Plantar Fasciopathy Flashcards
Plantar fasciopathy is aka as plantar _______ and _____ pain
fasciitis; heel
Prevalence
Most common _____ _______
foot condition
Risk Factors
Increased ____ ROM- indicating ankle instability and results in excessive pronation
High _____
_____ and work related ______ ______ with poor shock absorption
Impaired _____ _____ extension that reduces potential energy of fascia
Increased ____
PF
BMI
Running; prolonged WBing
1st MTP
age
Unclear Risk Factors
Tendinopathy origins
- excessive ______ ________
- excessive standing _____ ______
Decreased DF may contribute to excessive ________
dynamic pronation
calcaneal EV
pronation
Structures Involved
Fascia
1) ______
2) ______ - originates on medial tubercle
3) ______
Inserts on all proximal ________
medial
central
lateral
phalanges
Structures Involved:
Foot _______ muscles
heel (____) pad inn. by _____ nerve
_______ tendon fibers
Medial and lateral ______ n.
Bone _______
- Plantar fascia ________ and fat pad ________ BETTER indicators
intrinsic
fat; tibial
achilles
plantar
spurring
thickens; thinning
Structures Ivolved
Assists with gait through “______ _______” that is PE developed by normal foot and ankle motion
windlass effect
Etiology/Pathomechanics
_______ origins
tendinopathy
Symptoms
Often ________ onset of _____ pain after recent increase in WB activity
________> central heel pain
- especially after period of _______ (first step in the morning)
May improve with ____ to ______ activity
Worse at _____ of ____ ______ or after prolonged WB
gradual; heel
medial
inactivity
mild’ moderate
end; the day
Signs
Observation
________ plantar fascia
possible static _______ _______
possible _______ or ________ gait
possible excessive ______ _______
possibly impaired _____ ________
thickened
calcaneal EV
asymmetrical/antalgic
dynamic pronation
LQ control
Signs
ROM- possible and limitation with _______ and _____ ______ EXT
Resisted/MMT- possible weak and P!ful ____ ______
Special Test: lack of plantar fascia _________
Palpation: TTP over ______ ______ _____ > central heel P!
DF; 1st MTP
toe flexors
tautness
medial calcaneal insertion
PT Rx:
_______ education
- ______ rule
- load _________
- _________ cues
- weight loss
- _________ surfaces with prolonged sitting
POLICED
Patient
Soreness
management
Movement
cushioned
PT Rx: Modalities
_______ and _______ have short-term relief
Iontopheresis; LASER
Which modalities are not recommended for this condition?
US/electrotherapy
Shockwave therapy is _____ more effective than stretching and US
NOT
PT Rx: Manual Therapy
normalizes _____ and _____ ______ for P!, ROM, and function
JM- _______ benefits
mobility; muscle lengths
mixed
Stretching for calf and plantar fascia
calf stretching alone= _____- improvement
combination- both ______ pain
BE _______!
no
improved
cautious
PT Rx: Taping
____-_____ pain relief and function
short-term
PT Rx: Orthotics improve P! and function with _______ to control and help cushion
Prefabricated orthotic is _____ ______ to custom
orthotic better than ____ _____
pronation
equally effective
heel pad
PT Rx: Night Splint
Wear between ____ and ____ months with conistent first step P!
Improves impaired ______ due to shortened ______
1; 3
DF; PF
PT Rx: Dry Needling _____ ______
NOT RECOMMENDED
MET- purpose: primarily for _____ _________
fascial proliferation
MET prescription- same as tendinosis; except ________ toe with two diff. ____ ______
hyperextend; heel raises
Pronation controls excerises particuraly of tibialis ______
posterior
Prognosis: _____% resolution of symptoms
80
MD interventions
NSAIDS- no ____ ______ _____
Cortisone Injections- _____ and ____ term supportive evidence
Surgery: _______- cut to relieve
fascial tendon
Excision of _______
clinical trials
limited; short
fasciotomy
fibroma
