A Multisegmental Approach to Dry Needling Plantar Fasciitis: A Case Study

in Journal of Sport Rehabilitation
View More View Less
Restricted access

Context: Plantar heel pain is a common problem affecting foot function, causing pain in the foot under the heel. Plantar fasciitis is commonly treated with conservative treatment, such as joint and soft tissue mobilization, self-stretching home programs, foot orthoses, and night splinting or booting. Dry needling (DN) has shown to be an effective method of treating plantar fasciitis (PF) in multiple randomized control trials. Dry needling is a technique that has been reported to be beneficial in managing pain and dysfunction after PF. Still, there is limited published literature on DN, a myofascial sequence as part of the treatment of PF. Case Presentation: The patient was a 38-year-old female runner referred by a podiatrist for evaluation and treatment to include DN and therapy for persistent PF in the right foot. She was treated 4 times over 3 weeks with a home exercise program. Management and Outcomes: The DN intervention was beyond the local plantar fascia and incorporated 11 locations from the foot up the posterior chain and 2 electric stim channels. The patient had reduced pain as measured by a visual analog scale, increased function as measured by the functional ankle disability index, and range of motion increases. Conclusions: This case illustrates the use of DN and a home exercise program to provide a favorable outcome in a patient with PF.

Hortz and Falsone are with Structure and Function Education, and the School of Osteopathic Medicine, A.T. Still University, Mesa, AZ, USA.

Hortz (hortzb@gmail.com) is corresponding author.
  • 1.

    Landorf KB. Plantar heel pain and plantar fasciitis. BMJ Clin Evid. 2015;2015:1111. PubMed ID: 26609884

  • 2.

    Martin RL, Davenport TE, Reischl SF, et al. Heel pain-plantar fasciitis: revision 2014. J Orthop Sports Phys Ther. 2014;44(11):A1A33. doi:10.2519/jospt.2014.0303

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    McPoil TG, Martin RL, Cornwall MW, Wukich DK, Irrgang JJ, Godges JJ. Heel pain–plantar fasciitis: clinical practice guildelines linked to the international classification of function, disability, and health from the orthopaedic section of the American Physical Therapy Association. J Orthop Sports Phys Ther. 2008;38(4):A1A18. PubMed ID: 18434670 doi:10.2519/jospt.2008.0302

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Allam AE, Chang KV. Plantar Heel PainTreasure Island, FL: StatPearls Publishing; 2021. https://www.ncbi.nlm.nih.gov/books/NBK499868/

    • Search Google Scholar
    • Export Citation
  • 5.

    Goff JD, Crawford R. Diagnosis and treatment of plantar fasciitis. Am Fam Physician. 2011;84(6):676682. PubMed ID: 21916393

  • 6.

    Hossain M, Makwana N. “Not plantar fasciitis”: the differential diagnosis and management of heel pain syndrome. Orthopaedics and Trauma. 2011;25(3):198206. doi:10.1016/j.mporth.2011.02.003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Cotchett MP, Munteanu SE, Landorf KB. Effectiveness of trigger point dry needling for plantar heel pain: a randomized controlled trial. Phys Ther. 2014;94(8):10831094. PubMed ID: 24700136 doi:10.2522/ptj.20130255

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Dunning J, Butts R, Henry N, et al. Electrical dry needling as an adjunct to exercise, manual therapy and ultrasound for plantar fasciitis: a multi-center randomized clinical trial. PLoS One. 2018;13(10):e0205405. PubMed ID: 30379937 doi:10.1371/journal.pone.0205405

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Eftekharsadat B, Babaei-Ghazani A, Zeinolabedinzadeh V. Dry needling in patients with chronic heel pain due to plantar fasciitis: a single-blinded randomized clinical trial. Med J Islam Repub Iran. 2016;30:401. PubMed ID: 27683642

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Al-Boloushi Z, Gómez-Trullén EM, Arian M, Fernández D, Herrero P, Bellosta-López P. Comparing two dry needling interventions for plantar heel pain: a randomised controlled trial. BMJ Open. 2020;10(8):e038033. PubMed ID: 32819949 doi:10.1136/bmjopen-2020-038033

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Rastegar S, Baradaran MS, Hoseinzadeh B, Badiei S. Comparison of dry needling and steroid injection in the treatment of plantar fasciitis: a single-blind randomized clinical trial. Int Orthop. 2018;42(1):109116. doi:10.1007/s00264-017-3681-1

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    He C, Ma H. Effectiveness of trigger point dry needling for plantar heel pain: a meta-analysis of seven randomized controlled trials. J Pain Res. 2017;10:19331942. doi:10.2147/JPR.S141607

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Llurda-Almuzara L, Labata-Lezaun N, Meca-Rivera T, et al. Is dry needling effective for the management of plantar heel pain or plantar fasciitis? An updated systematic review and meta-analysis. Pain Med. 2021;22(7):16301641. PubMed ID: 33760098 doi:10.1093/pm/pnab114

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Ajimsha MS, Shenoy PD, Gampawar N. Role of fascial connectivity in musculoskeletal dysfunctions: a narrative review. J Bodyw Mov Ther. 2020;24(4):423431. PubMed ID: 33218543 doi:10.1016/j.jbmt.2020.07.020

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Bolívar YA, Munuera PV, Padillo JP. Relationship between tightness of the posterior muscles of the lower limb and plantar fasciitis. Foot Ankle Int. 2013;34(1):4248. PubMed ID: 23386760 doi:10.1177/1071100712459173

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Labovitz JM, Yu J, Kim C. The role of hamstring tightness in plantar fasciitis. Foot Ankle Spec. 2011;4(3):141144. doi:10.1177/1938640010397341

  • 17.

    Martin RL, Irrgang JJ. A survey of self-reported outcome instruments for the foot and ankle. J Orthop Sports Phys Ther. 2007;37(2):7284. PubMed ID: 17366962 doi:10.2519/jospt.2007.2403

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Dekker TJ, Hamid KS, Federer AE, et al. The value of motion: patient-reported outcome measures are correlated with range of motion in total ankle replacement. Foot Ankle Spec. 2018;11(5):451456. PubMed ID: 29277111 doi:10.1177/1938640017750258

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Hale SA, Hertel J. Reliability and sensitivity of the foot and ankle disability index in subjects with chronic ankle instability. J Athl Train. 2005;40(1):3540. PubMed ID: 15902322

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Stecco C, Day JA. The fascial manipulation technique and its biomechanical model: a guide to the human fascial system. Int J Ther Massage Bodywork. 2010;3(1):3840. PubMed ID: 21589701

    • Search Google Scholar
    • Export Citation
  • 21.

    Stecco C, Stecco A. Fascial manipulation. In: Fascia: The Tensional Network of the Human Body. Churchill Livingstone; 2012:335342. doi:10.1016/b978-0-7020-3425-1.00007-6

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Stecco L. Acupuncture Western Medicine Fascial Manipulation ®. Padova, Italy: Piccin Nuova Libraria S.p.A.; 2020.

  • 23.

    Dung H. Acupuncture: An Anatomical Approach. Taylor & Francis Inc; 2013.

  • 24.

    Ali U, Apryani E, Ahsan MZ, Shoaib RM, Ahmad KA, Wang Y. Acupuncture/electroacupuncture as an alternative in current opioid crisis. Chin J Integr Med. 2020;26(9):643647. PubMed ID: 31630362 doi:10.1007/s11655-019-3175-7

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Almeida MS, Aro AA, Guerra FDR, Vieira CP, Vidal BC, Pimentel ER. Electroacupuncture increases the concentration and organization of collagen in a tendon healing model in rats. Connect Tissue Res. 2012;53(6):542547. doi:10.3109/03008207.2012.710671

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26.

    Perreault T, Flannagan SO, Grubb MT, Grubb R. Mechanisms and dose parameters of electric needle stimulation: clinical considerations—part I. Acupunct Electrother Res. 2018;30(2):1726.

    • Search Google Scholar
    • Export Citation
  • 27.

    Duan-Mu CL, Zhang XN, Shi H, et al. Electroacupuncture-induced muscular inflammatory pain relief was associated with activation of low-threshold mechanoreceptor neurons and inhibition of wide dynamic range neurons in spinal dorsal horn. Front Neurosci. 2021;15:687173. PubMed ID: 34305519 doi:10.3389/fnins.2021.687173

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Zhang RX, Lao L, Wang X, et al. Electroacupuncture attenuates inflammation in a rat model. J Altern Complement Med. 2005;11(1):135142. PubMed ID: 15750372 doi:10.1089/acm.2005.11.135

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 29.

    Eechaute C, Vaes P, Van Aerschot L, Asman S, Duquet W. The clinimetric qualities of patient-assessed instruments for measuring chronic ankle instability: a systematic review. BMC Musculoskelet Disord. 2007;8(1):6. PubMed ID: 17233912 doi:10.1186/1471-2474-8-6

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Riddle DL, Pulisic M, Pidcoe P, Johnson RE. Risk factors for plantar fasciitis: a matched case-control study. J Bone Joint Surg Am. 2003;85(5):872877. PubMed ID: 12728038 doi:10.2106/00004623-200305000-00015

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Lee SH, Suh DH, Kim HJ, et al. Association of ankle dorsiflexion with plantar fasciitis. J Foot Ankle Surg. 2021;60(4):733737. PubMed ID: 33771432 doi:10.1053/j.jfas.2021.02.004

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Pohl MB, Hamill J, Davis IS. Biomechanical and anatomic factors associated with a history of plantar fasciitis in female runners. Clin J Sport Med. 2009;19(5):372376. PubMed ID: 19741308 doi:10.1097/JSM.0b013e3181b8c270

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Hamstra-Wright KL, Huxel Bliven KC, Bay RC, Aydemir B. Risk factors for plantar fasciitis in physically active individuals: a systematic review and meta-analysis. Sports Health. 2021;13(3):296303. PubMed ID: 33530860 doi:10.1177/1941738120970976

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    Boonchum H, Bovonsunthonchai S, Sinsurin K, Kunanusornchai W. Effect of a home-based stretching exercise on multi-segmental foot motion and clinical outcomes in patients with plantar fasciitis. J Musculoskelet Neuronal Interact. 2020;20(3):411420. PubMed ID: 32877978

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Siriphorn A, Eksakulkla S. Calf stretching and plantar fascia-specific stretching for plantar fasciitis: a systematic review and meta-analysis. J Bodyw Mov Ther. 2020;24(4):222232. PubMed ID: 33218515 doi:10.1016/j.jbmt.2020.06.013

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36.

    Kamonseki DH, Gonçalves GA, Yi LC, Júnior IL. Effect of stretching with and without muscle strengthening exercises for the foot and hip in patients with plantar fasciitis: a randomized controlled single-blind clinical trial. Man Ther. 2016;23:7682. PubMed ID: 26654252 doi:10.1016/j.math.2015.10.006

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    Huffer D, Hing W, Newton R, Clair M. Strength training for plantar fasciitis and the intrinsic foot musculature: a systematic review. Phys Ther Sport. 2017;24:4452. PubMed ID: 27692740 doi:10.1016/j.ptsp.2016.08.008

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    Stecco A, Stern R, Fantoni I, De Caro R, Stecco C. Fascial disorders: implications for treatment. PM R. 2016;8(2):161168. doi:10.1016/j.pmrj.2015.06.006

  • 39.

    Bertoldo D, Pirri C, Roviaro B, et al. Pilot study of sacroiliac joint dysfunction treated with a single session of fascial manipulation® method: clinical implications for effective pain reduction. Medicina. 2021;57(7):691. PubMed ID: 34356973 doi:10.3390/medicina57070691

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 40.

    Stecco C, Stern R, Porzionato A, et al. Hyaluronan within fascia in the etiology of myofascial pain. Surg Radiol Anat. 2011;33(10):891896. PubMed ID: 21964857 doi:10.1007/s00276-011-0876-9

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 41.

    Busato M, Quagliati C, Magri L, et al. Fascial manipulation associated with standard care compared to only standard postsurgical care for total hip arthroplasty: a randomized controlled trial. PM R. 2016;8(12):11421150. doi:10.1016/j.pmrj.2016.04.007

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 42.

    Branchini M, Lopopolo F, Andreoli E, Loreti I, Marchand AM, Stecco A. Fascial manipulation® for chronic aspecific low back pain: a single blinded randomized controlled trial. F1000Res. 2016;4:1208. doi:10.12688/f1000research.6890.2

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 43.

    Day JA, Stecco C, Stecco A. Application of fascial manipulation© technique in chronic shoulder pain—anatomical basis and clinical implications. J Bodyw Mov Ther. 2009;13(2):128135. PubMed ID: 19329049 doi:10.1016/j.jbmt.2008.04.044

    • Crossref
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 345 345 297
Full Text Views 541 541 3
PDF Downloads 249 249 4