Isolated gastrocnemius tightness in foot pathology: diagnostics, treatment and outcomes

Abstract

Several case series report on the connection between isolated tightness of the m. gastrocnemius and different foot overload conditions. However, insufficient data exist to describe the diagnostic method, as well as expected clinical and biomechanical outcomes after the procedure. The aims of the thesis were to assess patient reported results after gastrocnemius recession for patients with different foot and ankle condition. Further to evaluate the properties of the clinical Silfverskiöld test and a new device developed for the purpose, by testing and retesting patients and healthy participants. Another aim was to evaluate the clinical and biomechanical results for patients with chronic heel pain. A randomized controlled trial was conducted and patient related outcome measures as well as tests for Achilles function, ankle motion and plantar foot pressures were evaluated. The clinical Silfverskiöld test had a low inter- and intrarater reliability, but the new ankle motion device demonstrated good properties. Patients with chronic heel pain that were operated by gastrocnemius recession scored better on all outcome scores than the control group receiving stretching exercises. Ankle motion increased and plantar foot pressures also increased. No differences regarding strength or endurance could be observed between the groups at follow up and no serious complications were observed. Gastrocnemius recession effectively relieve symptoms for patients with chronic heel pain with a low risk of complications and preserved strength.