Research article

Effectiveness of calf muscle stretching for the short-term treatment of plantar heel pain: a randomised trial

Joel A Radford¹ , Karl B Landorf² , Rachelle Buchbinder³ and Catherine Cook¹

¹  School of Biomedical and Health Sciences, University of Western Sydney, Locked Bag 1797, Penrith South DC, NSW, 1797, Australia

²  Department of Podiatry, School of Human Biosciences, La Trobe University, Bundoora, Victoria, 3086, Australia

³  Monash Department of Clinical Epidemiology at Cabrini Hospital and Department of Epidemiology and Preventive Medicine, Monash University, Malvern, Victoria, 3144, Australia

author email corresponding author email

BMC Musculoskeletal Disorders 2007, 8:36doi:10.1186/1471-2474-8-36

Published:	19 April 2007

Abstract

Background

Plantar heel pain is one of the most common musculoskeletal disorders of the foot and ankle. Treatment of the condition is usually conservative, however the effectiveness of many treatments frequently used in clinical practice, including stretching, has not been established. We performed a participant-blinded randomised trial to assess the effectiveness of calf muscle stretching, a commonly used short-term treatment for plantar heel pain.

Methods

Ninety-two participants with plantar heel pain were recruited from the general public between April and June 2005. Participants were randomly allocated to an intervention group that were prescribed calf muscle stretches and sham ultrasound (n = 46) or a control group who received sham ultrasound alone (n = 46). The intervention period was two weeks. No participants were lost to follow-up. Primary outcome measures were 'first-step' pain (measured on a 100 mm Visual Analogue Scale) and the Foot Health Status Questionnaire domains of foot pain, foot function and general foot health.

Results

Both treatment groups improved over the two week period of follow-up but there were no statistically significant differences in improvement between groups for any of the measured outcomes. For example, the mean improvement for 'first-step' pain (0–100 mm) was -19.8 mm in the stretching group and -13.2 mm in the control group (adjusted mean difference between groups -7.9 mm; 95% CI -18.3 to 2.6). For foot function (0–100 scale), the stretching group improved 16.2 points and the control group improved 8.3 points (adjusted mean difference between groups 7.3; 95% CI -0.1 to 14.8). Ten participants in the stretching group experienced an adverse event, however most events were mild to moderate and short-lived.

Conclusion

When used for the short-term treatment of plantar heel pain, a two-week stretching program provides no statistically significant benefit in 'first-step' pain, foot pain, foot function or general foot health compared to not stretching.