Calcaneal Nerve (MCN) and Extracorporeal Shockwave Therapy (ESWT) in managing recalcitrant PF. Materials and Methods: This randomised controlled trial was conducted at the Department of Physical Medicine and Rehabilitation, Regional Institute of Medical Sciences, Imphal, Manipur, India over a two-year period from September 2018 to August 2020. A total of 78 patients with PF were included in the study, divided equally into two groups: a study group and a control group, each consisting of 39 participants. The study group received PRFA of the MCN, while the control group received ESWT of the plantar fascia. The Visual Analog Scale (VAS), Plantar Fascia Thickness (PFT), and American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score were measured at 1, 4, 12, and 24 weeks as outcome variables. Data analysis was performed using Statistical Package for the Social Sciences (SPSS) version 21.0, and statistical tests like Chi-square test, t-test, and repeated measures Analysis of Variance (ANOVA) were used. A p-value of &lt;0.05 was considered significant. Results: Of the 78 patients included in the study, 42 (53.8%) were females and 36 (46.2%) were males, with a mean age of 41.08±10.09 years. The VAS score in the study group improved from 5.51±0.82 at baseline to 1.92±0.80 at 24 weeks, while in the control group, the VAS score improved from 5.36±0.97 at baseline to 2.33±0.66 at 24 weeks. PFT in the study group improved from 4.45±0.374 at baseline to 2.26±0.231 at 24 weeks, while in the control group, PFT improved from 4.42±0.366 at baseline to 2.49±0.357 at 24 weeks. The AOFAS score also improved from 50.49±13.13 at baseline to 74.03±11.53 in the study group, and in the control group, the AOFAS score improved from 49.74±12.26 at baseline to 71.36±10.72 at 24 weeks (p-value &lt;0.05). Conclusion: Significant improvements were observed in all outcome measures in both the study and control groups, with a p-value &lt;0.05. However, the improvements were more pronounced in the study group, with minimal to no sideeffects. Hence, ultrasound-guided PRFA of the MCN can be considered an effective minimally invasive treatment modality for recalcitrant PF.

Ultrasound measurement of plantar fascia thickness: Is the current criterion for normality applicable to everyone?

AbstractBackgroundPlantar fasciitis is a common cause of heel pain. Understandably knowledge of normal sonographic plantar fascia thickness (PFT) is crucial to diagnose this condition as thickened plantar fascia is the most important ultrasound finding for its diagnosis.ObjectiveThe objectives of this study are to compare the PFT among heavy weight bearing and non‐weight bearing individuals sonographically and to assess the effect of age, gender and body mass index (BMI) on PFT.MethodologyPFT of 154 patients, 77 in each category of heavy weight bearing and non‐weight bearing groups, was assessed sonographically. Independent sample T test was used to compare it between two groups. Analysis of covariance was used to test the effect of heavy weight bearing and gender on PFT bilaterally, in both groups with adjustment for age, BMI and standing hours. Correlation of age with PFT was also calculated using Pearson's correlation analysis. p value ≤0.05 was considered significant.ResultsMean PFT in all patients was 3.8 and 3.2 mm on left and right respectively. There was no significant difference in the right and left foot on paired sample t test. Those bearing heavy weight had significantly thickened PF than the other group bilaterally. ANCOVA showed that bearing heavy weight and BMI had significant effects on PFT. Age was found to be correlated with PFT in non‐weight bearing group.ConclusionsFactors causing increased stress on the plantar fascia such as increased BMI and heavy weight lifting can cause thickening as part of physiological adaptation.