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Gastrocnemius slide found safe, effective as treatment for chronic plantar fasciitis
Investigators found that the technique provided significant symptom relief even in patients with a body mass index greater than 30.
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Plantar Fasciitis Discussions -
Haven't we seen a few similarly flawed studies posted in the last week or so? Where is the control group?
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NewsBot
What is a Gastroc slide? (do they have one at Disney World? :D )
No seriously what is the technique?
Dave Smith -
It does beg the question what would have happened had they just unzipped the skin behind the TA, sewn it back up and given the same post op instructions!
Anyone know what happens to heel pain if you stick the foot in a planterflexed cast for 6 weeks without doing any surgery?
Also begs the question how were the patients doing a year on! If the cause of the PF was not tight TA oriented i suspect that they'll be quite a few which recur (especially in the BMI>30 brackett)
As my learned colleague says, a very flawed study.
Regards
Robert -
Hmmm.... This study, although flawed, supports what I have been saying for years. Compliant patients who stretch get better, those that don't stretch do not get better. Most fat patients, in my practice, are far less compliant with self management, especially anything that has to do with exercise. In a couple of years the newly scarred calf will tighten again, the patients will gain more weight, and the success rate will drop from 93.6% to .936%.
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"Gastrocnemius slide found safe". --- Hooray!
A spokesman the Gasroc said "he was found safe and well and living in a shed beside Clapham rail junction." Young Gastroc was later transfered to Great Ormond St Hospital for observation after reporting feeling a little stiff from mild hypothermia and post static dyskinesia. :)
Dave -
Colleagues:
This study does make sense, even though I don't know I would consider it a first line alternative to conservative therapy. I have been very impressed with the clinical results that a few patients have achieved that have had chronic plantar fasciitis who have been otherwise unresponsive to all conservative measures. These patients did get good relief of symptoms with a gastrocnemius recession procedure. Even though I don't personally do this surgery, since plantar fascial tension is directly related to Achilles tendon, it makes sense that reducing the Achilles tendon tension during weightbearing activities has the potential to relieve the pain of plantar fasciitis.
This procedure could be the next big surgical alternative for plantar fasciitis treatment next to partial plantar fasciotomy..... we just don't know yet what the long term side effects are to gastrocnemius recession, even though the procedure is commonly done for flatfoot reconstructive surgery. Sural nerve injury is the biggest surgical complication so far, to my knowledge. -
Proximal medial gastrocnemius release in the treatment of recalcitrant plantar fasciitis.
Abbassian A, Kohls-Gatzoulis J, Solan MC.
Foot Ankle Int. 2012 Jan;33(1):14-9.
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Guns kill fleas, is what we call in my country.
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What kind of stretching do others give? Static? Dynamic? etc.
Recently been suggested to me that static stretching has little effect. I've started to give recipricol inhibition stretches and seen good results. -
This clinical trial was just registered:
Gastrocnemius Recession vs. Conservative Treatment for Chronic Plantar Fasciitis
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Results after gastrocnemius recession in 73 patients
Marius Molund, Øyvind Paulsrud , Elisabeth Ellingsen Husebye , Fredrik Nilsen , Kjetil Hvaal
Foot and Ankle Surgery; Available online 24 July 2014
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From Podiatry Today:
How Effective Is The Gastroc Recession For Plantar Fasciitis? -
Foot Function Index Outcomes of Gastrocnemius Recession for Treatment of Chronic Plantar Fasciitis
Ashish Shah, MD, Birmingham, AL
Michael J. Kimball, MD, Jenkintown, PA
Osama M. Elattar, Birmingham, AL
Brooks Ficke, MD, Birmingham, AL
Presented at AAOS Annual Meeting; March 2015
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Gastrocnemius Recession for Recalcitrant Plantar Fasciitis in Overweight and Obese Patients
Brooks Ficke, Osama Elattar, Sameer M. Naranje, Ibukunoluwa Araoye, Ashish B. Shah
Foot and Ankle Surgery; Article in Press
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Proximal Medial Gastrocnemius Recession and Stretching Versus Stretching as Treatment of Chronic Plantar Heel Pain.
Molund M et al
Foot Ankle Int. 2018 Aug 22:1071100718794659.
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Isolated Gastrocnemius Recession for Plantar Fasciitis
Nicholas Cheney, DO, Timothy Law, DO, MBA, David Zehnder, BA, Bryan Large, BS, Kyle Rockwell, MS, Brent Whitehead,
Mckinly Vazquez
AOFAS Annual Meeting 2018 1
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Radiofrequency Microtenotomy with Concurrent Gastrocnemius Recession Improves Postoperative Vitality Scores in the Treatment of Recalcitrant Plantar Fasciitis.
Huang DM, Chou AC, Yeo NE, Singh IR.
Ann Acad Med Singapore. 2018 Dec;47(12):509-515.
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Basically surgical lengthening procedure.
Or this stolen from the interwebz Gastrocnemius recession, which involves release of the gastrocnemius tendon and subsequent lengthening of the calf muscle, is specifically indicated for patients with equinas contractures.-
Like x 1 - List
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The effect of lengthening the gastrocnemius muscle in chronic therapy resistant plantar fasciitis
Eva M Hoefnagels et al
Foot Ankle Surg. 2020 Jul 12;S1268-7731(20)30152-1
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Outcomes of Gastrocnemius Recession in Patients with Plantar Fasciitis and Achilles Tendinosis: A Retrospective Study of 160 Patients
Wesley Stroud, Bradley Alexander, BS, Jared R. Halstrom, BS, ...
Foot & Ankle Orthopaedics November 6, 2020
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Clinical And Plantar Fascial Morphologic Changes After Proximal Medial Gastrocnemius Release Treatment of Recalcitrant Plantar Fasciitis
Alberto Ginés-Cespedosa, MD, PhD, Ignacio Wormull Ugarte, MD, Jesus Ares-Vidal, MD, ...
Foot & Ankle Orthopaedics July 15, 2021
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Gastrocnemius Recession in Recalcitrant Plantar Fasciitis: a Systematic Review
Catherine Claire Pickin et al
JFAS November 01, 2021
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Gastrocnemius Release in the Management of Chronic Plantar Fasciitis: A Systematic Review
Zaki Arshad et al
Foot Ankle Int. 2021 Nov 12
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Surgical Anatomy of the Endoscopic Gastrocnemius Recession
Sara Mateen et al
J Foot Ankle Surg. 2021 Nov 7
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Clinical Experience with Gastrocnemius Recession Surgery in Chronic Plantar Fasciitis
Rahul Upadhyay et al
Journal of Foot and Ankle Surgery (Asia Pacific) Volume 9 | Issue 1 | Year 2022
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PROMIS Scores for Plantar Fasciitis Before and After Gastrocnemius Recession
Thomas Sanchez et al
Foot Ankle Int. 2023 Mar 23
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Factors Associated With Poor Patient-Reported Outcomes in Isolated Gastrocnemius Recession for Heel Pain
Thomas Sanchez et al
Foot Ankle Orthop. 2023 Apr 18;8(2)
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Isolated Gastrocnemius Contraction and Gastroc Recession Surgery in Case of Planter Fasciitis: A Systemic Review and Meta-Analysis
Abhijit Bandyopadhyay, Sanjay Kumar & Prasun Mandal
Indian Journal of Orthopaedics (2023)
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Medial gastrocnemius proximal fasciotomy in patients with chronic plantar fasciitis: a systematic review
Julia Escalada Barrado et al
Rev Esp Cir Ortop Traumatol. 2023 Sep 18;S1888-4415(23)00191-1
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Outcomes After Proximal Medial Gastrocnemius Recession and Stretching vs Stretching as Treatment of Chronic Plantar Fasciitis at 6-Year Follow-up
Martin Okelsrud Riiser et al
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