Abstract:
Background and rationale: Since the plantar fascia and the Achilles tendon are anatomically connected, it is therefore plausible that stretching of both structures simultaneously will result in a better outcome. Methods: Fifty participants aged 40-60 years with a history of plantar heel pain greater than one month were recruited. They were randomly assigned into two groups. Group 1 was instructed to stretch the Achilles tendon while Group 2 simultaneous stretched the Achilles tendon and plantar fascia. The stretching interventions were performed for four weeks and the outcome measures were recorded at baseline, at the end of the 4th week, and at the end of three months. Results: After four weeks of both stretching protocol, participants in Group 2 demonstrated a greater significant increase in pressure pain threshold than participants in Group 1 (p = .040). No significant differences between groups were demonstrated in other variables (p > .05). Concerning within-group comparisons, both interventions resulted in significant reductions in pain at first step in the morning and average pain at the medial plantar calcaneal region over the past 24 hours while there were increases in the VAS-FA score and range of motion in ankle dorsiflexion (p < .001). More participants in Group 2 described their symptoms as being much improved to being completely improved than those in Group 1. Conclusion: The simultaneous stretching of the Achilles tendon and plantar fascia for four weeks is an effective intervention for plantar heel pain. Compared to the stretching of the Achilles tendon by itself, the simultaneous stretching of the Achilles tendon and plantar fascia tends to be superior in some aspects.
