Plantar Fasciitis

Question on a patient with Plantar Fasciits

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Scenario: Patient reports gradual worsening of heel pain over the last 6 months. It is worst with first step of the day and after prolonged sitting. The pain feels better after 2 to 3 minutes of walking. Pain also increases at the end of the day after she has been on her feet at work. Patient states no radicular leg symptoms. Patient has a positive toe raise test. When asked, patient states she likes to walk barefoot at home on the tile floors. Patient has had 2 injections into the heel with pain returning. The patient has tried a night splint and continues to have pain.

Question: What are the two variations of abnormal arch types of the foot. What type of arch would this patient potentially have in this scenario?

A. Pes Altus and Pes Pronus. Pes Altus.

B. Pes Campester and Pas Cavus. Pas Campester.

C. Pes Cavus and Pes Planus. Pes Planus.

D. Pes Alte and Pes Planus. Pes Planus.

Answer with rationale: C. Pes Cavus and Pes Planus. Pes Planus. Pes Cavus is high arch, and Pes Planus is low arch or flat foot. This patient is presenting with chronic, degenerative pain in the plantar fascia and associated muscles, therefore they would be classified with Pes Planus. Pes Cavus is associated with traumatic, acute, or sudden onset plantar fascia inflammation and pain.

For more information see Chapter 212: Plantar Fasciits in The Color Atlas of Physical Therapy

Eric Shamus, DPT, PhD

Professor, Chair of Department of Rehabilitation Sciences, Florida Gulf Coast University