Effect of Ultrasound and Calf Stretching in relieving Gastrocnemius Tightness in subjects with Plantar Fascitis

Objective: To evaluate the efficacy of ultrasound and calf stretching in subjects with gastrocnemius tightness in plantar fascitis to reduce pain and improve functional ability. Method: 30 patients with plantar fascitis selected from Saveetha college of physiotherapy and rehabilitation center (SPARC) based on inclusion and exclusion criteria. The patients were treated with ultrasound therapy and calf stretching. The pre and post test values of pain and functional ability was be calculated using Silfverskiold test and Foot Function Index as an outcome measure. Results: The mean value and standard errors were calculated for different variables and the difference in mean value was tested for statistical significance using paired t test. P value of <0.0001 was considered as statistically significant. Conclusion: From the statistical analysis and graphical interpretation the final derived results concluded that combined therapy of ultrasound and calf stretching is found to be effective in relieving gastrocnemius tightness in patient suffering with plantar fascitis and it can be used to improve the functional activities.

A Predictive Model for Gastrocnemius Tightness in Forefoot Pain and Intractable Plantar Keratosis of the Second Rocker

Background Many people experience gastrocnemius tightness. Few studies demonstrate the relationship between gastrocnemius tightness and forefoot pathology. This study aimed to define the association between intractable plantar keratosis of the second rocker (IPK2) (also known as well-localized IPK or discrete keratosis) and metatarsalgia. Methods The Silfverskiöld (ST) and lunge (LT) tests, used for measuring ankle dorsiflexion, were applied to diagnose gastrocnemius tightness. An instrument for measuring accurate performance and the force to be applied (1.7–2.0 kg of force to the ankle dorsiflexion) complemented the ST for clinical diagnosis and to obtain repeatedly reliable results (the authors apply force manually, which is difficult to quantify accurately). Results Of 122 patients studied, 74 were used to devise a prediction model from a logistic regression analysis that determines the probability of presenting gastrocnemius tightness in each test (LT and ST) with the following variables: metatarsalgia, IPK2, and maximum static pressure (baropodometry). The IPK2 plays the principal role in predicting this pathology, with the highest Wald values (6.611 for LT and 5.063 for ST). Metatarsalgia induces a somewhat lower change (66.7% LT and 64.3% ST). The maximum pressure of the forefoot is equally significant (P = .043 LT and P = .025 ST), taking α &lt; .05 as the significance level. Conclusions The results of this validation report confirm that a model composed of metatarsalgia, IPK2, and maximum pressure in static acts as a predictive method for gastrocnemius tightness.

Correlation Between Gastrocnemius Tightness and Heel Pain Severity in Plantar Fasciitis

Background: It is known that there is an association between gastrocnemius tightness and plantar fasciitis, but this has never been quantified. The purpose of the study was to determine the correlation between gastrocnemius tightness and the severity of heel pain in plantar fasciitis. Methods: Thirty-three patients were prescribed physiotherapist-directed gastrocnemius stretching exercises, a Strassburg Sock or night splint, and silicone heel insoles as required. Outcome measures included (1) gastrocnemius tightness, (2) 100-mm visual analog scale (VAS) for pain on the first steps in the morning, and (3) 100-mm VAS for the worst pain felt during the previous week. Gastrocnemius tightness was measured by the difference in maximal ankle dorsiflexion between knee bent and straight with a goniometer. Results: The mean gastrocnemius tightness was 22 degrees at baseline compared with 9 degrees at the final follow-up ( P < .01). A reduction in VAS for pain on the first steps in the morning and VAS for the worst pain felt during the previous week from baseline to final follow-up was observed ( P < .01). Correlation analysis of 105 data points between gastrocnemius tightness and VAS for pain on the first steps in the morning was R = 0.757 ( P < .001), and between gastrocnemius tightness and VAS for the worst pain felt during the previous week was R = 0.781 ( P < .001). Conclusion: The study observed a strong, statistically significant correlation between gastrocnemius tightness and the severity of heel pain in plantar fasciitis. Level of Evidence: Level IV, case series.

GASTROCNEMIUS TIGHTNESS AFFECTS HIP AND PELVIC MOVEMENT IN GAIT

The passive extensibility of skeletal muscles is an important health-related component of physical fitness. Tight gastrocnemius is a common orthopedic problem and frequently leads to overuse injuries of the lower extremity. Moreover, gastrocnemius tightness is commonly associated with lower back pain. Previous studies have reported that tight gastrocnemius results in kinematic and kinetic deviations of the ankle and knee during gait and a greater hip flexion at the moment of maximal ankle dorsiflexion. Accordingly, this study performs an experimental investigation into the effects of tight gastrocnemius on the hip and pelvic movements in gait. Sixteen subjects with tight gastrocnemius (defined as [Formula: see text] of ankle dorsiflexion with knee extended) and 16 healthy individuals matched by age and gender participated in the study. The three-dimensional angles of the hip and pelvis and moments of the hip were obtained for both groups during the stance phase of gait using force plates and a motion analysis system. Compared with the control group, the peak hip flexion angle is significantly higher in the tight group ([Formula: see text]), while the peak hip extension angle is significantly lower ([Formula: see text]). Moreover, the peak pelvic anterior tilt is significantly higher than that of the control group ([Formula: see text]), while the peak pelvic posterior tilt is significantly lower ([Formula: see text]). Finally, the peak extensor moment of the tight group is significantly higher than that of the control group ([Formula: see text]), while the peak flexor moment is significantly lower ([Formula: see text]). The results confirm that tight gastrocnemius leads to changes in the three-dimensional hip and pelvic angles and hip moments during gait. Disturbance of the hip and pelvic movement is thus a critical clinical consideration when evaluating soft tissue injuries in patients with tight gastrocnemius.