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OCS Preparation > Heel pain/Plantar fasciitis > Flashcards

Heel pain/Plantar fasciitis Flashcards

1
Q

What is the evidence grade for manual therapy and what is its goal in regards to plantar fasciitis?

A

Grade A - Treat lower extremity joint mobility and calf flexibility, decrease pain and improve function.

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2
Q

What technique is being used here and what’s its purpose?

A

STM to the soleus and weight bearing to increase dorsiflexion.

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3
Q

What is the technique applied and what is the target muscle?

A

STM to the medial head of the gastrocnemius for dorsiflexion ROM.

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4
Q

What technique is being applied here, what is the target structure and the goal?

A

STM to the pre-tibials for extensibility.

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5
Q

What technique is being demonstrated and what is the purpose?

A

Anterior grade mobilization of the mortise on the talus for dorsiflexion.

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6
Q

What is the technique being applied and what is the purpose?

A

Grade mobilization to gain rear foot mobility or decrease pain.

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7
Q

What technique is this and what is the purpose of it?

A

Talocrural long axis distraction thrust manipulation.

The purpose is to increase dorsiflexion.

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8
Q

What is the technique and what is the purpose of it?

A

Cuboid or navicular thrust manipulation aimed at decrease arch pain or heel pain.

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9
Q

What is the technique applied and what is the purpose of such technique?

A

Mobilization with movement in weight bearing of mortise on talus to increase dorsiflexion.

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10
Q

What is the indication for stretching for heel pain and plantar fasciitis and what is the grade of evidence?

A

Grade A

Use plantar fascia and gastroc/soleus stretching for

short-term pain relief.

Use heel pads to increase beneftis.

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11
Q

What are the recommendation for neuromuscular facilitation and strengthening and grade of evidence for heel pain?

A

Grade F

Strengthening exercises to control pronation and attenuate forces during weight bearing activities.

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12
Q

What is the pictured exercise and what is the purpose of it?

A

This is a plantar fascia stretch.

Shoulder performed with toe dorsiflexion as well as stretching of the sole of the foot.

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13
Q

What is the exercise depicted and what is the purpose?

A

Gastroc stretch.

Increase dorsiflexion.

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14
Q

What is the recommendation for tape for patients with heel pain related to plantar fasciitis?

A

Grade A

Consider use of anti-pronation tape for short-term relief.

Elastic tape to the gastrocnemius for short-term pain reduction (1 week)

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15
Q

What is the purpose of the technique depicted?

A

Lo-die - McConnel tape

Off-load the heel fat pad.

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16
Q

What is the test being performed and what it the differential diagnosis it confirms in terms of heel pain/plantar fasciitis?

A

Windless test

(Heel fat pad irritation)

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17
Q

What is the purpose of this taping technique?

A

Off-load the plantar fascia.

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18
Q

What is the purpose of this taping technique?

A

Tape type: Zinc Oxide

Tape Sliper

Support the longitudinal arch

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19
Q

Should therapist use foot orthosis and what is the level of evidence for the recommendation?

A

Level A

Consider using pre-fabricated or custom foot orthoses to support longitudinal arch.

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20
Q

What patients respond better to foot orthoses?

A

Those patients who responde positively to antipronation taping technique.

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21
Q

What devices could be used to heel pain?

A

Off the shelf semi-rigid devices

Heel pads

Gel heel cups

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22
Q

What should be the recommendation for night splints in plantar fasciitis?

A

Evidence level A

1-3 months of night splints for individuals with heel pain/plantar fasciitis who have first step pain in the morning.

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23
Q

What are the physical agents recommended for plantar fasciitis?

A

1 - Electrotherapy - Level D

2 - Low level laser (new) - Level C

3 - Phonophoresis (new) Ketoprofen - Level D

4 - Ultrasound - Level C (Not recommended)

24
Q

What footwear should be recommended for patients with plantar fasciitis?

What is the level of evidence?

A

Rocker-bottom shoes + foot orthoses

Rotation of shoes during the work week for those who stand for long periods of time.

25
Q

What is the recommendation for education and weight loss for plantar fasciitis?

A

Level D

Education and counseling regarding weight loss for optimal body mass.

Referral to appropriate professional.

26
Q

What is the recommendation for dry needling for plantar fasciitis?

Level of evidence.

A

Level F

It cannot be recommended at this time.

Study from 2014

27
Q

Are steroid injections beneficial for heel pain/plantar fasciitis?

A

No. Clinical benefits did not outweigh the risk of harm.

Risk of plantar fascia rupture.

28
Q

Is shockwave therapy indicated for plantar fasciitis?

A

Better studies did not favor the use of shock wave therapy.

29
Q

How many levels of evidence are there for plantar fasciitis guidelines and what are they derived from?

A

I-V

I - High level studies

II - Lower level studies

III - Case controlled studies or retrospective studies

IV - Case series

V - Expert opinions

30
Q

What are the grades of recommendation?

A

A - F

A - Strong evidence -

B - Moderate evidence

C - Weak evidence

D - Conflicting evidence

E - Foundational evidence

F - Expert opinion

31
Q

What is the lifetime percentage of people expected to be affected by plantar fasciitis?

A

10% of the population

(Approximately 2 million people)

32
Q

What is the prevalence of plantar fasciitis in runners?

A

5-18%

33
Q

What are the most common foot overuse injuries?

A

Achilles tendinopathy

Plantar fasciitis

Stress fractures

34
Q

What is the relation between plantar fascia thickness and plantar fasciitis?

A

Increased thickness is associated with symptoms and altered compressive properties of the fat pad and plantar heel pain.

35
Q

What is the strongest contributor for disability of people with general foot and ankle disability?

A

Pain-related fear of movement.

36
Q

What is the mean duration of symptoms for people with heel pain related to plantar fasciitis?

A

13.3 to 14.1 months.

37
Q

What are risk factors for plantar and heel pain according to 2014 CPGs?

A

High body mass (in nonathletic population)

Decreased dorsiflexion range of motion

Running

Work-related weight bearing activities (with poor shock absorption)

38
Q

What is the relationship between hamstring tightness and leg length discrepancy and plantar fasciitis?

A

Plantar fasciitis tends to present itself at the longer leg.

39
Q

What are the indicators of plantar fasciitis?

A

First step out of bed

Pain worse with weight bearing

Precipitated by increase in weight bearing activities (such as standing, running)

40
Q

What is the relationship of foot posture as measured by the Foot Posture Index (FPI-6) and people with plantar fasciitis?

A

More foot pronations for chronic plantar heel pain (2.4 - 3.3) than controls (1.1-2.3)

41
Q

What is the current “Level B” 8 factors utilized to determine plantar fasciitis?

A

Plantar medial heel pain: first step pain or pain after inactivity

Worse after prolonged of activity

Pain at proximal insertion of plantar fascia

Positive Windlass test

Negative tarsal tunnel test

Limited dorsiflexion AROM / PAROM

Abnormal Foot Posture Index (FPI)

High BMI in non-athletic individuals

42
Q

What are some common differential diagnosis for symptoms consistent with plantar fasciitis?

A

Fat-pad atrophy

Spondyloarthritis (rheumatological)

Plantar fibroma

43
Q

What are two of the most important pen and paper assessment tools for plantar fasciitis?

A

Foot and ankle ability measure

Visual analog scale

44
Q

What is the MDC and MCID for ADL section of the FAAM questionnaire?

A

6 Points for the MDC

8 Points for the MCID

45
Q

What is the MDC and MCID for Sport section of the FAAM questionnaire?

A

12 Points for the MDC

9 Points for the MCID

46
Q

What is the following test and its sensitivity/specificity?

A

Specificity 100%

Sensitivity 32%

47
Q

What is the following test called and that is the specificity and sensitivity for it?

A

Tarsal Tunnel Test

(Dorsiflexion/Eversion test)

Sp 99%

Sn 92%

48
Q

What are the common nerve entrapments which could produce plantar pain?

A

Sciatic

Femoral

Tarsal Tunnel

Peroneal/Fibular

Lateral plantar

49
Q

Which condition affects this structure normally?

A

Tarsal tunnel

50
Q

What condition affects Baxter’s nerve?

A

Tarsal tunnel syndrome

51
Q

What are the six criteria of the FPI-6?

A

Rear foot:

Talar head palpation

Contour above and below the malleoli

Calcaneal position

Forefoot:

Talonavicular congruence

Medial arch height

Forefoot position

-2 to 3+

52
Q

What are the score ranges for FPI-6?

A
  • 12 to -5: Highly supinated
  • 4 to -1: Supinated

0 to +5: Neutral

+6 to +9: Pronated

+10 to +12: Highly pronated

53
Q

If the first metatarsophalangeal joint has less than 65º of extension at pre-swing it indicates what?

A

Plantar flexion limitation.

54
Q

What is one of the main functions of the tibialis posterior fibularis longus?

A

Control the rate and extent of foot pronation.

55
Q

What is the relationship of hamstring tightness and plantar fasciitis?

And what should be the ankle of SLR for normal HS length?

A

People with tight hamstrings are 9x as likely to get plantar fasciitis?

70º

OCS Preparation (7 decks)

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