Heel Pain & Myofascial Work
Reference:Renan-Ordine R1, et al Effectiveness of myofascial trigger point manual therapy combined with a self-stretching protocol for the management of plantar heel pain: J Orthop Sports Phys Ther. 2011 Feb;41(2):43-50.
Treating heel pain can be frustrating especially when new shoes, heel cushions, orthotics, and self stretching have failed. So you try ultrasound, shock wave, acupuncture …still no relief.
Here is another suggestion: try some myofascial work on the calf muscles. This RCT allocated 60 patients with plantar heel pain to:
i) Self-stretching + soft-tissue release (STR) techniques to the calf muscles
ii) Self-stretching program only
Result: After 4 weeks, the patients in group 1 had significantly better outcomes in tenderness, pain and function than those in group 2.
Clinical Relevance: Consider doing some kind of soft-tissue work on the gastroc-soleus complex muscles with your future patients with heel pain.
Personal Comment: With only anecdotal evidence to support it, I have found Tissue Distraction Release (TDR) with movement to be very effective for helping those with either calf cramps or heel pain.
Warn the patient that it is very painful, but the treatment lasts only 3 minutes and I typically do it for only 2 sessions; when it works, it works immediately. You may download my free TDR manual and order the cups from www.aptei.com
I personally rarely use any modalities other than the cups, (…and that is when I am desperate). If you have not yet tried TDR on tight muscles, I strongly recommend that you get a set of cups ASAP!
Posted on: July 03, 2015