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Scientific News in Foot Pain (Part 3):
Association between Plantar Fasciitis and Isolated Contracture of the Gastrocnemius
My book, The Whole Foot Book, is focused on the nonoperative treatment of foot pain. One of my main tenets is that many common chronic foot pains are caused and can be treated by correcting overloading of the forefoot. Many studies have shown an association of limited ankle dorsal flexion or gastrocnemius contracture and plantar fasciitis and other foot problems. In fact, they have shown that surgical loosening of a portion of the gastrocnemius is effective at relieving the pain. This is mentioned not so much to advocate it as a panacea for the treatment of foot problems, as there are many serious consequences to gastrocnemius lengthening, but to illustrate that directing treatment towards the underlying stiffness in the Achilles and hamstring muscles is a powerful tool in curing plantar fasciitis.
Dr. Patel and Dr. DiGiovanni (Patel A, DiGiovanni B. Association between plantar fasciitis and isolated contracture of the gastrocnemius. Foot Ankle Int. 2011 Jan;32(1):5-8.) examined people with plantar fasciitis. They found that 83% of people with plantar fasciitis had some form of limited ankle dorsal flexion or stiffness. Many of these were felt to be due to contracture of the gastrocnemius/Achilles muscles and tendons.
Other researchers have noted this in the past. One researcher, Dr. Labovitz et al. (Foot Ankle Spec, Jun 2011, 4(3), p 141-144), commented that, in addition to gastrocnemius tightness, patients with hamstring tightness were about 8.7 times as likely to experience plantar fasciitis. This helps doctors design rehabilitative treatments that are likely to help people with plantar fasciitis.
–Brett Fink, MD. Co-author of The Whole Foot Book: A Comprehensive Guide to Taking Care of your Feet
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