Allegra Barnes1, Justin Sullivan2, Evangelos Pappas3, Roger Adams4, Joshua Burns5. 1. Physiotherapy Department, Royal North Shore Hospital, New South Wales, Australia(∗). 2. Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia 1825(†). Electronic address: justin.sullivan@sydney.edu.au. 3. Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, New South Wales; Arthritis and Musculoskeletal Research Group, Faculty of Health Sciences, The University of Sydney, New South Wales, Australia(‡). 4. Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, New South Wales, Australia(§). 5. Sydney Children's Hospitals Network (Randwick and Westmead), University of Sydney, New South Wales, Australia(¶).
Abstract
BACKGROUND: Plantar heel pain is a common condition that reduces health-related quality of life. Recovery usually occurs within 12 months; however, up to 20% of people remain symptomatic beyond this time frame. The level of pain and function in this chronic heel pain group is not well described. OBJECTIVE: To identify clinical and functional characteristics associated with chronic plantar heel pain compared with heel pain of recent onset. DESIGN: Cross-sectional study. SETTING: University research laboratory and private physiotherapy clinic. PARTICIPANTS: A total of 71 people with plantar heel pain for longer than 12 months and 64 people with plantar heel pain for less than 6 months were recruited from the general public. METHODS: Functional characteristics of participants in both heel pain groups were assessed with a variety of clinical measures and the Foot Health Status Questionnaire. Clinical measures included body mass index, foot and ankle muscle strength using hand-held dynamometry, as well as ankle and first metatarsophalangeal joint range of motion. The Foot Health Status Questionnaire was used to collect self-reported measures of foot pain severity, foot function and physical activity. MAIN OUTCOME MEASUREMENTS: Univariate analyses of variance were performed to detect differences between the 2 groups for each of the variables measured. RESULTS: The chronic heel pain group exhibited reduced ankle dorsiflexor and toe flexor strength yet better self-reported foot function. There was no difference between groups for body mass index, ankle and first metatarsophalangeal joint range of motion, inversion strength, eversion strength, calf endurance, self-reported foot pain, and physical activity. CONCLUSIONS: Chronic plantar heel pain is associated with selective weakness of foot and ankle muscle groups but less affected foot function compared with heel pain of recent onset. Those with chronic symptoms may moderate or make adaptations to their daily activities, or simply accept their condition, enabling more effective coping. Strength deficits, although possibly a cause or consequence of chronic symptoms, suggest a need to include resistance exercise in the management of plantar heel pain. LEVEL OF EVIDENCE: IV.
BACKGROUND:Plantar heel pain is a common condition that reduces health-related quality of life. Recovery usually occurs within 12 months; however, up to 20% of people remain symptomatic beyond this time frame. The level of pain and function in this chronic heel pain group is not well described. OBJECTIVE: To identify clinical and functional characteristics associated with chronic plantar heel pain compared with heel pain of recent onset. DESIGN: Cross-sectional study. SETTING: University research laboratory and private physiotherapy clinic. PARTICIPANTS: A total of 71 people with plantar heel pain for longer than 12 months and 64 people with plantar heel pain for less than 6 months were recruited from the general public. METHODS: Functional characteristics of participants in both heel pain groups were assessed with a variety of clinical measures and the Foot Health Status Questionnaire. Clinical measures included body mass index, foot and ankle muscle strength using hand-held dynamometry, as well as ankle and first metatarsophalangeal joint range of motion. The Foot Health Status Questionnaire was used to collect self-reported measures of foot pain severity, foot function and physical activity. MAIN OUTCOME MEASUREMENTS: Univariate analyses of variance were performed to detect differences between the 2 groups for each of the variables measured. RESULTS: The chronic heel pain group exhibited reduced ankle dorsiflexor and toe flexor strength yet better self-reported foot function. There was no difference between groups for body mass index, ankle and first metatarsophalangeal joint range of motion, inversion strength, eversion strength, calf endurance, self-reported foot pain, and physical activity. CONCLUSIONS:Chronic plantar heel pain is associated with selective weakness of foot and ankle muscle groups but less affected foot function compared with heel pain of recent onset. Those with chronic symptoms may moderate or make adaptations to their daily activities, or simply accept their condition, enabling more effective coping. Strength deficits, although possibly a cause or consequence of chronic symptoms, suggest a need to include resistance exercise in the management of plantar heel pain. LEVEL OF EVIDENCE: IV.
Authors: Zaid Al-Boloushi; Eva María Gómez-Trullén; Pablo Bellosta-López; María Pilar López-Royo; Daniel Fernández; Pablo Herrero Journal: J Orthop Surg Res Date: 2019-01-25 Impact factor: 2.359
Authors: Zaid Al-Boloushi; Eva Maria Gómez-Trullén; Mohammad Arian; Daniel Fernández; Pablo Herrero; Pablo Bellosta-López Journal: BMJ Open Date: 2020-08-20 Impact factor: 2.692