Journal of Clinical and Diagnostic Research. 2022 May, Vol-16(5): YC05-YC08 5 5 DOI: 10.7860/JCDR/2022/53304.16373 Original Article Physiotherapy Section Effect of Foam Rolling along with Self-stretching on Pain and Range of Motion in Plantar Fasciitis Patient- A Quasi-experimental Study INTRODUCTION The most commonly known cause of heel pain is plantar fasciitis, which is seen around in 10% of non athletic and athletic population. Plantar fasciitis is commonly considered as the degeneration of the plantar fascia and could be classified as “fasciosis” or “fasciopath [1]. The most common clinical signs are first step pain after a period of rest, local tenderness mostly over the medial calcaneum, decreased pain after some activity and decreased ROM to some extent at ankle joint [2]. The calf muscle plays a role in the development of plantar fasciitis as it becomes tight and reduce the dorsiflexion movement at ankle joint [3]. As the condition becomes chronic it affects the quality of life of a person including the general health, foot specific quality, reduction in the physical activities, isolation from the society and less energetic to participate in the activities. The biomechanical alterations are because of the calf muscle tightness which leads to excessive tensile forces on the planter fascia during the stance phase [2]. The treatment option available for plantar fasciitis has a wide range and variety. Some physiotherapy treatment options are stretching and strengthening exercise, manual therapy, proper foot wear, orthotic devices, electrotherapy [1,2,4]. Non Steroidal Anti- Inflammatory Drugs (NSAIDS) and local corticosteroid injections may be recommended by the physicians [4]. Based on the previous literature findings, stretching exercises had shown the better results among all the available non surgical treatment options [2,5]. Stretching exercise have some advantages over the other treatments as it is time saving for the patient, a low cost treatment, and it can be practiced at any place or time by the patient itself. It is found that the achilles tendon stretching along with the plantar fascia stretching has almost the double effect on the pain reduction and the improvement in the dorsiflexion range of movement at ankle joint when compared with the achilles tendon stretching alone [6]. Thus, static stretching is recommended for the pain reduction and increase flexibility but it is found that static stretching is associated with decreased muscle strength and immediate sporting activities or movements [7,8]. Myofascial release or Self-Myofascial Release (SMR) is an alternate treatment option available and known for increasing flexibility and pain reduction and that too without compromising the muscle strength and force production ability. With the gaining popularity, the SMR methods like using foam roller has significantly increase the flexibility, improve arterial function, improvement in vascular endothelial function, reduction in arterial stiffness [9] and decrease in soreness of muscle [10] which makes their use more popular in general population as well as athletic population. The Golgi Tendon Organ (GTO) reflex arc model and other mechanoreceptors are the possible mechanisms to increase fascia flexibility using SMR. As there is an increase in the pressure on the fascia by the SMR, the GTOs are stimulated and there is a reduction in the firing rate of motor unit which is responsible for reduction of muscle tone [11,12]. However, it is unclear that how long the acute effect of SMR lasts but is shown in previous studies that it lasts at least for 10 minutes [7,13,14]. Jay K et al., 2014 found that there is no significant difference in flexibility at 30 minutes after the treatment between fascial release and control group [14]. It was also postulated in previous study that there is a reduction in the pain immediately after the intervention but for how long this effect can last and whether it will be beneficial for patient in home-based rehabilitation on a long SUNNY YADAV 1 , SHIKHA MALIK 2 , SARU BANSAL 3 Keywords: Heel pain, Visual analog scale, Weight bearing lunge test ABSTRACT Introduction: The most common cause of heel pain is plantar fasciitis. Previous literature suggests that stretching exercise had shown better results in the non surgical treatment options available, due to this technique muscle strength and the force production capacity is reduced. Myofascial release is an alternate technique which can improve Range Of Motion (ROM) and reduce pain without compromising the muscle performance. Aim: To evaluate the effect of foam rolling along with self- stretching on pain and ROM in plantar fasciitis patients. Materials and Methods: This quasi-experimental study was conducted between May 2020 to May 2021, at Kailash Institute of Nursing and Paramedical Sciences, Greater Noida, Uttar Pradesh, India. Thirty participants with plantar fasciitis meeting the inclusion criteria of age between 24-60 years were included and allocated into two groups by convenience sampling. Group A received self-stretching of calf and plantar fascia whereas group B received foam rolling along with self-stretching of calf and plantar fascia for three weeks. Visual Analog Scale (VAS) and Weight Bearing Lunge Test (WBLT) were recorded at baseline and by the end of 3 rd week for both the groups to measure pain and ankle ROM. Data was analysed using Statistical Package for the Social Sciences (SPSS) version 16.0 statistical software. The independent sample t-test was used for intergroup comparison and student’s paired t-test was utilised for within group comparison. The statistical difference significance was set at p-value <0.05 for all the test performed. Results: Within group analysis has shown that there was a statistically significant difference (p<0.001) in all the outcome measures in both the groups. The between group analysis showed no statistically significant difference in VAS (p=0.405) however significant difference were found in WBLT (p=0.003). Conclusion: The present study proved that both self-stretching and foam rolling with self-stretching showed significant improvement on pain and increasing ROM in plantar fasciitis. However, effectiveness of foam rolling with self-stretching was superior to self-stretching in terms of increasing WBLT.