The Orthopaedic Section of the American Physical Therapy Association (APTA) has an ongoing effort to create evidence-based practice guidelines for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). The purpose of these revised clinical practice guidelines is to review recent peer-reviewed literature and make recommendations related to nonarthritic heel pain.

Background: A study was conducted to determine the reliability and minimal detectable change for a new composite measure of the vertical and medial-lateral mobility of the midfoot called the foot mobility magnitude.

Plantar fasciitis is a common pathological condition of the foot and can often be a challenge for clinicians to successfully treat. The purpose of this article is to present and discuss selected literature on the etiology and clinical outcome of treating plantar fasciitis. Surgical and nonsurgical techniques have been used in the treatment of plantar fasciitis. Nonsurgical management for the treatment of the symptoms and discomfort associated with plantar fasciitis can be classified into 3 broad categories: reducing pain and inflammation, reducing tissue stress to a tolerable level, and restoring muscle strength and flexibility of involved tissues. Each of these treatments has demonstrated some level of effectiveness in alleviating the symptoms of plantar fasciitis. Previous studies have grouped all forms of nonsurgical therapy together. It is, therefore, difficult to determine if one type of treatment is more effective compared with another. Until such research is available, the clinician would be wise to include treatments from all 3 categories. 1 Orthop Sports Phys Ther 1999;29:756 760.Key Words: foot pathology, injuv overuse, treatment lantar fasciitis is classified as a syndrome that results from repeated trauma to the plantar fascia at its origin on the calcan e~s . " J~.~V h e resulting pain and dysfunction can often become a source of frustration to both the patient and clinician. The purpose of this article is to present a review of the etiology and various treatments advocated in the literature for plantar fasciitis. To the extent possible, the efficacy and expected clinical outcomes of these treatments will be discussed. COMMON CLINICAL SIGNS AND SYMPTOMSThe most common symptom associated with plantar fasciitis is pain and discomfort in the inferior heel region, which is aggravated on weight-bearing after a period of non-~eight-bearing.~~.~~ Patients will often note that they have excruciating pain when arising from bed in the morning, but the discomfort will slowly subside during the next 30-45 minutes. If the patients have a long commute to work, they can also report that their heels were not painful during the commute but that the pain commenced immediately as they attempted to weight-bear again

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The purpose of this study was to first determine the intra-rater reliability of four different static measurement procedures used to assess first metatarsophalangeal joint extension range of motion and, second, determine which of the four static procedures provided a valid measure of the amount of first metatarsophalangeal joint extension required for normal walking. Twenty healthy adult subjects between the ages of 21 and 43 years participated in the study. Four static techniques were evaluated and dynamic first metatarsophalangeal joint extension was also determined from video recordings during walking. The results indicate that 1) all static measurement techniques were reliable; 2) the degree of first metatarsophalangeal joint extension obtained for each of the four static measurement techniques exceeded the amount of first metatarsophalangeal joint extension required for walking; 3) although each of the static measurement techniques was reliable, they should not be considered interchangeable; and 4) approximately 65 degrees of first metatarsophalangeal joint extension are required for normal walking.