3 Written Questions

1. Improve plantar fascia extensibility; normalize joint mobility; improve muscle flexibility; decrease impact loading; and support the MLA.
   Gastroc/Soleus stretching in STJ neutral position.
   Plantar fascia soft tissue techniques & stretching - monitor stress on plantar aspect 1st Ray.
   Mobilization of foot - Especially 1st Ray (often hypomobile or rigid) and 1st MTP joint extension. STJ and MTJ also may need attention.
   Decrease Impact Loading - Silicone heel pad or Accommodative Functional Foot Orthosis primarily for shock absorption.
   Cushion type running shoe with ethylene vinyl acetate shock absorbing midsole and flexible forefoot and rearfoot.
2. Control Inflammation; Protect Plantar Fascia; Soft Tissue Mobility
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   Phonophoresis or Iontophoresis (B evidence).
   Transverse Friction Massage to plantar fascia
   Night DF Splint (5 degrees).Wear 1-3 mos. (chronic symp. >6 mos.). (B evidence)
   Active Rest - Swimming; Pool running; cycling; rowing
   Prefabricated or custom foot orthoses (A evidence)
   Stretching of Gastroc/Soleus; plantar fascia; TFL/ITB.
   Mobililzation - 1st MTPJ, STJ, and Talonavicular Jt.
   Soft tissue & neural mobilization procedures
3. 1. Functional Foot Orthoses
   2. Modalities - Reduce swelling and fibrosis
   3. NSAIDS
   4. Steroid/Anesthetic Injection into tunnel
   5. Casting or Splinting in neutral position

3 Multiple Choice Questions

1. 1. Modalities for inflammation if acute
   2. Protect fat pad: cut-out heel pad; heel cup; tape heel to support septa
   3. Use shoe with firm heel counter
   4. May need protected WB for 72 hours if heel protection measures not sufficient to relieve pain during walking
   1. What are RCCB tx options?
   2. What are tarsal tunnel syndrome tx options?
   3. Post surgical management plantar f.
   4. What is tx for calcaneal fat pad contusion?
2. Gradual increase in loading the plantar fascia
   Plantar fascia and Gastroc/Soleus stretching
   Graded Walk-Run program: mini tramp; BAPS board
   Proper shoe selection for specific physical activities
   Extrinsic and Intrinsic muscle exercises
   Functional progression for specific tasks
   1. What are RCCB tx options?
   2. Acute Stage:
   3. Sub-Acute Stage:
   4. 6-12 Weeks to Recovery PF
3. Soft tissue dressing and posterior splint for 10 days to 2 weeks
   Gentle stretching and swimming begun at 2 weeks
   Cycling begun at 3 weeks
   Running program begun at 6 weeks if appropriate
   Athlete resumes daily running training program at 8 weeks
   Address lower kinetic chain biomechanical alignment issues if necessary
   1. Sub-Acute Stage:
   2. Post surgical management plantar f.
   3. 6-12 Weeks to Recovery PF
   4. What are RCCB tx options?

3 True/False Questions

1. Acute Stage: → Control inflammation and protect plantar fascia
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   Ice massage
   NSAIDs
   Controlled rest from painful activities.
   Protect tender area: Soft sponge heel pad with cutout; heel cup.
   5. Control abnormal stresses: Low dye strapping for hyperpronator; shock absorbing inserts for the rigid cavus foot; heel lift.

   True        False

2. Treatment Considerations for the Excessive Pronator → Improve plantar fascia extensibility; normalize joint mobility; improve muscle flexibility; decrease impact loading; and support the MLA.
   Gastroc/Soleus stretching in STJ neutral position.
   Plantar fascia soft tissue techniques & stretching - monitor stress on plantar aspect 1st Ray.
   Mobilization of foot - Especially 1st Ray (often hypomobile or rigid) and 1st MTP joint extension. STJ and MTJ also may need attention.
   Decrease Impact Loading - Silicone heel pad or Accommodative Functional Foot Orthosis primarily for shock absorption.
   Cushion type running shoe with ethylene vinyl acetate shock absorbing midsole and flexible forefoot and rearfoot.

   True        False

3. What are RCCB tx options? → Control inflammation and protect plantar fascia
   ---------------------------------------------------------------
   Ice massage
   NSAIDs
   Controlled rest from painful activities.
   Protect tender area: Soft sponge heel pad with cutout; heel cup.
   5. Control abnormal stresses: Low dye strapping for hyperpronator; shock absorbing inserts for the rigid cavus foot; heel lift.

   True        False