title: High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up.
abstract: 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.
authors.affiliation: Orthopaedic Surgery Research Unit, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: M S
authors.initials: MS
authors.lastname: Rathleff
authors.affiliation: Department of Occupational and Physiotherapy, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: C M
authors.initials: CM
authors.lastname: Mølgaard
authors.affiliation: Diagnostic Centre, Silkeborg Regional Hospital, Silkeborg, Denmark.
authors.forename: U
authors.initials: U
authors.lastname: Fredberg
authors.affiliation: Elective Surgery Center, Silkeborg Regional Hospital, Silkeborg, Denmark.
authors.forename: S
authors.initials: S
authors.lastname: Kaalund
authors.affiliation: Diagnostic Centre, Silkeborg Regional Hospital, Silkeborg, Denmark.
authors.forename: K B
authors.initials: KB
authors.lastname: Andersen
authors.affiliation: Elective Surgery Center, Silkeborg Regional Hospital, Silkeborg, Denmark.
authors.forename: T T
authors.initials: TT
authors.lastname: Jensen
authors.affiliation: Kaalunds Klinik (Private/Public Orthopaedic Clinic), Aalborg, Denmark.
authors.forename: S
authors.initials: S
authors.lastname: Aaskov
authors.affiliation: Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark.|Institute of Sports Medicine Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: J L
authors.initials: JL
authors.lastname: Olesen
mesh_terms: D000328:Adult; D036981:Fasciitis, Plantar / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D061826:Foot Orthoses; D006801:Humans; D008297:Male; D008875:Middle Aged; D052580:Muscle Stretching Exercises; D010147:Pain Measurement; D055070:Resistance Training / Q000379:methods*; D016896:Treatment Outcome
keywords: plantar fasciitis; plantar heel pain; progressive strength training