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Podiatrist vs GP management of plantar heel pain

Discussion in 'Biomechanics, Sports and Foot orthoses' started by NewsBot, Sep 23, 2020.

  1. NewsBot

    NewsBot The Admin that posts the news.

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    Custom insoles versus sham and GP-led usual care in patients with plantar heel pain: results of the STAP-study - a randomised controlled trial
    Nadine Rasenberg et al
    British Journal of Sports Medicine Published Online First: 02 September 2020
     
  2. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
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  3. NewsBot

    NewsBot The Admin that posts the news.

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  4. scotfoot

    scotfoot Well-Known Member

    In the Podcast referenced above a well know podiatrists called Ian Griffiths gives some feedback on Rasenberg et al 2020 .

    During the broadcast , Ian informs us that he is part of a group who have put together a study into the treatment of plantar heel pain , and which is presently going through the review process .

    He also states " strengthening work does not feature " in this paper under review . I don't understand that and here is why .

    We know that heel pain is associated with weakened intrinsic foot muscles but don't know which comes first .

    If the pain causes the weakness then surely this should be addressed by the treatment since intrinsic weakness is associated with poorer balance and even deformity in the long term .

    So although there may be little formal evidence at present ( see Australian ballet info on injury prevention on internet ) that strengthening helps treat the pain it does, by definition , treat the weakness .

    Any thoughts Ian .

    Ps I enjoy your broadcasting .
     
  5. scotfoot

    scotfoot Well-Known Member

    Re the above , some might make the assumption that if plantar heel pain is successfully treated the intrinsics will regain their former levels of strength in due course and without any specific strengthening .

    In my opinion this is not a sound treatment plan for people involved in sports who want to return to their sports as soon as possible and in the best condition , nor is it a sound plan for those older patients with sarcopenia .

    Heel pain can be viewed as an injury which is associated with intrinsic muscle weakness ,so how can a rehab program for the condition not involve strengthening ???

    Sorry if I have picked you up wrongly Ian but, if not , I believe your " paper under review " is seriously flawed .
     
  6. Brian A. Rothbart

    Brian A. Rothbart Active Member

    Another outcome that demonstrates that using any type of insole without first diagnosing the foot structure present in the patient is a misfeasance at best, and malpractice at worst.
     
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