In 2006, Wynne, et. al., conducted the study on Plantar fasciitis which is a common foot condition characterized by pain and inflammation in the plantar fascia, a thick band of tissue running across the bottom of the foot. Osteopathic manipulative treatment, specifically counterstrain therapy, has shown promise in reducing symptoms and improving outcomes in individuals with various musculoskeletal conditions. Previous research has demonstrated a decrease in stretch reflex activity in the calf muscles of individuals with Achilles tendinitis following counterstrain therapy. This study aimed to investigate the effects of counterstrain therapy on stretch reflex activity, clinical outcomes, and potential underlying mechanisms in subjects with plantar fasciitis.

A single-blind, randomized controlled trial with a crossover design was conducted, involving 20 adult subjects diagnosed with plantar fasciitis. Participants were led to believe that both counterstrain therapy and a placebo intervention were therapeutic modalities being compared. Ten subjects (50%) received 3 weeks of counterstrain treatment during phase 1, while the remaining 10 subjects received placebo capsules. After a washout period of 2 to 4 weeks, phase 2 of the trial commenced with the interventions reversed. Clinical outcomes were evaluated using daily questionnaires. Stretch reflex and H-reflex (Hoffmann reflex) in the calf muscles were assessed twice during each laboratory visit, both before and after treatment in the counterstrain phase.

No significant changes were observed in the electrically recorded reflexes of the calf muscles in response to treatment. However, significant mechanical alterations were detected in the twitch responses resulting from the electrical stimuli. Specifically, peak force and time to reach peak force both increased significantly (P ≤ .05) in the posttreatment measurements, with the counterstrain phase demonstrating a more pronounced increase (P < .05). A comparison of symptom severity before and after treatment revealed significant relief of symptoms, particularly immediately following treatment, which persisted for 48 hours.

Counterstrain therapy led to clinical improvements in subjects with plantar fasciitis. Although no electrical changes in the reflex responses of the calf muscles were observed, mechanical alterations were evident. The causative relationship between these mechanical changes and the clinical responses requires further investigation. The study’s findings suggest that counterstrain therapy may provide effective symptomatic relief in individuals with plantar fasciitis, potentially through biomechanical mechanisms that influence muscle function. Further research is needed to elucidate the precise mechanisms underlying the observed effects of counterstrain therapy in this population.

This scientific journalism article presents a study investigating the effects of counterstrain therapy on stretch reflex activity and clinical outcomes in individuals with plantar fasciitis. The research suggests that counterstrain therapy offers clinical benefits, with symptomatic relief and mechanical changes in calf muscle responses. These findings contribute to the understanding of the therapeutic potential of counterstrain therapy in managing plantar fasciitis and highlight the need for further exploration of its underlying mechanisms.

Reference: Wynne, M. M., Burns, J. M., Eland, D. C., Conatser, R. R., & Howell, J. N. (2006). Effect of counterstrain on stretch reflexes, hoffmann reflexes, and clinical outcomes in subjects with plantar fasciitis. Journal of Osteopathic Medicine, 106(9), 547-556.