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Proximal medial gastrocnemius recession
with a stretching program is a safe and effective method of treatment for chronic
plantar heel pain.
As per a recent
study, the chronic plantar heel pain can be effectively managed using proximal
medial gastrocnemius recession with a stretching program. Plantar heel pain is
one of the primary cause of heel pain, tenderness and soreness which can spread
into the medial arch. This condition of feet leads to considerable disability
and diminished health-related quality of life. Gastrocnemius recession is an
excellent operative procedure to treat plantar heel pain, but the prospective clinical
and biomechanical outcome data were limited.
Thus the study was
aimed to assess the biomechanical and clinical outcomes of gastrocnemius
recession and stretching resembled with a stretching exercise protocol among 40
patients suffering from plantar heel pain for more than one year.
The patients
randomly categorised to proximal medial gastrocnemius recession along with
stretching exercises or a home stretching exercise program only. American
Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scores at one year,
and visual analogue scale (VAS) along with Short Form-36 (SF-36) scores were
considered as the primary and secondary outcome. Achilles function and ankle
dorsiflexion were taken as the biomechanical outcomes determined by plantar
pressure (via pedobarography) and a test battery with six independent tests.
Data were collected two times; at baseline and follow-up. The operative group
showed from 59.5 to 88.0 and the non-operative group from 52.5 to 65.5 AOFAS
scores.
Moreover, the
operative group exhibited better SF-36, AOFAS and VAS scores as compared to the
nonoperative group at one-year follow-up (P < .05). Achilles function
presented no between-group difference and Ankle dorsiflexion raised from 6 to
10.5 degree. The operative group also exhibited increased average forefoot
plantar pressure from 536 KPa to 642 KPa at follow-up ( P < .001). These
outcomes very well explain that Proximal medial gastrocnemius recession with
stretching exercises is the better way to manage plantar heel pain.
Foot & Ankle International
Proximal Medial Gastrocnemius Recession and Stretching Versus Stretching as Treatment of Chronic Plantar Heel Pain.
Marius Molund et al.
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