Effects of Myofascial Trigger Point Dry Cupping on Plantar Heel Pain
Condition: Plantar Fasciitis; Heel Spur Syndrome; Chronic Plantar Fasciitis
MeSH terms: Fasciitis; Fasciitis, Plantar; Heel Spur
Study type: Interventional

Summary: 
      The main aim of this study is to investigate the effects of dry cupping on calf muscle
      trigger points in patients with plantar heel pain. A secondary aim is to examine the
      correlation between several outcome measures in those patients.
    

Detailed description: 
      Plantar heel pain is a condition often seen by healthcare providers. It is presented as pain
      and tenderness under the heel with weight bearing activities. Approximately 15% of athletic
      and non-athletic adults who have foot complaints seek professional care for plantar heel
      pain. There are different names and definitions for this condition in the literature such as
      plantar heel pain, plantar fasciitis, plantar fasciosis, plantar fasciopathy, heel spur
      syndrome, and jogger's heel. The reason for inconsistency in defining the condition is due to
      disagreement on the underlying pathology. A number of conditions may result in plantar heel
      pain, namely plantar fasciitis (most common), calcaneus fracture, heel fat pad atrophy, and
      peripheral nerve dysfunction. Recently, several studies have shown that myofascial trigger
      points (MTrPs) or tender points in the calf muscles may be associated with plantar heel pain.
      Many studies have determined risk factors in the development of plantar heel pain,
      classifying them as either intrinsic or extrinsic. Intrinsic risk factors comprise the
      anatomical (ROM of the ankle and subtalar joints position) or demographic characteristics of
      the individual (age, gender, weight and height). Extrinsic risk factors are related mainly to
      the subject's activity environment, such as running on a hard surface, time spent weight
      bearing, and previous injury. All these factors lead to an increase in the mechanical load on
      the foot, specifically the plantar fascia. Treatment of plantar heel pain usually targets the
      plantar fascia or other structures in the plantar heel area using several interventions such
      as cortisone injection, therapeutic ultrasound, laser, ice, heel pads, and night splints.
      Evidence varies regarding the effectiveness of these interventions.

      The main aim of this study is to investigate the immediate and carry-over effects of dry
      cupping on calf muscle trigger points on pain and function in patients with plantar heel
      pain.
    

Intervention name(s): Dry cupping; Stretching exercises
Intervention type(s): Device; Other
Intervention description(s): Dry cupping. First, the therapist identified the trigger point on calf muscle.After identification of the trigger point, the participant was in prone with the ankle outside the edge of the bed. Ultrasound gel was then placed over the trigger point as a lubricant to increase the suctioning of the plastic vacuum cup, after which the cup was placed. Air was withdrawn from the cup to create a suction force. The cup was maintained for 10 minutes, and the participant was asked to do active ankle dorsiflexion exercise after 5 minutes of placing the cup. The therapist held the cup in place while the participant performed exercise.; The participant was in prone with the ankle outside the edge of the bed. The participant was asked to do active ankle dorsiflexion exercise after 5 minutes of lying on bed.
Standing self-stretching of the calf muscles.
Plantar fascia-specific self-stretching.The participant was instructed to start gently at first and then to work more aggressively as long as the pain is tolerable.
All stretches were done six times and the duration of each stretch is 30 seconds.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Cupping; Dry cupping; Myofascial trigger points