Beware of Junk Science for Heel Pain

Recently, I read an article about a new and improved method to strengthen the plantar fascia. This article talks about using a step or a sturdy box and performing a heel lift type of movement. According to the article, which can be found in the New York Times and all over the internet, this new technique promises faster and better relief of plantar fasciitis. The article even states that this was proven in a published research paper in the Scandinavian Journal of Medicine and Science in Sports. Please don't believe the headlines! I took the time to read the actual paper in the above named journal. It is a classic case of junk science. First off, there were only 48 patients total. This is a small number, especially when you have to split the patients into two groups. Now you are comparing only 24 people. Next, both groups wore orthotic shoe inserts. The only difference was one group stretched and the other performed this heel lift maneuver. There was no group that wore orthotics alone and did neither the stretching or the heel lift. We can not ascertain the importance of the orthotic by itself. Thirdly and in my opinion, most importantly, the stretching arm of the study was woefully substandard. The stretching they had the participants perform was pathetic to the point of being comical. Finally, the results of this study are purely based on non-blinded, self reported, questionnaire data. The results were tabulated at 1 month, 3 month, 6 month and 12 month intervals. No difference, let me repeat that, NO DIFFERNECE was found at the 1 month, 6 month or 12 month interval. No difference. The only difference was found at the 3 month interval. This is an incredibly weak study. The editors of the newspapers that publish this rubbish should be ashamed. If any one of them took the time to read the original paper they could see this is garbage. I have personally had plantar fasciitis and I have been treating it in my patients for over 10 years now. There is no doubt that proper stretching of the gastrocnemius muscle group, (one of the muscles that makes up the calf) is vital to the treatment of plantar fasciitis. In fact, a surgical procedure that is often employed to help with plantar fasciitis is to cut a portion of the calf muscle in order to weaken it, not strengthen it! This can also be said for the fascia itself. While only 5-10% of patients ever need surgery for plantar fasciitis, the surgery does not involve bolstering or strengthening of the fascia. In fact, the surgery consists of cutting 75% of the fascia in order to weaken it's pull on the heel bone. If you, or someone you love is having sharp, stabbing pain in the heel, get to your nearest podiatrist. We treat this condition every day. The internet is a great place for information, but that information must be verified. Don't believe the headlines. Trust the experts. Committed to your health, Dr. Craig Conti Sarasota Foot Care Center

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