PAIN FROM PLANTAR FASCIITIS

Introduction: Fasciitis of the foot is an inflammatory condition characterized by pain in the medial, central and lateral sectors of the sole accompanied by stiffness. The aim of this study was to examine and interpret the features of the pain focus in this condition from a clinical and esthesiological point of view and in relation to the objective findings of a biomechanical evaluation. Material and Method: Twenty-two subjects (17males, 5 females), aged 19-51 years were examined who practised sport regularly; all presented pain in the sole of the foot. Each subject underwent a clinical and esthesiological examination with measurement of pain thresholds to electrical stimulation of the skin, subcutaneous tissue and muscle in the trigger point zone and unaffected controlateral area and also an evaluation of biomechanical parameters related to function by means of an analysis of the foot-ground reaction and peak force revealed by isokinetic dynamometer. The patient were then fitted with a corrective insole and re-subjected to the above examinations after 30 and 60 days. Results: The subjects were divided into 3 groups on the basis of the TrP site and area of referred pain, as follows:Group A (12 cases) had fascial pain in the calcaneum attachment. The objective examination showed an active TrP determining referred pain in the median part of the sole of the foot. Group B ( 8 cases) had pain localized in the middle third of the medial part of the fascia. The objective examination showed an active TrP causing pain radiating disto-proxiamlly to the attachment of the peroneus muscle at the base of the V metatarsus. The esthesiological evaluation of these groups showed lowered pain thresholds in the skin and muscle compared with the controlateral areas. The isokinetic examination revealed a significant decrease in the peak force in concentric contraction and peak force in eccentric contraction. The foot-ground reaction were abnormal for same spatial and temporal components. A significant reduction of the painful symptoms was observed in these subjects after 30 days with corrective insole, together with a normalization of locomotion. After 60 days, the pain had disappeared and there was an objective reduction of the irritability of the TrPs and absence of the target zone. The esthesiological examination of the pain threshold to electrical stimulation of the skin and muscle showed a further increase with respect to the previous control. All components of the foot-ground reaction were improved. Conclusion: These results show that pain from fasciitis of the sole of the foot is due to an abnormality of movement which gives rise to an imbalance of the force and flexibility of the flexor muscle in this area. The improvement of the ground-foot reaction brings about a gradual disappearance of the painful symptoms

PLANTAR FASCIITIS: AN UPDATE ON CLINICAL AND BIOMECHANICAL FEATURES

Plantar fasciitis is an inflammatory condition, characterized by pain in the medial, central and lateral plantar compartments, accompanied by stiffness. The purpose of this study is to compared 30 runner affected by plantar fasciitis to a. control group and to point out 1) the different areas of pain and referred pain, 2) the isokinetic muscular performance of the plantar flexor muscle, by means of a Cibex 6000 isokinetic dynamometer and tests performed concentrically and eccentrically at 30, 60, 90, 180 deg/sec. 3) the data of the foot-ground reaction got by means of a. dynamometric platform. Results: In all the three sectors of plantar fascia there are different areas of pain and referred pain. An high incidence of plantar flexor muscle strength deficits has been showed both during concentric and eccentric contraction, and in addition the ankle range of motion is reduced. The gait analysis has shown a persistent alteration of the foot-ground reaction's parameters. The Aa. present the results of the treatment based on the correction of biomechanical deficits with follow-up of three years

EFFECT OF TAPING ON THE SOCCER ANKLE LATERAL INSTABILITY: A BIOMECHANICAL STUDY

Chronic ankle joint instability, mechanical and/or functional, is common among athletes. The aim of this study is to evaluate, in the area of mechanical instability, the effect of the ankle adhesive tape related to the kind of ground reaction, and to evaluate with stress radiography its efficiency to determine the static stability. Material and Methods Ten soccer players (mean age 19.5 y) with ruptures of the calcaneo-fibular ligaments were tested during normal walking and running on the Bertec platform. The evaluation was repeated after 1 hour. The subjects were also studied using standardized radiographies. An elastic tape that was applied to the ankle, was the basket weave type combined with stirrup and heel lock. Results According to Karlsson, the reduction of the mechanical ankle instability by ankle tape, when evaluated with stress x-rays, is not significant. The data of the first ground-reaction analysis showed a significant reduction of the area of the lateral shear and also of the lateral shear peak in the terminal stance during walking; the reduction was not significant during the runnings. The analysis of the ground-reaction during walking afkr one hour of taping showed a disappearance of the first result. These results need to be confirmed in a greater number of subjects