Heel pain CPG

Question 1

In regards to foot pain, what is the most common condition diagnosed in patients by health care providers?

Answer 1

Plantar fasciitis

Question 2

Does plantar fasciitis affect athletic or non-athletic populations?

Answer 2

Both

Question 3

Describe nonathletic and athletic population trends in those affected with plantar fasciitis:

Answer 3

Non-athletic with limited df and higher BMI

Athletic runners esp with varus hind foot posture, workers with hard surfaces and much jumping on/off equipment

Question 4

Classically, what are four subjective/objective factors leading to diagnosis of plantar fasciitis:

Answer 4

1) pain with palpation at medial plantar heel region
2) highest pain with first few steps in AM/ after long periods of inactivity
3) worse pain with prolong WB
4) pain is precipitated by inc in WB related activity

Question 5

Do those with plantar fasciitis typically have a high or low score on the Foot Posture Index according to the CPG?

Answer 5

Typically have high FPI score = more pronated foot

Question 6

How can you differentiate between plantar fasciitis and fat pad syndrome?

Answer 6

1) pain at night

2) no pain after first few steps in AM

Question 7

True/false: calcaneal spur is necessary to make radiographic diagnosis of plantar fasciits

Answer 7

False - not a key radiographic feature

Question 8

What outcome measure has been validated for physical therapy practice in regards to plantar fasciitis?

Answer 8

Foot and ankle ability measure - FAAM

Question 9

What is the MDC / MCID for the FAAM?

Answer 9

MDC - 5

MCID - 8-9

Question 10

In terms of exercise prescribed for plantar fasciitis, what has the most positive effect and highest weighted evidence?

Answer 10

Stretching esp for plantar fascia and gastroc/soleus

Weaker evidence for strengthening and motor control for MLL, corrective movement

Question 11

Does taping provide short- or long-term pain relief for plantar fasciitis?

Answer 11

Short-term

Question 12

What group of patients may respond better to either prefab or custom orthoses for plantar fasciitis?

Answer 12

Those who had positive response to taping

Question 13

Do prefab or custom orthoses have short- or long-term relief for plantar fasciitis?

Answer 13

Both - depending on study looked at

Question 14

When and for how long should night splints be used for plantar fasciitis?

Answer 14

With diagnosis > 6 months and should be worn for 1-3 months for best outcome

Question 15

What two modality applications may be useful for plantar fasciitis?

Answer 15

Phonophoresis with ketoprofen gel

Laser

Question 16

What two modality applications are not recommended for use with plantar fasciitis?

Answer 16

Ultrasound

Estim

Question 17

True/false: rotating shoes during the work week may have positive impact on plantar fasciitis

Answer 17

True

Question 18

True/false: rocker bottom shoes with a foot orthosis can be helpful with plantar fasciitis

Answer 18

True