Deep massage to posterior calf muscles in combination with neural mobilization exercises as a treatment for heel pain

A pilot randomized clinical trial
Manual Therapy
Volume 19, Issue 2 , Pages 102-108, April 2014
Bernice Saban

Abstract
Background
Plantar heel pain syndrome (PHPS) is a common foot disorder; however, there is limited clinical evidence on which to base treatment. Repeated clinical observations indicating heel pain during heel rise and minisquat on the affected leg, involving activation of posterior calf muscles, formed the basis of this study.

Objective
To compare deep massage therapy to posterior calf muscles and neural mobilization with a self-stretch exercise program (DMS) to a common treatment protocol of ultrasound therapy to the painful heel area with the same self-stretch exercises (USS).

Methods
Patients with PHPS were assigned to a program of 8 treatments over a period of 4–6 weeks in a single-blind randomized clinical trial. Functional status (FS) at admission and discharge from therapy as measured by the Foot & Ankle Computerized Adaptive Test was the main outcome measure.

Results
Sixty-nine patients were included in the trial (mean age 53, standard deviation (SD) 13, range 25–86, 57% women), 36 received DMS treatment and 33 with USS. The overall group-by-time interaction for the mixed-model analysis of variance (ANOVA) was found statistically significant (p=0.034), with a change of (mean (confidence interval, CI)) 15 (9–21) and 6 (1–11) FS points for the DMS and USS groups, respectively.

Conclusions
Data indicated that both treatment protocols resulted in an overall short-term improvement, however, DMS treatment was significantly more effective in treating PHPS than USS treatment.

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