OBJECTIVE: To synthesize qualitative research exploring patient experiences of lower limb tendinopathies and identify themes to support patient-centered care. DESIGN: Systematic review with thematic synthesis. LITERATURE SEARCH: MEDLINE, EMBASE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and SPORTDiscus were searched from inception to September 2024, using MeSH (Medical Subject Headings) terms and key words. Forward and backward citation tracking of included studies was performed in Web of Science. STUDY SELECTION CRITERIA: Peer-reviewed qualitative studies published at any date and using interviews or focus groups exploring perspectives on common lower limb tendinopathies (plantar heel pain, Achilles tendinopathy, tibialis posterior tendinopathy, patellar tendinopathy, gluteal tendinopathy, or proximal hamstring tendinopathy) were included. Participants of any age were eligible if diagnosed by a health care professional and symptomatic for at least 3 months. DATA SYNTHESIS: Thematic synthesis was conducted using an inductive approach. Two reviewers independently coded data. Descriptive themes were developed, refined through discussion, and structured into final analytical themes. RESULTS: Thirteen studies were included (n = 153; 84 females), with Achilles tendinopathy being the most common focus (n = 70; 7 studies). Ten themes were identified and organized hierarchically. These included psychosocial impacts; activity limitations; knowledge gaps regarding diagnoses, causes, and management; the importance of therapeutic alliance; and mixed treatment experiences. Six of 29 items in the Critical Appraisal Skills Programme Checklist for Qualitative Studies were unmet in over half of the studies. Confidence in findings ranged from low to moderate (GRADE-CERQual [Grading of Recommendations Assessment, Development and Evaluation Confidence in the Evidence from Reviews of Qualitative Research]). CONCLUSION: Lower limb tendinopathies impact patients beyond physical pain, affecting work, daily function, and sports and social participation. These challenges often lead to psychosocial consequences, including frustration, anxiety, and isolation. Strong therapeutic alliances can improve patient experiences and satisfaction with care. J Orthop Sports Phys Ther 2026;56(6):334-345. Epub 23 April 2026. doi:10.2519/jospt.2026.13666.

Background Plantar fasciitis (PF) is one of the most common causes of heel pain and is associated with significant functional limitation and reduced quality of life. Alterations in foot biomechanics and plantar pressure distribution are considered key contributors. Short foot exercises effectively strengthen intrinsic foot muscles, improve arch support, and dynamic stability. We can incorporate the arch-building gait as a short-foot exercise. This study aims to evaluate and compare biomechanical parameters and plantar forces at the forefoot, midfoot, and heel among individuals with unilateral and bilateral PF and healthy individuals, using a dynamic gait analysis system. Additionally, it analyses the correlations during barefoot walking and arch-building gait. Methods This cross-sectional study was conducted at the Department of Physical Medicine and Rehabilitation (PMR), All India Institute of Medical Sciences (AIIMS), Mangalagiri, India, over 15 months. A total of 141 participants were included: 47 with unilateral PF, 47 with bilateral PF, and 47 healthy individuals. Gait analysis was performed using the Diers Formetric 4D system (DIERS, Biomedical Solutions, Germany) to assess biomechanical gait parameters, as well as plantar force distribution at the forefoot, midfoot, and heel during barefoot walking and arch-building gait. Statistical analysis was carried out using ANOVA, the chi-square test, and Pearson's correlation coefficient, with p-values < 0.05 considered statistically significant. Results A total of 141 participants were included, with 47 in each of the following groups: unilateral (U/L), bilateral (B/L), and normal. No significant differences in biomechanical gait parameters were observed among the groups during barefoot walking. In contrast, during arch-building gait, significant differences were present in cadence and antero-posterior (A/P) centre of pressure. For barefoot walking, a significant difference in midfoot plantar force was found between the unilateral and bilateral PF groups, whereas no significant differences emerged during arch-building gait. Strong-to-moderate positive correlations were observed between barefoot walking and arch-building gait parameters across all groups. Conclusion Individuals with unilateral and bilateral PF show near-normal gait during barefoot walking. Arch-building gait reveals subtle biomechanical changes and improves plantar load distribution. These findings support that the arch-building gait activates the intrinsic foot muscles and can serve as both a sensitive assessment tool and a potential rehabilitation strategy.

BackgroundPlantar fasciitis (PF) is a leading cause of heel pain, impairing function and quality of life. While manual therapy is widely used, comparative evidence between specific techniques remains limited.ObjectiveThis study aimed to compare the effects of articulatory manual therapy (AMTG) and soft tissue massage based on the GDS muscle chains method (MCTG) on pain, function, and quality of life in individuals with PF.MethodsA two-arm, parallel-group randomized pilot trial with assessor blinding was conducted at a university physiotherapy clinic in Spain. Seventeen adults (18-65 years) with unilateral PF ≥1 month were randomized to AMTG (n = 8) or MCTG (n = 9). Both groups received 8 sessions over 4 weeks, including plantar massage, myofascial trigger point inhibition, and daily home exercises. AMTG included joint mobilizations; MCTG applied soft tissue massage based on GDS principles. The primary outcome was pressure pain threshold (PPT). Secondary outcomes included ankle dorsiflexion, dynamic balance, foot health (FHSQ), pain/disability (FFI), and quality of life (SF-12).ResultsSignificant within-group improvements were observed in PPT (p < 0.001), dorsiflexion (p = 0.005), and FFI (p < 0.001). AMTG showed greater improvement in SF-12 physical role (p = 0.045) and physical component (p = 0.049).ConclusionClinically, these findings suggest that both treatments can be considered valid options for reducing pain and improving function in patients with plantar fasciitis, although articulatory techniques offer an additional advantage in the physical component of quality of life. No adverse events were reported. Both treatments were effective; AMTG showed greater physical health benefits.

Background: Plantar fasciitis is a leading cause of heel pain, affecting approximately 10% of the population. Despite its prevalence, treatments may result in symptom recurrence and chronicity, which can significantly increase patient dissatisfaction. Google Trends provides insights into public interest through search volume analysis. This study examines global and USA trends in plantar fasciitis, focusing on temporal, seasonal, and income-based variations. Methods: Google Trends data for "Plantar Fasciitis" (2004-2024) were analyzed for both global and USA search trends. Monthly and seasonal search volumes were grouped by time and location. Regression and post hoc tests were conducted to identify significant patterns. Comparisons were made between high- and low-income states in the USA. Results: Public interest in plantar fasciitis increased significantly over time, both globally (R2 = 0.871, p < 0.001) and in the USA (R2 = 0.854, p < 0.001). Interest peaked in summer and declined in winter, with seasonal differences significant worldwide (p < 0.05). Monthly variations were significant only in the USA. No significant difference was found between high- and low-income states (p > 0.05). Conclusions: Interest in plantar fasciitis has grown steadily, reflecting its prevalence and impact. The findings emphasize the need for accessible, high-quality information to address public demand. These insights can guide healthcare professionals and policymakers in developing targeted resources.

Background: Chronic ankle instability (CAI) post-sprain leads to persistent functional deficits. This study evaluated CAI's specific impact on ankle dorsiflexion, heel lift function, stability, broader functional impairments, and quality of life. Methods: A case-control study enrolled 100 CAI patients (post-ankle sprain) and 100 healthy controls. Ankle strength (isokinetic dynamometer), stability (pressure plate), maximum dorsiflexion/plantar flexion ROM (mobility meter), functional limitations (0-10 activity scale), pain (VAS), coordination (Agility T-test, figure-of-eight test), and quality of life (FAOS) were compared. ANOVA and Mann-Whitney U tests were used. Results: Compared to controls, the CAI group showed significantly reduced ankle dorsiflexion strength (114.53 ± 10.47 N vs. 156.34 ± 13.26 N), heel lift strength (78.69 ± 5.44 N vs. 105.45 ± 8.28 N), stability scores (4.73 ± 0.52 vs. 8.65 ± 0.71 points), and ROM (dorsiflexion: 16.49° ± 1.23° vs. 22.35° ± 1.65°; plantar flexion: 27.58° ± 6.51° vs. 43.27° ± 5.45°). CAI patients reported higher activity limitation (6.34 ± 1.25 vs. 2.16 ± 0.55) and pain (5.37 ± 1.02 vs. 0.23 ± 0.01) and prolonged Agility T-test (11.24 ± 1.37 s vs. 7.51 ± 1.16 s) and figure-of-eight (16.35 ± 1.67 s vs. 12.43 ± 1.39 s) times. FAOS subscale scores (symptoms, daily activities, sports, pain) were significantly lower in the CAI group. All p < 0.05. Conclusions: CAI significantly compromises ankle dorsiflexion, heel lift strength, stability, and functional mobility, correlating with increased pain, activity restriction, and diminished quality of life. Rehabilitation should prioritize neuromuscular re-education, strength restoration, and dynamic stability training to improve outcomes.

Background: Children with juvenile idiopathic arthritis (JIA) exhibit gait abnormalities, postural instability, and compensatory movement strategies due to joint pain, inflammation, and reduced neuromuscular control. These alterations negatively affect functional mobility and movement efficiency. Although gait retraining is commonly recommended in rehabilitation, objective evidence on its short-term biomechanical effects remains limited. This study aimed to evaluate the immediate impact of a single-session standardized movement training intervention on gait biomechanics in children with JIA. Methods: Seventeen children with JIA underwent pre-post gait assessments using the Xsens MVN Awinda wearable motion capture system. The intervention focused on step symmetry, stride length, heel-toe progression, and upright trunk posture, delivered by an experienced physiotherapist following a standardized protocol. Scalar kinematic outcomes were analyzed using paired statistical tests, and time-normalized kinematic waveforms were compared with healthy reference data from 25 age-matched participants derived from the COMPWALK-ACL dataset. Results: Significant improvements were observed in multiple gait parameters following the intervention. Trunk lateral lean decreased significantly (p = 0.0002; d = -1.35), indicating enhanced postural stability. Significant changes were also found in ankle dorsiflexion-plantarflexion (p = 0.0081; d = 0.83) and knee flexion-extension (p = 0.0252; d = 0.68). Waveform analyses showed increased similarity to healthy patterns, particularly in trunk and knee kinematics. Spatiotemporal parameters reflected a slower, more controlled gait pattern, with increased stride time and stance duration. Conclusions: A single session of standardized movement training can produce immediate improvements in gait biomechanics in children with JIA, especially in trunk control and lower-limb kinematics. Wearable motion analysis provides a sensitive tool for detecting these short-term adaptations and supports the inclusion of structured movement training in pediatric JIA rehabilitation.

Background and objectives Preterm neonates undergo multiple painful procedures in neonatal intensive care units (NICU). It is difficult for nurses to utilise non-pharmacological pain control measures every time due to low nurse-patient ratio. Mother is a low-cost resource and can be integrated in management of neonatal pain. The current study was planned to compare maternal facilitated-tucking with nurse facilitated-tucking for pain alleviation following heel-lancing in preterm neonates. Methods A Randomised, controlled, two-period, cross-over trial was conducted in a level III NICU of a tertiary care hospital. Participants included preterm neonates (≤35 wk) admitted in NICU. Interventions included: facilitated-tucking provided to preterm neonates during heel-lancing by simulation-trained mothers or nurses. The tucking sequence was randomised (AB/BA sequence). The primary outcome was the premature infant pain profile - revised (PIPP-R) score. The study was registered under Trial registration: CTRI/2023/08/056592. Results Study neonates (n=45) had significantly lower PIPP-R following maternal tucking compared to nurse facilitated tucking: [10.1 (2.9) versus 11.8 (2.8); mean difference (95% CI): -1.7 (-2.8,-0.6); P=0.003]. No period effect and carry-over effects were observed. Pre-post intervention maternal confidence and parenting-self-efficacy scores were significantly higher, and stress levels were significantly lower. Interpretation and conclusions During heel-lancing of preterm neonates in the NICU, tucking performed by simulation trained mothers was associated with a significant reduction in pain compared to tucking performed by nurses.