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Hamstring tightness and plantar fasciitis

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Admin2, Jan 6, 2006.

  1. Admin2

    Admin2 Administrator Staff Member


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    The Role of Hamstring Tightness in Plantar Fasciitis
    Foot & Ankle International December 2005 (Vol.26#12)
     
  2. krome

    krome Active Member

    Hi Everyone

    It is interesting to read the intensity of short-term studies relating to the aetiology of plantar fasciitis. In this study only 15 patients with chronic plantar fasciitis were compared to 15 volunteers. Although statistical differences were observed one must be cautious with the results.

    From a statistical view point there is a likelihood of a type 1 statistical error and from a clinical perspective only 15 patients may not reflect the general population.

    I am glad that further research is continuing in this area but until a large longitudinal study is undertaken evaluating all intrinsic and extrinsic risk factors...the aetiology of this condition will remain elusive.

    Keith
     
  3. phil

    phil Active Member

    I don't know how significant hamstring tightness would really be with patients with plantar fasciitis, relative to other factors.

    I mean, if they've got gastro-soleus tightness, they're running around in pluggers all day, or they are 40 kgs overweight for example, is hamstring tightness particularly significant??

    Has anyone ever found hamstring tightness to be clinically significant in any patients with plantar fasciitis?

    Sorry, probably shouldn't be so negative! Someone obviously put in some effort to do this study for a reason.

    Phil
     
  4. DaveK

    DaveK Member

    Hamstring tightness is something I test in all my patients. Nearly all my patients that present with PF have a degree of hamstring tightness and a referral to a Physiotherapist is part of my treatment protocol.

    Most, commonly, also present with FHL/abductory twist/early heel rise. Something definately worth doing some serious thinking about/study into when I get some time!!
     
  5. DaFlip

    DaFlip Active Member

    Could someone please explain to me why it would be part of standard protocol to refer a patient for hamstring tightness to a PT?
    No disrespect to the PT's here, but does this require referral. Sure you find something neural on loading or you suspect a radicular pattern of presentation then refer them out, but as standard protocol?
    Maybe this is part of the reason why so many other professions encroach on 'podiatric' conditions. Why even consider the podiatrist when you will end up with another health professional who can treat both the foot and hamstring?

    Oh and i do need a manager for my track career if anyone is still interested.Someone did express interest previosuly. I have a big selection meet coming up next month. Let's just say things are looking good for team selection. I cannot say too much but my threshold training may have been the killer to get me there. As long as my hamstring induced plantar fasciitis doesn't prevent me from running all should go well.
    May the Broncos destroy the Patriots!
    DaFlip
    :mad:
     
  6. DaveK

    DaveK Member

    Im sorry you're so angry :( However I work in a multi disciplinary team of excellent healthcare professionals that are experts in their area which means 2 things:

    1. ""OUR"" patient gets the best possible care/treatment

    2. I can let more patients see me cause Im not tied up doing something that I've no need to be doing

    If your isolationist practices are beneficial to your patients then good luck.
     
  7. DaFlip

    DaFlip Active Member

    Very interesting points DaveK. Obviously you took offence to my previous comments. they were not meant to offend, just raise the points that got your response. So thank you!
    It appears strange that hamstring tightness equals referral. Where did you get taught this and why? Was it a intro-office decision to do this?

    By "our" patients getting the best possible care, i presume it is your opinion referring them to the PT is beneficial in these cases.
    Could you explain what criteria this is based upon.
    How much hamstring tightness equals referral?
    How do you determine if you think this is causative in the presenting case?

    I also feel very happy(not mad at all right now) that this frees up time so more people can see you! Lucky them.

    Yours in isolationist podiatric medicine,
    Mike

    ;)
     
  8. PF 3

    PF 3 Active Member

    Who doesn't have tight hamstrings anyway? I have never come across a pt who isn't clnically tight in their hamstrings apart from Yoga techers and a few elite athletes.

    All podiatrists should be able to instruct on atleast a basic stretching program. Doubt the PT profession will feel threatened by by this.


    Cheers


    Tom
     
  9. pgcarter

    pgcarter Well-Known Member

    HOW do we define tight?...cause if everyone is tight does this mean no-one is because this is actually normal?......my aren't we touchy about different practice attitudes, no need to play "mines bigger than yours" boys....if you don't have anything constructive to add then......
    Regards Phill Carter
     
  10. DaFlip

    DaFlip Active Member

    Phill,
    there is no argument here. Mine is bigger. :D

    The point is, as you have also raised, when is tight - tight? But my more relevant questions, which remain unanswered, included when does this require referral and how do we determine if this is causative in cases of plantar fasciitis?

    Here is my constructive part, just for Phill and also for DaveK since there has been no response from my questions. If there is:
    1.positive neurodynamic assessment suggestive of peripheral neurological entrapment,
    2.specific neurological referral pattern from the lumbosacral spine or some suggestion of pathological process occurring in the spine including the thoracic and cervical spine,
    3.there is bilateral plantar fasciitis of unknown causative origin but suspected referral pattern,
    send them away from the pod office to someone who knows what they are doing with these conditions.

    All other cases of 'restricted' hamstring ROM, whatever this is, if believed to be of cause should be able to be managed in office by the pod. Now this leads me to the practice attitude because it is relevant to the patient. Why? Well this may appear to some as a nice little bit of extra clinical income for the practice. You know how it may work......standard intra-office program, all cases of plantar fasciitis, go to the pod, referred to the PT. The business may do very well.
    DaFlip :mad:
     
  11. Craig Payne

    Craig Payne Moderator

    Articles:
    6
    The interesting thing here is the role that neurodynamics/neural tension plays in hamstring tightness and in 'heel pain' - maybe the link is in this between the two and not as the authors of the study in message 1 allege as being altered forefoot loading.
     
  12. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    The Role of Hamstring Tightness in Plantar Fasciitis
    Jonathan M. Labovitz, Jenny Yu, Chul Kim,
    Foot Ankle Spec June 2011 vol. 4 no. 3 141-144
     
    Last edited: Nov 27, 2012
  13. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Relationship Between Tightness of the Posterior Muscles of the Lower Limb and Plantar Fasciitis
    Yolanda Aranda Bolíva, Pedro V. Munuera Martínez and Juan Polo Padillo
    Foot and Ankle International (in press) PDF
     
  14. Craig Payne

    Craig Payne Moderator

    Articles:
    6
    Lower Extremity Review did a summary on that one a yr ago and got some comments on it:
    Full article
     
    Last edited by a moderator: Aug 28, 2015
  15. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Tightness of Calf and Hamstring Musculature among Plantar
    Fascitis

    LARAIB JAVAID, SHOAIB WAQAS, HAFIZ MUHAMMAD ASIM
    P J M H S Vol. 11, NO. 3, JUL – SEP 2017
     
  16. Len

    Len Member

     
  17. Len

    Len Member

    My friend had bilateral plantar fasciitis for about a year and tried everything. It was not until he got some hamstring and neural stretches that it finally resolved.
     
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