• Journal of Korean Foot and Ankle Society
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• v.21 no.1
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• pp.17-20
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• 2017

Purpose: The purpose of this study is to analyze the clinical features of plantar fascia rupture. Materials and Methods: We retrospectively reviewed 312 patients with plantar fasciitis between March 2008 and February 2013. We investigated age, sex, site, visual analogue scale (VAS), body mass index (BMI), characteristics of pain, awareness of rupture, and duration of symptoms. Acute rupture was defined as a rupture that occurred during exercise; chronic rupture was defined as a degenerative rupture after plantar fasciitis. We investigated the frequency of acute and chronic rupture. Results: Among 312 patients, 38 patients (12.2%) were diagnosed with plantar fascia rupture. Thirty-eight patients consisted of 14 men (36.8%) and 24 women (63.2%). The mean age of plantar fascia rupture was $58.29{\pm}12.54years$. The mean VAS score was 5.92 points (3~9 points). The mean BMI was $25.92{\pm}1.59kg/m^2$. Among the 38 patients, 2 patients had acute plantar fascia rupture and 36 had chronic plantar fascia rupture. In 34 patients-out of 36 chronic plantar fascia rupture, there were no subjective symptoms. Conclusion: Chronic rupture of the plantar fascia that occurred after plantar fasciitis was more common than acute rupture. Chronic rupture occurred at approximately 12% of patients treated with plantar fasciitis. In chronic rupture of the plantar fascia, there were no subjective symptoms of rupture. Therefore, we should doubt chronic rupture of plantar fascia when plantar fasciitis is prolonged.

• Journal of Korean Foot and Ankle Society
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• v.11 no.2
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• pp.145-148
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• 2007

Purpose: This retrospective study was designed to evaluate the appearances of plantar fasciitis by ultrasonography. Materials and Methods: 48 cases of unilateral plantar fasciitis were enrolled in this study. Plain radiograph and realtime sonography of both feet were perfomred and the results were compared between the affected feet and controlateral symptomless feet. Calcaneal spur were observed on plain radiograph and thickness of plantar fascia, hypoechogenecity, blurring of border of plantar fascia, perifascial effusion, wavy plantar fascia were observed on sonography. Results: Women (35 cases) and left feet (30 cases) were more frequent than men and right feet. Thickness of plantar fascia in affected site was thicker than normal site (p<0.01). Hypoechogenecity was observed only in 39 cases (81%) affected site, blurring of border of plantar fascia in affected site was 30 cases (62%) and 7 cases (15%) in normal site, perifascial effusion was observed only in 38 cases (79%) affected site, wavy plantar fascia in affected site was 43 cases (90%) and 2 cases (4%) in normal site. Calcaneal spur in affected site was 36 cases (75%) and 33 cases (69%) in normal site. Conclusion: Sonography is a useful diagnostic procedure for the plantar fasciitis especially in the unilateral plantar fasciitis.

• The Journal of Korean Physical Therapy
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• v.21 no.3
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• pp.41-46
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• 2009

Purpose: This study investigated the change in plantar fascia thickness in hemiplegic and non-hemiplegic feet in stroke patients using an ultrasonographic evaluation. Methods: Sixteen hemiplegic and non-hemiplegic feet from 16 hemiplegic patients (patient group) and 16 feet from 8 healthy subjects (control group) were evaluated by ultrasonography. The sagittal sonograms were obtained in the prone position, and the plantar fascia thickness was measured at its insertion into the calcaneus. Results: The mean plantar fascia thickness was measured to be $4.5\pm0.8$mm in hemiplegic feet of the patient group, $3.4\pm1.0$mm for the contralateral non-hemiplegic feet and $2.8\pm0.3$mm for the control group. There was a statistically significant difference in plantar fascia between the hemiplegic feet and contralateral non-hemiplegic feet as well as between the contralateral non-hemiplegic feet and control group (p<0.01 and p<0.05, respectively). The plantar fascia thickness according to the Brunnstrom stage and modified Ashworth scale was increased significantly in the hemiplegic feet (p<0.01). Conclusion: These results show that the plantar fascia is overloaded in the hemiplegic and non-hemiplegic feet of stroke patients. A therapeutic approach should be considered for these patients.

• Physical Therapy Rehabilitation Science
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• v.2 no.2
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• pp.75-80
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• 2013

Objective: The purpose of this study was to examine the effect of cold applied the night before or in the morning on pain and symptoms of plantar fasciitis. Design: Experimental study. Methods: Thirty subjects with plantar fasciitis were recruited for this study. Subjects with plantar fasciitis either had no intervention, cold applied (20 minutes) at night before bed, or 20 minutes in the morning upon wakening. Plantar fascia tenderness and pain were evaluated. There were ten subjects in each group. Measures included visual analog scale, plantar facial thickness via high resolution ultrasound, algometer measure, and range of motion of the ankle and foot. There were 3 groups of 10 subjects, control (no intervention), cold the night before bed, and cold in the morning before rising. Results: The greatest relief of symptoms was cold used at bedtime the night before the measurements. Cold used in the morning was not as effective as cold used in the evening before bed. Cold use reduced the thickness of the plantar fascia and irritation. There was a 13% reduction in plantar fascia thickness with cold the night before (p<0.05), a 44% reduction in pain and an 86 % increase in the force that could be applied to the bottom of the foot without pain (p<0.05). Conclusions: Cold applied for 20 minutes prior bedtime is effective for reduced symptomology caused by plantar fascia inflammation.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.1
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• pp.151-161
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• 2021

Purpose : This study was to investigate the effectiveness of ESWT and plantar fascia-specific stretching exercise vs ESWT and high-load strengthening exercise in patients with chronic plantar fasciitis. Methods : The subjects were randomized to extracorporeal shock wave therapy ( ESWT, for 3 weeks) and daily plantar-specific stretching (Group I: Stretch group) or ESWT and high-load progressive strength (Group II: Strength group) performed every second day. The main outcome measures were ultrasound, visual analogue scale (VAS), and Korean Foot Function Index (KFFI). The ultrasound (plantar fascia thickness), pain intensity I, II (the most painful of the day?, the pain when you first step in the morning?) and KFFI (functional performance) were compared between the groups. Results : No significant difference was observed between the groups in the plantar fascia thickness but pain intensity I, II was significantly lower in Group 2 than in Group 1 at only 12weeks and functional performance was also significantly increased in Group 2 compared to Group 1 at only 12 weeks. Conclusion : The high-load strengthening exercise consisting of the progressive exercise protocol, resulted in superior after 12 weeks compared with plantar-specific stretching. High-load strength exercise may aid in a quicker reduction in pain and improvements in functional performance.

• Journal of Korean Foot and Ankle Society
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• v.12 no.2
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• pp.122-127
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• 2008

Purpose: To evaluate the clinical outcome of proximal plantar fasciitis after nonoperative treatment, and also to find the correlation of the heel pain with the plantar fascia thickness measured by ultrasonography. Materials and Methods: The study is based on 41 patients, 46 feet of the proximal plantar fasciitis that were treated conservatively with at least 12 months follow-up. All were treated with heel pad, Achilles and plantar fascia stretching and pain medications for at least 3 months. Heel ultrasonography was performed at the beginning of the treatment to measure the plantar fascia (PF) thickness and the echogenicity. PF thickness over 4 mm and less were grouped in to group A and B respectively to compare the clinical outcome. Results: Average thickness of the PF at the calcaneal attach was 5.2 mm. Symptom duration before the treatment was average 13.2 month; group A being 14.6 months and group B being 9.0 months with no significant difference (p=0.09). As functional evaluation, Roles-Maudsley score improved from 3.4 initially to 2.3 at final follow-up, while morning heel pain also improved from average VAS pain score of 7.2 to 4.0. However Maudsley and VAS score both didn't show statistical difference between the 2 groups (p>0.05). Conclusion: Plantar fasciitis improved substantially with the nonoperative treatments. However, the 2 groups, divided according to 4 mm thickness by ultrasonography, didn't show significant difference in either symptom duration or in the clinical outcomes.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.17 no.1
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• pp.47-53
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• 2022

Objectives This case study aimed to investigate the effect of acupotomy and fascia chuna therapy on talipes cavus-type plantar fasciitis. Methods We classified the foot arch type using a podoscope and estimated the outcome by evaluating the numeric rating scale, pain disability index, and EuroQol-5-dimension measurement. Results After treatment, heel pain decreased and the quality-of-life score improved. Conclusions This study suggests that treatment with acupotomy and muscle energy techniques based on the foot arch type may be effective for plantar fasciitis. A limitation of this study is the small number of cases. Further clinical studies are required.

• The Journal of Korean Medicine
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• v.44 no.1
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• pp.108-116
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• 2023

Objectives: This study is to report the usefulness of ultrasound in diagnosing plantar fasciitis and the effectiveness of ultrasound-guided bee venom pharmacopuncture as a treatment of it. Methods: A 61-year-old woman suffered from plantar fasciitis on her right foot for 1 month. The sonographic findings were fascial thickening, blurring of perifascial border and perifascial effusion. The ultrasound-guided bee venom pharmacopuncture for 6 times and conventional Korean medicine therapies like acupuncture and moxibustion for 12 times in 5 weeks. Numeric rating scale (NRS) and foot function index(FFI) was used to evaluate the pain and its progress. and thickness of plantar fascia was measured by sonography every week. Results: After treatments, NRS and FFI were reduced from 10 to 1 and from 190 to 72. The thickness of fascia was reduced from 0.43cm to 0.40. Blurring and effusion of perifascial border were also improved. Conclusion: This report suggests that the Ultrasound-guided Bee Venom Pharmacopuncture is effective for Plantar Fasciitis. Ultrasonography could be one of the most valuable items in the clinical practice of Korean medicine doctors who seek minimally invasive treatment.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.2 no.1
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• pp.1-6
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• 2009

Purpose: The goal of this study is to evaluate the relationship between the clinical findings and ultrasonographic findings of plantar fasciitis. Materials and Methods: Forty-nine symptomatic heels of 36 patients with plantar fasciitis and 21 asymptomatic heels were included. Twenty-three patients had unilateral lesions and 13 had bilateral lesions. Of these, 16 were men and 20 were women. The average age of the patients was 48.6 years. The plantar fascia thickness was measured at its insertion of the calcaneus. Qualitative parameters such as decreased echogenity, biconvexity, partial rupture and calcification of plantar fascia, and subcalcaneal spur on plain radiographs were also noted. Comparisons of ultrasonographic parameters between symptomatic heels and asymptomatic heels as well as between unilateral and bilateral groups were done. Results: There was no differences in the age, sex, body mass index, and duration of symptom between the unilateral and bilateral group. There were a statistically significant difference between the thickness of plantar fascia of unilateral group (mean 5.2 mm, SD1.5 mm) and that of bilateral group (mean 4.4 mm, SD 1.4 mm) (p=0.045). The hypoechogenity of plantar fascia and subcalcaneal spur did not differ between two groups. No fascial rupture or fascial calcification were identified. There was a statistically significant difference between the thickness of plantar fascia of symptomatic heels (mean 4.8 mm, SD1.5 mm) and that of asymptomatic heels (mean 3.1 mm, SD 0.5 mm) (p=0.000). The thickness of plantar fasia was negatively correlated with duration of symptoms (p=0.046). Conclusion: The thickness of plantar fascia in plantar fasciitis seems to be negatively correlated with the duration of symptoms, and the thickness of symptomatic heels and unilateral group was significantly thicker than that of asymptomatic heels and bilateral group, respectively.

• Physical Therapy Rehabilitation Science
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• v.7 no.1
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• pp.35-40
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• 2018

Objective: The purpose of this study was to investigate the immediate effect of applying self-myofascial release (SMR) to the plantar fascia using a foam roller on hamstring and lumbar spine superficial back line (SBL). Design: Randomized controlled trial. Methods: Thirty-one healthy adults agreed to the method and purpose of the study. Selection and exclusion criteria were screened, and baseline measurements for the Toe Touch test and passive straight leg raise (PSLR) test were obtained. The participants were then randomly assigned to the SMR group or the sham group. After group assignment, the SMR group rolled the surface of the foot from the heel to the metatarsal head using a foam roller for 5 minutes. The sham group received passive mobilization of the ankle joint in the supine position. Afterwards, the Toe Touch test and the passive straight leg-raise test were re-assessed. Results: In the SMR group, the Toe Touch test results showed significant improvement (p<0.05). Left and right PSLR test results showed a significant increase (p<0.05). In the sham group, there was no significant difference between pre and post-test results. The SMR group showed a significant difference in the PSLR test and Toe Touch test compared to the sham group (p<0.05). Conclusions: The results of this study showed that SMR on the plantar fascia was immediately effective for improving the flexibility of the SBL of the lumbar spine and hamstring.