Category Archives: Musculoskeletal

Platelet Rich Plasma for Plantar Fasciitis – writing about something I know nothing about…

Platelet Rich Plasma for Plantar Fasciitis

I have to be honest and admit that the use of platelet rich plasma (PRP) for plantar fasciitis is something that I have had no more than a superficial interest in. I pretty much scanned the abstracts of the studies and systematic reviews as they are published of it in this thread and the one comparing it to other interventions on Podiatry Arena. I also note comments in social media on it from those whose views I respect. From my superficial understanding, it works, it does not work, it works, it does not work … a lot of the studies that compare it to other treatments do not do the “other” treatment very well (ie wrong dosing), which can easily bias the study to PRP being better. Some of the comments in social media from people who I consider real experts, especially in the context of tendinopathy are that it does not work, yet a lot of people claim it does. Yes, I know that the “plantar fasica” is not a “tendon” and it may or may not be appropriate to translate “tendinopathy” research to “plantar fasciitis” (not that this stops people doing so or not doing so if the research on it matches their pre-conceived biases!).

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Plantar fasciitis loading programs – overhyped evidence

I have managed to get myself into a few spats in social media lately over the results of the Rathleff et al (2014) study on loading programs for plantar fasciitis mainly because I think the study is way overhyped and blindly and widely shared by too many devoid of critical thinking skills. I blogged about this study at the time on my other blog, so thought I would re-litigate the main issues here, so I can refer those in my social media spats to have a read of.

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Natural Cures for Heel Spurs – the quack is strong in this one.

The whole ‘natural cures’  industry is a scam. Just because something is natural does not make it better. Arsenic is natural. Ionizing radiation is natural. Neither of them are any good for you. Arguing that something is better because it is natural is a logical fallacy.

As for the natural cures for heel spurs in the infographic below. None of them will or can work. Its that simple. It is physiologically implausible and biologically impossible for any of them to work; let alone there being a single shred of evidence showing they work. I never cease to be amazed at those who should know better are so devoid of any critical thinking skills.

 

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Sometimes academics do overthink things

I have to be careful what I say here as I am criticizing my professional colleagues, but …

A while back there was this a couple of studies on proximal changes in those with Achilles tendinopathy. I blogged about one of them here and the other one is here. Both studies found those with Achilles tendinopathy did have change in proximal function such as muscle activity and hip motion. Both studies did lead the author to discuss the role of the proximal structures in Achilles tendinopathy. This lead to responses in social media on how important the hip and core are and that we need to focus the treatment interventions there. This was despite that this is not what the studies showed as correlation is not causation.

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Is forefoot varus related to patellofemoral osteoarthritis?

It is if you believe this study that just appeared in prepublication. However, yet again the editorial and peer review processes let us down as that is not the case at all. The authors and the peer reviewers superficial understanding of the issues have led them to conclusions that are not substantiated and should not have made it to publication.

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JAPMA lets us down again: Shock wave for mortons neuroma

Back in 2009, the Journal of the American Podiatric Medical Association (JAPMA) published this impressively titled study: Extracorporeal Shockwave Therapy for Interdigital Neuroma: A Randomized, Placebo-Controlled, Double-Blind Trial that found:

The treatment group showed a significant difference before and after extracorporeal shockwave therapy (P < .0001). The sham group did not have a significant difference after 12 weeks (P = .1218).

and as such concluded

Conclusions: Extracorporeal shockwave therapy is a possible alternative to surgical excision for Morton’s neuroma

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