The following study concluded that:
"A program of
non-weight-bearing stretching exercises specific to the plantar fascia is
superior to the standard program of
weight-bearing Achilles
tendon-stretching exercises for the treatment of symptoms of
proximal plantar fasciitis."
BACKGROUND: Approximately 10% of patients with plantar fasciitis
have development of persistent and often disabling symptoms. A poor
response to treatment may be due, in part, to inappropriate and
nonspecific stretching techniques. We hypothesized that patients
with chronic plantar fasciitis who are managed with the
structure-specific plantar fascia-stretching program for eight weeks
have a better functional outcome than do patients managed with a
standard Achilles tendon-stretching protocol.
METHODS: One hundred and
one patients who had chronic proximal plantar fasciitis for a
duration of at least ten monthswere randomized into one of two
treatment groups. The mean age was forty-six years. All patients
received prefabricated soft insoles and a three-week course of
celecoxib, and they also viewed an educational video on plantar
fasciitis. The patients
received instructions for either a plantar fascia tissue-stretching
program (Group A) or an Achilles tendon-stretching program (Group
B).All patients completed the pain subscale of the Foot
Function Index and a subject-relevant outcome survey that
incorporated generic and condition-specific outcome measures related
to pain, function, and satisfaction with treatment outcome.
The patients were reevaluated
after eight weeks.
RESULTS: Eighty-two patients returned for follow-up evaluation.
With the exception of the duration of symptoms (p < 0.01),
covariates for baseline measures revealed no significant differences
between the groups. The pain subscale scores of the Foot Function
Index showed significantly better results for the patients managed
with the plantar fascia-stretching program with respect to item 1
(worst pain; p = 0.02) and item 2 (first steps in the morning; p =
0.006). Analysis of the response rates to the outcome measures also
revealed significant differences with respect to pain, activity
limitations, and patient satisfaction, with greater improvement seen
in the group managed with the plantar fascia-stretching program.
CONCLUSIONS: A program of non-weight-bearing stretching exercises
specific to the plantar fascia is superior to the standard program
of weight-bearing Achilles tendon-stretching exercises for the
treatment of symptoms of proximal plantar fasciitis. These findings
provide an alternative option to the present standard of care in the
nonoperative treatment of patients with chronic, disabling plantar
heel pain.
BF Digiovanni, et al. "Plantar Fascia-Specific
Stretching Exercise Improves Outcomes in Patients with Chronic
Plantar Fasciitis. A Prospective Clinical Trial with Two-Year
Follow-Up" J. Bone Joint Surg. Am., Aug 2006; 88: 1775 - 1781.
Link
In contrast, the "stair stretches"are standard
weight-bearing stretching exercises designed to stretch the calf
muscles and Achilles tendon.
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