BRINGING SCIENCE TO TREATMENT
Surveys report complaints of heel pain in 13.4% of respondents over 50-years-old(1). Amongst runners, the incidence of heel pain is even higher – over 20%(2). Although it often resolves on its own, posterior heel pain can be particularly stubborn. The plantar fascia can even rupture, as Chris Mallac explains in a recent article on SportsInjuryBulletin.com.
For most athletes, however, symptoms typically wax and wane, lasting upwards of five years for some(3). Therefore, researchers from La Trobe University sought out the best strategy to resolve plantar heel pain. In a randomized study, they compared the effectiveness of foot orthotics to corticosteroid injections in young adults with heel pain.
Subjects with heel pain lasting four weeks or more who had not received previous treatment (n=113) were assigned to either a foot orthotic group (n=57) or a corticosteroid group (n=56). The orthotic group received customizable prefabricated orthotics. The corticosteroid group received an ultrasound-guided peri-plantar fascia injection of medication. Both groups received a stretching protocol, which addressed plantar fascia, gastrocnemius, and soleus tightness.
The findings of this study were similar to those in the research. Subjects who received the corticosteroid injection showed significant improvement at four weeks follow up over those wearing the orthotics. The two groups showed similar improvement at eight weeks follow up. However, at the 12-week follow up, the orthotics group showed greater improvement of symptoms. While both treatments provided significant improvement to the subjects from the baseline measures, the differences between them did not meet clinical relevance. Therefore, it seems both are valid approaches.
One must consider also that the only other intervention the participants received was a stretching protocol. There are additional approaches, such as active exercise and splinting that show positive results in the treatment of heel pain due to plantar fasciitis. Furthermore, as Tracy Ward explains, corticosteroid injections, while able to provide relief in the early stages of recovery, carry potential risks. Thus while orthotics and injections continue to be part of an effective treatment protocol, neither alone will fix the problem of plantar heel pain.
in Diagnose & Treat, Email Newsletters, Musculoskeletal injuries
Nearly 50% of sports injuries occur at the tendon(1). That tough yet semi-elastic piece of connective tissue that connects muscles to bones still seems to be the weak link in athletic movement. As Alicia Filley reviews, we’ve come a long way from thinking of it as a purely inflammatory problem. We now know that there... MORE
in Ankle and foot injuries, Musculoskeletal injuries
Chris Mallac explores talar dome injury in athletes; how do they occur and how can they be treated? Talar dome injuries such as osteochondral lesions of the talus (OLT) can occur following an ankle injury, resulting in ongoing residual ankle pain and functional disability. Initially, OLT was described and classified as ‘transchondral fractures of the... MORE
They defined RRIs to include, “any self-reported complaint involving muscles, joints, tendons, and/or bones deemed by the runner to be caused by running.” The RRI had to impact at least one running workout by requiring the runner to decrease their speed, distance, length of run, or the number of runs. In addition to RRIs,... MORE
in Email Newsletters, Improve, Knee injuries
Runners suffer injuries at an alarming rate. Up to 80% of runners will report an injury each year! Most injuries are due to the inability of tissues to handle the loads applied to them. Often this is due to training error such as increasing distance or pace too quickly or taking on an aggressive... MORE
in Email Newsletters, Neck and back injuries
Sports professionals often equate dance with the arts rather than sport. However, dancers spend as much time, if not more, in training as other competitive sports (1). Dance encompasses the whole gamut of physical performance: power, strength, agility, speed, and flexibility. Therefore, it is no surprise that dancers suffer injuries too. In Australia, girls choose... MORE
in Diagnose & Treat, Email Newsletters, Improve
The days of lying in a dark room until concussion symptoms resolve are over. Research now shows that although exercise may make concussion symptoms worse, finding that sub-threshold level of activity –movement that doesn’t trigger symptoms – may help resolve the effects of a concussion(1). Concussive symptoms can be varied and, as Alicia Filley explains,... MORE
