Effectiveness of myofascial release in the management of plantar heel pain: a randomized controlled trial.
BACKGROUND
Previous studies have reported that stretching of the calf musculature and the plantar fascia are effective management strategies for plantar heel pain (PHP). However, it is unclear whether myofascial release (MFR) can improve the outcomes in this population.


OBJECTIVE
To investigate whether myofascial release (MFR) reduces the pain and functional disability associated with plantar heel pain (PHP) in comparison with a control group receiving sham ultrasound therapy (SUST).


METHODS
Randomized, controlled, double blinded trial.


METHODS
Nonprofit research foundation clinic in India.


METHODS
Sixty-six patients, 17 men and 49 women with a clinical diagnosis of PHP were randomly assigned into MFR or a control group and given 12 sessions of treatment per client over 4 weeks. The Foot Function Index (FFI) scale was used to assess pain severity and functional disability. The primary outcome measure was the difference in FFI scale scores between week 1 (pretest score), week 4 (posttest score), and follow-up at week 12 after randomization. Additionally, pressure pain thresholds (PPT) were assessed over the affected gastrocnemii and soleus muscles, and over the calcaneus, by an assessor blinded to the treatment allocation.


RESULTS
The simple main effects analysis showed that the MFR group performed better than the control group in weeks 4 and 12 (P<0.001). Patients in the MFR and control groups reported a 72.4% and 7.4% reduction, respectively, in their pain and functional disability in week 4 compared with that in week 1, which persisted as 60.6% in the follow-up at week 12 in the MFR group compared to the baseline. The mixed ANOVA also revealed significant group-by-time interactions for changes in PPT over the gastrocnemii and soleus muscles, and the calcaneus (P<0.05).


CONCLUSIONS
This study provides evidence that MFR is more effective than a control intervention for PHP.
Department of Physiotherapy, Hamad Medical Corporation, Doha, Qatar; Myofascial Therapy and Research Foundation, India. Electronic address: ajimshaw.ms@gmail.com.
M S
MS
Ajimsha
Myofascial Therapy and Research Foundation, India.
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D
Binsu
Myofascial Therapy and Research Foundation, India.
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S
Chithra
D000328:Adult; D005081:Exercise Therapy / Q000379:methods*; D036981:Fasciitis, Plantar / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005528:Foot / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008349:Manipulation, Orthopedic / Q000379:methods*; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D016896:Treatment Outcome; D055815:Young Adult
Myofascial release; Myofascial restrictions; Plantar heel pain