Deep massage to posterior calf muscles in combination with neural mobilization exercises as a treatment for heel pain: a pilot randomized clinical trial.
Study Goal
To compare the effectiveness of deep massage therapy combined with neural mobilization and self-stretch exercises (DMS) versus ultrasound therapy combined with the same self-stretch exercises (USS) in treating plantar heel pain syndrome (PHPS).
Results Summary
Both treatments improved functional status, but DMS was significantly more effective, with a mean improvement of 15 FS points compared to 6 FS points for USS. The difference between the two treatments was statistically significant (p=0.034).
Population
Patients with plantar heel pain syndrome (mean age 53, 57% women).
Effective Dosage
8 treatments over 4-6 weeks.
Duration
4-6 weeks.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
deep massage therapy to posterior calf muscles and neural mobilization with a self-stretch exercise program (DMS) | increase | functional status | Patients with plantar heel pain syndrome (PHPS) | 15 (9-21) FS points | resulted in an overall short-term improvement | #1 |
ultrasound therapy to the painful heel area with the same self-stretch exercises (USS) | increase | functional status | Patients with plantar heel pain syndrome (PHPS) | 6 (1-11) FS points | resulted in an overall short-term improvement | #2 |
deep massage therapy to posterior calf muscles and neural mobilization with a self-stretch exercise program (DMS) | increase | treating plantar heel pain syndrome (PHPS) | Patients with plantar heel pain syndrome (PHPS) | - | was significantly more effective | #3 |
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.