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bibliography * The PainScience Bibliography contains plain language summaries of thousands of scientific papers and others sources, like a specialized blog. This page is about a single scientific paper in the bibliography, Rathleff 2015.

Strengthening helps plantar fasciitis

Rathleff MS, Mølgaard CM, Fredberg U, Kaalund S, Andersen KB, Jensen TT, Aaskov S, Olesen JL. High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up. Scand J Med Sci Sports. 2015 Jun;25(3):e292–300. PubMed #25145882.
Tags: plantar fasciitis, strength, treatment, good news, foot, leg, limbs, pain problems, overuse injury, injury, tendinosis, exercise, self-treatment

PainSci summary of Rathleff 2015?This page is one of thousands in the bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible. ★★★★☆?4-star ratings are for bigger/better studies and reviews published in more prestigious journals, with only quibbles. Ratings are a highly subjective opinion, and subject to revision at any time. If you think this paper has been incorrectly rated, please let me know.

Raise a little heel 🎶 raise a little heel 🎶 raise a little heel! If you don’t like what you got, why don’t you change it? If you know there’s something wrong why don’t you right it?

Trooper, from the classic song, “Raise a Little Heel”

In 48 plantar fasciitis patients, Rathleff et al. compared the effect of stretching to heel raises (AKA repeatedly standing up on your tip-toes). A towel was inserted under the toes for a little extra angle. When patients were able to comfortable manage a dozen slow lifts every other day, they added weight: a backpack full of books. Elegant simplicity! They kept this regimen up for several months … but it didn’t take long to help. Although everybody got better eventually, the heel raisers got better a lot quicker than the stretchers. They were already much better off after three months.

This isn’t proof that heel raises are going to work … but it’s more than good enough to justify trying it. Obviously we’ll hope to see replication by other researchers.

~ Paul Ingraham

original abstractAbstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

The aim of this study was to investigate the effectiveness of shoe inserts and plantar fascia-specific stretching vs shoe inserts and high-load strength training in patients with plantar fasciitis. Forty-eight patients with ultrasonography-verified plantar fasciitis were randomized to shoe inserts and daily plantar-specific stretching (the stretch group) or shoe inserts and high-load progressive strength training (the strength group) performed every second day. High-load strength training consisted of unilateral heel raises with a towel inserted under the toes. Primary outcome was the foot function index (FFI) at 3 months. Additional follow-ups were performed at 1, 6, and 12 months. At the primary endpoint, at 3 months, the strength group had a FFI that was 29 points lower [95% confidence interval (CI): 6-52, P?=?0.016] compared with the stretch group. At 1, 6, and 12 months, there were no differences between groups (P > 0.34). At 12 months, the FFI was 22 points (95% CI: 9-36) in the strength group and 16 points (95% CI: 0-32) in the stretch group. There were no differences in any of the secondary outcomes. A simple progressive exercise protocol, performed every second day, resulted in superior self-reported outcome after 3 months compared with plantar-specific stretching. High-load strength training may aid in a quicker reduction in pain and improvements in function.

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