Plantar fasciitis (PF) involves the degeneration of the medial calcaneal tuberosity and nearby perifascial tissues in the heel. It is the leading cause of heel pain, typically resulting from repetitive strain on the plantar fascia, causing structural damage. Key risk factors for PF include an increased body mass index in active individuals and a greater range of plantar flexion motion. Treatment options for PF vary, and there is no clear consensus on the most effective approach. Conservative treatments may include rest, stretching exercises for the plantar fascia and Achilles tendon, strengthening exercises for foot intrinsic muscles, nonsteroidal anti-inflammatory drugs (NSAIDs), orthotics, heel pads, dorsiflexion night splints, and corticosteroid injections. These treatments may be used individually or in combination. Corticosteroid injections are the most frequently used invasive treatment. However, there has been limited research examining the effects of corticosteroid injections combined with exercises targeting intrinsic foot muscle strength on functionality and walking distance. The objective of this study was to evaluate the impact of an exercise program added to corticosteroid injections on pain relief and functional performance in individuals with PF.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
40
Our exercise program in our study; (i) foot intrinsic muscle strengthening exercise (with a load of 3 kg), (ii) plantar fascia stretching with finger extension, (iii) standing gastrocnemius muscle stretching, (iv) sitting achilles tendon stretching, (v) plantar fascia and gastrocnemius stretch on the step, (vi) cold massage exercise in the arch of the foot. We stated that the group to which exercise was added should do the exercises regularly for 6 weeks, in the specified number and time.
The orthopedic physician administered the corticosteroid injection as a mixture of 1 ml of arthropane (5 mg of triamcinolone hexacetonide) and 4 ml of citanest. Before the application, the physician cleaned the area to be treated with 10% povidone iodine. He made a single dose injection by entering the painful point determined by palpation around the calcaneal spur and plantar fascia from the percutaneous foot-heel lateral. The patients were in the prone position with the ankle in a neutral position. After the application, he covered the area with a sterile cloth and said to remove it after 3 hours. He stated that patients could apply ice to the injected area if necessary for pain control, and advised patients to avoid all jogging and other high-impact activities on the day of injection. No additional treatments, including NSAIDs, orthoses, and night splints, were allowed during the study period.
Kütahya Health Sciences University
Kütahya, Turkey (Türkiye)
Muscle Shortness Tests
Plantar and Dorsi Flexion Flexibility, Gastrocnemius Shortness, Hamstring Shortness, Hip Flexor Shortness, Tensor Fascia Lata Shortness shortness tests were performed.
Time frame: a day before the rehabilitation
Muscle Shortness Tests
Plantar and Dorsi Flexion Flexibility, Gastrocnemius Shortness, Hamstring Shortness, Hip Flexor Shortness, Tensor Fascia Lata Shortness shortness tests were performed.
Time frame: up to 3 weeks
Muscle Shortness Tests
Plantar and Dorsi Flexion Flexibility, Gastrocnemius Shortness, Hamstring Shortness, Hip Flexor Shortness, Tensor Fascia Lata Shortness shortness tests were performed.
Time frame: up to 6 weeks
American Orthopedic Foot and Ankle Society Hindfoot Clinical Evaluation System (AOFAS- hindfoot)
The AOFAS hindfoot clinical assessment system evaluates the ankle, subtalar, talonavicular, and calcaneocuboid joints. The scoring system allocates 50 points for function, 40 points for pain, and 10 points for alignment. A higher score indicates a better condition for the patient.
Time frame: a day before the rehabilitation
American Orthopedic Foot and Ankle Society Hindfoot Clinical Evaluation System (AOFAS- hindfoot)
The AOFAS hindfoot clinical assessment system evaluates the ankle, subtalar, talonavicular, and calcaneocuboid joints. The scoring system allocates 50 points for function, 40 points for pain, and 10 points for alignment. A higher score indicates a better condition for the patient.
Time frame: up to 3 weeks
American Orthopedic Foot and Ankle Society Hindfoot Clinical Evaluation System (AOFAS- hindfoot)
The AOFAS hindfoot clinical assessment system evaluates the ankle, subtalar, talonavicular, and calcaneocuboid joints. The scoring system allocates 50 points for function, 40 points for pain, and 10 points for alignment. A higher score indicates a better condition for the patient.
Time frame: up to 6 weeks
American Orthopedic Foot and Ankle Society Midfoot Clinical Evaluation System (AOFAS- midfoot)
This scale allocates 45 points for function, 40 points for pain, and 15 points for alignment. Higher scores indicate that the patient's condition is favorable.
Time frame: a day before the rehabilitation
American Orthopedic Foot and Ankle Society Midfoot Clinical Evaluation System (AOFAS- midfoot)
This scale allocates 45 points for function, 40 points for pain, and 15 points for alignment. Higher scores indicate that the patient's condition is favorable.
Time frame: up to 3 weeks
American Orthopedic Foot and Ankle Society Midfoot Clinical Evaluation System (AOFAS- midfoot)
This scale allocates 45 points for function, 40 points for pain, and 15 points for alignment. Higher scores indicate that the patient's condition is favorable.
Time frame: up to 6 weeks
Foot Function Index
It is a 23-item questionnaire designed to assess how foot pathology affects pain, disability, and activity limitations. The FFI score was calculated based on 5 questions related to pain (with a maximum of 50 points). Each question was scored on a scale from 0 to 10, where 0 represents no pain and 10 indicates unbearable pain. In our study, we utilized the Turkish version of the FFI questionnaire.
Time frame: a day before the rehabilitation
Foot Function Index
It is a 23-item questionnaire designed to assess how foot pathology affects pain, disability, and activity limitations. The FFI score was calculated based on 5 questions related to pain (with a maximum of 50 points). Each question was scored on a scale from 0 to 10, where 0 represents no pain and 10 indicates unbearable pain. In our study, we utilized the Turkish version of the FFI questionnaire.
Time frame: up to 3 weeks
Foot Function Index
It is a 23-item questionnaire designed to assess how foot pathology affects pain, disability, and activity limitations. The FFI score was calculated based on 5 questions related to pain (with a maximum of 50 points). Each question was scored on a scale from 0 to 10, where 0 represents no pain and 10 indicates unbearable pain. In our study, we utilized the Turkish version of the FFI questionnaire.
Time frame: up to 6 weeks
6-minute walk test
The 6MWT is a simple, safe, and well-tolerated test that effectively reflects daily life activities. In our study, the 6MWT was conducted in a 30-meter long, flat, enclosed corridor. We measured the patient's heart rate, respiratory rate, and blood pressure before the test, immediately after completion, and again 5 minutes later. Fatigue levels were evaluated using the Borg Scale, and the distance walked by the patient was recorded in meters.
Time frame: a day before the rehabilitation
6-minute walk test
The 6MWT is a simple, safe, and well-tolerated test that effectively reflects daily life activities. In our study, the 6MWT was conducted in a 30-meter long, flat, enclosed corridor. We measured the patient's heart rate, respiratory rate, and blood pressure before the test, immediately after completion, and again 5 minutes later. Fatigue levels were evaluated using the Borg Scale, and the distance walked by the patient was recorded in meters.
Time frame: up to 3 weeks
6-minute walk test
The 6MWT is a simple, safe, and well-tolerated test that effectively reflects daily life activities. In our study, the 6MWT was conducted in a 30-meter long, flat, enclosed corridor. We measured the patient's heart rate, respiratory rate, and blood pressure before the test, immediately after completion, and again 5 minutes later. Fatigue levels were evaluated using the Borg Scale, and the distance walked by the patient was recorded in meters.
Time frame: up to 6 weeks
50 meters walking test
The test evaluates walking ability, and patients were instructed to walk at their own comfortable pace for a distance of 50 meters. The stopwatch was started with the command to begin at the starting point. Upon reaching the 50-meter mark, we stopped the stopwatch and recorded the time.
Time frame: a day before the rehabilitation
50 meters walking test
The test evaluates walking ability, and patients were instructed to walk at their own comfortable pace for a distance of 50 meters. The stopwatch was started with the command to begin at the starting point. Upon reaching the 50-meter mark, we stopped the stopwatch and recorded the time.
Time frame: up to 3 weeks
50 meters walking test
The test evaluates walking ability, and patients were instructed to walk at their own comfortable pace for a distance of 50 meters. The stopwatch was started with the command to begin at the starting point. Upon reaching the 50-meter mark, we stopped the stopwatch and recorded the time.
Time frame: up to 6 weeks
Visual Analogue Scale
Patients were asked to indicate their current pain level on a visual analog scale, which consisted of a 10 cm line. The distance was then measured using a ruler and recorded. A lower score indicates decreased pain.
Time frame: a day before the rehabilitation
Visual Analogue Scale
Patients were asked to indicate their current pain level on a visual analog scale, which consisted of a 10 cm line. The distance was then measured using a ruler and recorded. A lower score indicates decreased pain.
Time frame: up to 3 weeks
Visual Analogue Scale
Patients were asked to indicate their current pain level on a visual analog scale, which consisted of a 10 cm line. The distance was then measured using a ruler and recorded. A lower score indicates decreased pain.
Time frame: up to 6 weeks
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