plantar fasciopathy - final exam

Question 1

what is the most common foot condition?

Answer 1

plantar fasciopathy aka heel pain

Question 2

clear risk factors of plantar fasciopathy?

Answer 2

increased PF ROM - indicates ankle instability & excessive pronation
high BMI
running/prolonged WB
impaired 1st MTP ext
increased age

Question 3

UNCLEAR risk factors of plantar fasciopathy

Answer 3

decreased DF
tendinopathy origins
- excessive dynamic pronation
- excessive standing calcaneal EV

Question 4

structures involved with plantar fasciopathy

Answer 4

3 bands
inserts on all proximal phalanges
assists with gait through windlass effect that is PE developed by normal foot and ankle motion
foot intrinsic muscles
heel pad
achilles tendon
medial and lateral plantar nerves

Question 5

true or false. bone spurring can occur with and without plantar fasciopathy

Answer 5

true

Question 6

what are better indicators of bone spurring than plantar fasciopathy

Answer 6

plantar fascia thickening and fat pad thinning

Question 7

what is the main cause of plantar fasciopathy

Answer 7

fasciosis (structural change) (54%)
neither inflammatory nor neoplastic

Question 8

symptoms of plantar fasciopathy:

Answer 8

gradual onset of heel P! after increase in WB activity
medial > central heel P!
– esp after period of inactivity
– worse at end of day or prolonged WB
– may improve with mild to moderate activity

Question 9

signs of plantar fasciopathy:
- observation:
- ROM:
- resisted:
- palpation:

Answer 9

• thickened plantar fascia
• P! and limitation w DF and 1st MTP ext. limited DF w knee ext (83%)
• weak and P!ful toe flexors
• TTP over medial calcaneal insertion > central heel P!

Question 10

what special test is this:

stabilize calcaneus in EV; ext 1st MTP jt; palpate fascia
(+) =

Answer 10

plantar fascia
(+) = soft

Question 11

PT Rx for plantar fasciopathy

Answer 11

patient education (cushioned surfaces w prolonged standing)
POLICED

Question 12

PT Rx for plantar fasciopathy: modalities
- iontophoresis w dexamethasone or acetic acid:
- LASER and phonophoresis
- shockwave therapy
- US

Answer 12

• short term relief
• short term relief
• not more effective than stretching & US
• not recommended

Question 13

manual therapy for plantar fasciopathy:
- JMs:
- stretching for calf and plantar fascia:
- JM and STM:

Answer 13

• mixed benefits. improved DF and 1st MTP ext
• more reduction w fascia stretching vs calf
• deep massage to gastroc & plantar fascia, rear foot JMs, impairment based JM to hip & knee

Question 14

true or false. taping provides short term relief for P! and function with anti-pronation/arch taping

Answer 14

true

Question 15

how do orthotics help for someone with plantar fasciopathy

Answer 15

improve P! and function with pronation and cushioning

Question 16

plantar fasciopathy:
orthotics are indicated for:

Answer 16

those who benefit with arch taping
persistent
better than heel pad

Question 17

what is proper footwear for somenone with plantar fasciopathy?
- inadequate representation:

Answer 17

shoe rotation (multiple running shoes)
rocker bottom shoe

static standing method is inadequate representation of dynamic function in shoes

Question 18

what does a night splint do for plantar fasciopathy and how long should pt wear it?

Answer 18

improves impaired DF due to shortened PF
wear 1–3 months with consistent first step P!

Question 19

true or false. dry needling is recommended for plantar fasciopathy

Answer 19

false

Question 20

MET Rx for plantar fasciopathy

Answer 20

primarily for fascial proliferation
tendinosis prescription - but hyperextend toe with two heel raises
pronation control exercises part. of tibpost and other LE muscles that may contribute to impaired LE control and excessive pronation

Question 21

prognosis of plantar fasciopathy

Answer 21

80% resolution of symptoms

Question 22

MD Rx for plantar fasciopathy

Answer 22

NSAIDS
cortisone injections - benefits don’t outweigh risks
surgery - fasciotomy or excision of fibroma