Heel pain/ Plantar Fasciitis Flashcards
What are the key clinical findings with heel pain/ plantar fasciitis?
plantar/ medial heel pain with initial steps/ prolonged weight bearing
Recent increase in weight bearing activity
Pain with palpation at proximal insertion of plantar fascia
+ windlass test
- Tarsal tunnel test/ LLT testing/ sensation tests
- lumbar referral testing/ neurological screening
What is the windlass test?
Heel pain reproduced with passive great toe extension
What outcome measure should you use with Heel pain?
FAAM- Foot Ankle Ability Measure
FSHQ- Foot Health Status Questionnaire
FFI- Foot Functional Index
LEFS
What manual therapy techniques are indicated for heel pain/ plantar fasciitis?
Joint- Talocrural dorsiflexioin
soft tissue mobilization- plantar fascia and gastroc/ soleus trigger points
What exercises would you prescribe for plantar fasciitis? What duration would you expect relief from this alone?
plantar fascia stretching
G/S stretching
Relief for 1 week- 4 mon
What recommendation can be made for taping for those with plantar fasciitis? for how long?
Antipronation taping- for up to 3 weeks pain reduction
Or Tape applied to achilles and gastroc for 1 week pain reduction
What about orthotics for plantar fasciitis? How long do you advise this use?
OTC or pre-fab custom orthotics to support medial arch
For 2 weeks up to a year
Night splints for plantar fasciitis?
1-3 month program for night splints
Would you recommend U/S for Plantar fasciitis
No- cannot be recommended
What modalities/ physical agents could you recommend?
Iontophoresis-
Low- level laser (pain reduction. but not altering morphology)
Phonophoresis pain reduction
What footwear recommendations can you make for plantar fasciitis
Rotate footwear during work week
rocker shoes with orthotics
What is the special test to rule out tarsal tunnel and what would positive test reveal?
Max DF, eversion, and toe DF- 5 sec hold with tapping posterior to medial malleoli
+ test- tingling to foot or tenderness with palpation
What is the longitudinal arch angle?
Angle with midpoint being navicular and axis being midpoint of medial mall and the base of 1st MT
What recommendation can be made regarding heel pads?
They may be used to increase benefits of stretching
What about Low frequency e-stim?
No benefit
