plantar fasciitis CPG

Question 1

What is the typical duration of plantar fascia pain

Answer 1

13-14 months 2014 study

80% within one year 2008 study

Question 2

What are the risk factors for plantar fasciitis in general population and the grade of the data

Answer 2

grade B

• limited DF, High BMI
• chronic standing on feet
• HS tightness

Question 3

differential diagnosis and grade

Answer 3

grade B

• first step pain
• worse after prolonged activity
• pain at insertion of PF
• positive windless mechanism
• NEGATIVE tarsal tunnel test
• limited DF
• High BMI
• NEGATVIE lumbar screen

Question 4

What are some co-morbiities

Answer 4

• spondyloarthritis
• fat pad atrophy
• bening histological growth

Question 5

What do the clinical practice guideline suggest is the biggest cause of disability related to PF

Answer 5

• high fear avoidance beliefs

Question 6

What is the typical mechanism of injury in PF occurring to the CPG

Answer 6

insidious onset

Question 7

What disability index is recommend for PF

Answer 7

Grade A PF
FAAM - 21 item form
- Minimal clinically detectable change 9 points for ADL, 12 point for sport sub scale
- Minimal statistical difference is 7 points
- 4 weeks is the recommended time frame

Question 8

What pain scales are validated for PFitis

Answer 8

Grade B for PF
VAS - 10cm lines
pain rating scale

Question 9

Describe the Windlass test

Answer 9

Perform NWB and WB with and without palpation of the PF insertion
- SPIN 100%
- SNOUT 32%
Be careful not to flex 1st MTP

Question 10

describe the tarsal tunnel test (AKA?)

Answer 10

AKA - DF eversion test

• maximally DR and ever the foot while sitting and MAINTAIN for 5 seconds while tapping over the medial tarsal tunnel
• SPIN 99%
• SNOUT 92%

Question 11

What is Baxter’s nerve entrapment

Answer 11

entrapment of the first branch of the lateral plantar nerve along the medial heel

Question 12

Describe how you can measure WB DF

Answer 12

Use UE support and single leg max DF with knee flexion

Question 13

How do you calculate DMI

Answer 13

weight (kg)/height(M) x height (m)

Question 14

Describe the foot posture index

Answer 14

6 observations scored -2 to +2

• talar head position (- 2 lateral only)
• supra- and infra- lateral malleolar curve (-2curve below mal straight or convex)
• rear foot frontal plane posture (-2 greater than 5 degree varus)
• TNJ prominance (-2 concave TNJ region)
• medial longitudinal arch (-2 very high arch)
• forefoot from behind (-2 no toes visible laterally)

Question 15

How much first MTP ext and rear foot motion is needed during normal Gait

Answer 15

1 MTP 65 degree

rear foot eversion 6 degrees