Plantar fasciitis

Overuse condition resulting in inflammation of the plantar fascia

Cause

Overuse, poor biomechanics, short gastrocnemius and soles mxl, improper footwear, Wt gain

SXS

unilateral or bilateral

mild to severe pain in the heel no hx of injury or trauma

Repetitive mvt of plantar fascia causing inflammation

Pain occurs with the first steps after non-wt bearing such as getting out of the bed first in the morning

Pes planes, pes cavus and achilles tendinitis are often present

Bone spur may develop on the medial aspect of the calcaneus

Assessment

Postural assessment, Palpation of anteromedial aspect of the plantar surface of the calcaneus is painful, palpable adhesions may present

Testing

AROM of metatarsophalangeal jt is painful, mxl length test for soles and gastrocnemius, Contusion of base of the heel may occur d/t overuse, Tarsal tunnel syndrome, stress fx may occur

Treatment

Acute: cold hydrotherapy,NM tech, TrP make sure to work on calf mxl

Chronic: Deep moist heat hydrotherapy, passive stretch to calf mxl, mxl stripping, ischemic compression, cross fibre friction, Jt play

Self care

Acute: RICE

Chronic:Rest if aggravating after activities, Ice 3-4 times/day to prevent from inflammation, Stretch plantar fascia, stretch calf mxl

TX frequency

weekly tx for 4-6 wks is appropriate

Comments

Tendinitis

Tendinitis Inflammation of a tendon or tendons NOTE : What is the difference between "Tendinitis" and "Tendinosis"? The main difference between tendinosis and tendinitis is time. Tendinosis is a chronic (persistent or recurring) condition caused by repetitive trauma or an injury that hasn't healed. By contrast, tendinitis is an acute (sudden, short-term) condition in which inflammation is caused by a direct injury to a tendon (from Google search) Another Link regarding this difference HERE Okay, From here below, informations are taken from Rattray textbook! Tendon : Made of regularly arranged, dense collagen fibrils. It appear in 2 shapes: Cord-like structures and broad, sheet-like structures called aponeuroses Limited blood supply compared to Mxl and that makes it slow down of healing process Cause Chronic overload of the tendon leading to micro tearing and inflammatory response in the tendon Cont

Frozen Shoulder

Frozen Shoulder Painful, significant restriction of active and passive ROM at the shoulder Most frequently in abduction and external rotation Frozen shoulder theories Subacromial bursitis, biceps tendon pathology, disuse, supracapsular nerve entrapment leading to muscle dysfunction, small rotator cuff tears Joint capsule is primarily involved, with secondary involvement of the surrounding structures Close association among frozen shoulder, referred neck pain, rotator cuff tears and impingement syndrome Normally, the superior joint capsule attaches proximal to the greater tuberosity of the humerus and runs medially to the bony rim of the glenoidd fossa of the scapula Inferior joint capsule hangs in the fold or pleat called the “auxiliary recess” This fold is stretched out when the humerus is abduct Contractures have been noted in the coracohumeral ligament, which may limit external rotation Idiopathic frozen shoulder may also be d/t hyperkyphosis causing an alterati

Dislocations

Dislocations Complete dislocations of the articulating surfaces of a joint Subluxation is when the articulating surfaces of a joint remain in partial contact with each other Cause Trauma related sudden twist or wrench of the Jt beyond its normal ROM Risk factors Pathologies such as RA, paralysis, NM dz Congenital ligament laxity, Jt malformation Previous dislocation MC location of dislocation Ant. GH jt Lunate dislocation by fall on the outstretched hand, forcing the hyper extension Elbow dislocation is usually accompanied by Fx Palpation Acute : Heat, tender to touch, firm edema, protective mxl spasm Subacute : Heat diminishes, tenderness still present, Adhesion starts to form High mxl tone, TrP are present Chronic: cool to touch d/t ischemia Tenderness to the lesion site Adhesions to jt. capsule and injured lig. High tone mxl and TrP Disuse atrophy may be present d/t casting or taping Testing Acute: AROM, other testing are contraindicated Chron

Massage therapy (Rattray)

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