MSK II Module 5 Plantar Heel Pain
What is plantar heel pain?
-pain arising from insertion of the plantar fascia
-with or without a heel spur
-progressive pain with weight bearing
-especially 1st steps in the morning
-rarely a case of inflammation
What are the risk factors for plantar heel pain?
-limited ankle DF
-prolonged standing during the day
-BMI >30
-pes planus with subsequent overstretch of fascia
-rigid, cavus foot with tight fascia
-sudden increase in frequency, intensity, during of activity
-calcaneal spur may develop due to chronic pull of fascia on calcaneus
What are objective exam factors of plantar heel pain?
-pain with palpation of plantar fascia insertion
-limited DF ROM
-higher BMI in non athletic individuals
-positive windlass test
-negative tarsal tunnel test
-possible impaired neurodynamics
-assumes cleared up through L-spine for contributing conditions
-US thickness >4mm at calcaneal attachment
What are the Grade A manual therapies for plantar heel pain?
-address relevant LE impairments using joint mobilizations and soft tissue
mobilization
-combine with target exercise
What is plantar heel pain?
-pain arising from insertion of the plantar fascia
-with or without a heel spur
-progressive pain with weight bearing
-especially 1st steps in the morning
-rarely a case of inflammation
What are the risk factors for plantar heel pain?
-limited ankle DF
-prolonged standing during the day
-BMI >30
-pes planus with subsequent overstretch of fascia
-rigid, cavus foot with tight fascia
-sudden increase in frequency, intensity, during of activity
-calcaneal spur may develop due to chronic pull of fascia on calcaneus
What are objective exam factors of plantar heel pain?
-pain with palpation of plantar fascia insertion
-limited DF ROM
-higher BMI in non athletic individuals
-positive windlass test
-negative tarsal tunnel test
-possible impaired neurodynamics
-assumes cleared up through L-spine for contributing conditions
-US thickness >4mm at calcaneal attachment
What are the Grade A manual therapies for plantar heel pain?
-address relevant LE impairments using joint mobilizations and soft tissue
mobilization
-combine with target exercise
