Taping for Plantar Fasciitis
SENTARA IN-SERVICE: 6/18/2015 KAYLEA KIRVEN, SPT Plantar Fasciitis: Statistics
Most common cause of foot pain Accounts for 11-15% of all foot pathologies in adults Heel spur MYTH Risk Factors: Excessive foot pronation Excessive running/ activity High arch Leg length discrepancy Obesity/ sedentary Prolonged standing/ walking occupations Decreased ankle ROM Achilles tendon tightness/ foot intrinsic muscle tightness Occurs in approximately 2 million Americans each year particularly individuals between the ages of 40 and 60 years old. Although some individuals with plantar fasciitis have heel spurs, spurs are NOT typically the cause of plantar fascia pain. 1 out of 10 individuals have heel spurs, but only 1/20 (or 5%) w/ heel spurs have foot pain or plantar fascia pain. Therapeutic Taping Purpose: Most Common Types of Heel Taping:
Pain Reduction Joint Support / Arch Tension Reduction External splint that indirectly supports arch Proprioceptive Feedback Muscle Tone Normalization Most Common Types of Heel Taping: Low-dye Taping (LDT) Calcaneal Taping Windlass Taping Most common types of heel taping found in the current literature: Reducing tension in arch Taping for Plantar FasciitisRoman Podolsky & Leonid Kalichman (2015) Journal of Back and Musculoskeletal Rehabilitation Purpose: To investigate the efficacy of different taping techniques in relieving sxs & dysfunction caused by plantar fasciitis Databases: PubMed, CINAHL, PEDro, ISI, Web of Science, Google Scholar Design: 5 RCT, 2 cross-over studies, 1 repeated measures study Sham Taping or Plantar Fascia Stretching Plantar Fasciitis Taping
Landrof et al. Radford et al. Hyland et al. Vishal et al. Pain Duration: 0.9 yrs 0.83 yrs Not given >0.08 yrs Intervention: LDT + Sham US 3 x/ 3 wks Control: Sham US LDT 1 wk No taping Calcaneal Taping Sham Taping or Plantar Fascia Stretching Intervention1 : Intervention 2: Plantar Fasciitis Taping Combined intervention favored VAS, Patient Satisfaction (20% greater) LDT significantly first step pain at 1 wk Calcaneal Taping significantly pain (VAS) at 1 wk Intervention 1 & 2 showed statistically significant improvement in pain score & FFI VAS scores when walking & jogging VAS scores following LDT
El Salam et al. Van Lunen Ha et al. Jamali et al. Pain Duration: >0.08 yrs Not given Intervention 1: LDT 9 sess/3 wks Intervention 2: Medial Arch Support 9 sess/ 3 wks Heel-pain orthosis Intervention: Windlass Taping Interv. 1 & 2: p! fxn Post-VAS & Post-FDPS more in MAS group VAS scores when walking & jogging VAS scores following LDT VAS scores at 24 hrs. No biomechanical explanation for use Rob The windlass taping technique was utilized in only a single-group repeated measures study on 20 subjects w/ PF Uses a low-dye tape with active hallux dorsiflexion and eversion of the forefoot to stabilize the first ray 19/20 reported a decrease in pain post-taping Discussion: Various taping techniques for relieving plantar fasciitis pain in the short-term [24 hrs 3 weeks] In acute or chronic stages In lieu of or prior to use of orthotics Most common (5/8 studies) = LDT Goal: To decrease medial heel pressure by lifting the navicular bone 2nd most common (2/8 studies) = Calcaneal Taping Goal: To invert calcaneus so it is closer to neutral alignment Increasing medial longitudinal arch height All taping techniques aimed at correction foot biomechanics similar to foot orthotics but the advantage of tape is its availability & adjustability in accordance to pts anatomy & symptom changes. Taping can be applied in the acute LDT vs. Calcaneal Taping: LDT: aimed at providing extra support to medial longitudinal arch (midfoot focus) Calcaneal taping: aimed at repositioning calcaneal alignment closer to neutral , thus increasing MLA height, thus reducing stress & subsequent micro traumas to the plantar fascia (rearfoot focus) 4 pieces of tape RCT of Calcaneal Taping, Sham Taping, and Plantar Fascia Stretching for Short-Term Management of Plantar Heel Pain Hyland et al. (2006) JOSPT Purpose: To determine if calcaneal taping will provide a greater in p! & a greater in functional activity when compared to plantar fascia stretching, sham taping, & no treatment Inclusion Criteria: 18 65 yrs old > 3/10 first step pain in AM P! located at heel or plantar surface of midfoot (Consistent w/ plantar fasciitis) Everted calcaneus > 2 Exclusion Criteria: Previous surgery or tx for plantar fasciitis in previous 6 mo or during study period Hx of foot or ankle fracture Congenital deformity of foot or ankle LE spasticity Assistive device for ambulation Methods: Randomly Assigned to 1 of 4 groups
Duration: 1 week (VAS, PSFS) Maintain usual activity level No termination of activity No initiation of new activity Group 1: Stretching Group 3: Control(NT) Group 2: Calcaneal Taping Group 4: Sham Taping Passive stretching of plantar flexors & plantar fascia (day 1, and either day 3 or 4) Stretched soleus w/ knee flexed Stretched gastroc w/ knee extended Stretch applied to great toe to incorporate stretch to plantar fascia = 3 x 30 sec hold in clinic; Not to be performed at home Group 1: Stretching Passive stretching of plantar flexors & plantar fascia (Day 1 & either Day 3 or 4) Soleus m. Gastrocnemius m. Great Toe 3 x 30 sec in clinic ;NOT to be performed at home Passive stretching of plantar flexors & plantar fascia (day 1, and either day 3 or 4) Stretched soleus w/ knee flexed Stretched gastroc w/ knee extended Stretch applied to great toe to incorporate stretch to plantar fascia = 3 x 30 sec hold in clinic; Not to be performed at home Group 2: Calcaneal Taping
Rear-foot Focus Goal: To invert heel to raise medial longitudinal arch 4 pieces of tape: Easier application Faster application Less expensive than techniques using larger quantities of tape Group 3: Control/ No Treatment
Measured at baseline Measured at 1 wk w/ no treatment provided Group 4: Sham Taping Cover-Roll & Leukotape overlaid on skin
NO medially-directed force applied to tape during application Results: Stretching frequency may have been insufficient to get or expect greater results; Patients instructed not to replicate at home Slight reduction in VAS p! in sham taping group May be due to proprioceptive feedback from the tape (placebo effect) Results: Within 2 treatment sessions:
Calcaneal taping resulted in a significantly greater reduction in VAS p! than stretching, sham taping, or no treatment Limitations: Stretching frequency Small sample size Long-term benefits of taping? Chronicity on p! reduction Is there continued reduction in symptoms with taping? Does taping remain more effective than stretching over time? Duration of symptoms not obtained, so the effect of chronicity on pain reduction was not examined Take-Home Message Taping provides immediate plantar heel p! relief
Taping to be used as a short-term bridge between other long-term therapies Taping addresses both pain relief & poor foot biomechanics Unlike US, laser, ionto, cryotherapy taping addreses Demonstrations/ Links for Instructions
Low-Dye Taping: Apta.org/APTAMedia/Handouts/PT2012/selectmanagement_McPoil_1.pdf [Pg. 3] https://www.dailymotion.com/video/x158dtx_plantar-fasciitis-taping_news Demonstrations/ Links for Instructions
Calcaneal Taping: Windlass Taping: [Pg ] Calcaneal taping: Pg 4 Windlass taping: Pg 7-8 References: Hyland MR, Webber-Gaffney A, Cohen L, Lichtman PT. Randomized controlled trial of calcaneal taping, sham taping, and plantar fascia stretching for the short-term management of plantar heel pain.J Orthop Sports Phys Ther. 2006;36(6):364371. James D. Goff, Roert Crawford, Summa Health System, Akron, Ohio Am Fam Physician.2011Sep15;84(6): Landorf K, Menz H. Plantar heel pain and fasciitis. Clin Evid. (Online) 2008; 2008: 1111. References: Radford JA, Landorf KB, Buchbinder R, Cook C. Effectiveness of low-Dye taping for the short-term treatment of plantar heel pain: a randomised trial.BMC Musculoskelet Disord. 2006;7:64. Riddle DL, Pulisic M, Pidcoe P, Johnson RE. Risk factors for plantar fasciitis: A mached case control study. J Bone Joint Surg Am. 2003: 85-A: Roman Podolsky and Leonid Kalichman. Taping for plantar fasciitis: Review article. Journal of Back and Musculoskeletal Rehabilitation. 2015; 28:1-6