Heel Pain—Plantar Fasciitis: Revision 2014

Abstract

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.

Combination of Hip Strengthening and Manipulative Therapy for the Treatment of Plantar Fasciitis: A Case Report

“…The patient reported plantar pain during the initial steps after a period of inactivity, which is often reported in patients diagnosed with PF, 1 and reduction of this pain is an important outcome in a patient-centered approach. A visual analog scale is used to measure pain, and it has been suggested that a change of 19 mm is the minimum measurement to indicate a clinical improvement in pain during these first steps.…”

“…The PF diagnosis was made from the patient history and a physical examination, which was consistent with published PF guidelines. 1 The woman had a body mass index of 31.2 kg/m 2 and was physically active (jogging), with no hormonal dysfunction or rheumatic disease. The patient reported plantar medial heel pain and tenderness at the calcaneal tuberosity.…”

“…1 This painful condition can cause impairment of activity and disability. 2 In the United States, about 2 million people are treated annually for this complaint.…”

“…3,4 Patients usually report pain after palpation of the proximal insertion of the plantar fascia and plantar medial heel, and the pain is most noticeable when patients begin walking after a period of inactivity. 1 Clinicians have used many approaches for treating pain and enhancing function.…”

“…7,8 The techniques for PF treatment include passive joint manipulation of the ankle and foot; myofascial maneuvers of the gastrocnemius, soleus muscles, and plantar fascia; neural mobilization of the tibial nerve; and stretching of the plantar fascia and triceps surae. 1 A recent study reported that strengthening the hip abductors and external rotators is effective for reducing pain in fasciitis. 12 The strengthening of hip muscles has been recommended for the treatment of various musculoskeletal disorders, with improvement reported in patients with knee, 13 hip, 14 and lower back pain.…”