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

Strain VS Sprain

Strain vs Sprain STRAINS s"T"rain = "T"endon Overstretch injury to musculotendinous unit (tendon) Concentric : Mxl contraction as the origin and insertion of the mxl comes closer together, Mxl fibres shorten Eccentric :Origin and insertion move farther apart, the mxl fibres lengthen Eccentric contraction can produce. greater force within the mxl than concentric contraction, predisposing the mxl to injury at this time Hypovascular nature of tendons contributes to decreased tissue health, allowing the tendon itself to rupture Fun fact! The younger people where the epiphyseal plate in the bone has not yet ossified, the mxl and tendons are stronger than the bone! Because tendons are moderately vascularized, they are prone to partial or complete rupture at the area of least blood supply either in the middle of the tendon or at the musculotendinous junction. What is the cause of STRAINS? Sudden overstitching of the mxl Extreme contraction o

Fractures

Break in the continuity of a bone Type of fracture Transverse, oblique, spiral, comminuted, avulsion, osteochondral Common fx names Stage of healing 1. Hematoma within 72H of initial trauma 2.Inflammatory rxn, proliferation of osteoblasts at the periosteum 3.Soft callus or splint is formed from mass of proliferating osteoblast, repair is still incomplete 4.Consolidation occurs as the immature woven bome is changed into mature lamellar bone This is a complete repair 5.Remodeling of the irregular outer surface and reshaping of the marrow space inside the bone take place through alternating osteoclastic and osteoblastic activity Complications of Fx Compartment syndrome This can occur in the forearm and lower legs following fx Nerve compressions This may be indicated by paresthesia in the tissues under the cast Untreated vascular damage It may be indicated by an increase in observable distal red, black or blue bruising Refer to MD!! Bone

Massage therapy (Rattray)

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