Lecture 8B

Question 1

These are associated with what foot type:

Plantar fasciitis

Answer 1

Pronator and Supinator, but moreso Pronator

Question 2

These are associated with what foot type:

Interdigital neuroma

Shin splint

Answer 2

Pronator

Question 3

These are associated with what foot type:

Tarsal tunnel syndrome

Patellofemoral dysfunction

Posterior tibialis tendon dysfunction

Answer 3

Pronator

Question 4

These are associated with what foot type:

Stress fracture

Peroneal tendinitis

Answer 4

Supinator

Question 5

These are associated with what foot type:

IT band friction

Lateral ankle sprain

Low back pain

Answer 5

Supinator

Question 6

Do studies support the use of manual therapy alone to treat ankle sprains?

Answer 6

Yes

Question 7

Do studies support RICE and immobilization for ankle sprains

Answer 7

No

Question 8

Do studies show that exercise can help prevent chronic ankle sprains?

Answer 8

Yes, but does not reduce postural sway

Question 9

Studies show a large relationship between _____ and the occurrence of ankle sprains

Answer 9

BMI

Question 10

What does the McGuine et al balance program include for treating ankle sprains

Answer 10

Static and dynamic balance activities

Question 11

What is the CPG for using manual therapy to help with inversion ankle sprains

Answer 11

Symptoms worse when standing

Symptoms worse in evening

Navicular drop over 5mm

Distal tibiofibular joint hypomobility

Question 12

Is manual therapy with therex proven better than just therex alone for lateral ankle sprains?

Answer 12

Yes

Question 13

Is manual therapy + therex + soft tissue release proven better than just

Manual therapy + therex

for the management of acute inversion ankle sprain?

Answer 13

No

Question 14

When implementing the 4 week comprehensive rehab program for chronic ankle instability do we need to do all of the exercises listed?

Answer 14

Don’t do all exercises immediately, focus on fewer exercises with quality movement

Question 15

What clinical measures are important for ankle

Answer 15

Measure ankle swelling

Measure ankle ROM (particularly dorsiflexion in open and closed chain when possible)

Talar inversion/eversion

SL balance (star excursion test)

Note: need to measure everything 2 or more times during care

Question 16

What outcome measures have Strong evidence for foot and ankle

Answer 16

FAAM (foot ankle ability measure)

LEFS

Question 17

how much evidence do single leg hop tests have for foot and ankle outcomes

Answer 17

moderate

Question 18

Should you use ultrasound for acute ankle sprains?

Answer 18

NO

strong evidence NOT to use

Question 19

Evidence levels for ankle

Cryotherapy:

Manual therapy:

Therex:

External support/Assistive devices:

Answer 19

Cryotherapy: weak

Manual therapy: strong

Therex: strong

External support/Assistive devices: strong

Question 20

What do you need to rule out for every case that could be an ankle sprain:

Answer 20

Fractures!

Use the ottawa ankle and foot rules

Question 21

What is needed if a patient is positive under the ottawa foot and ankle rules

Answer 21

Immobilization, clearance by MD w/ repeated imagining required

NO MANIPS or MOBs

Question 22

While a patient has an immobilized ankle/foot what do we treat

Answer 22

edema, gait w/ AD, and CV conditioning

Question 23

Ottawa ankle rule

Answer 23

Boney tenderness at lat mal

Bone tenderness at med mal

Inability to bear weight in ER and after injury

Question 24

Ottawa foot rules:

Answer 24

bone tenderness at base of 5th met

bone tenderness at navicular

inability to bear weight in ER and after injury

Question 25

Is compartment syndrome urgent or emergent?

Answer 25

acutely, it can be emergent (*especially if there is pulselessness*)

Question 26

How do we prevent compartment syndrome from developing: No massage, no modalities, if casted use bivalve cast, extended rest Place limb ________________

Answer 26

AT the level of heart not above or below

Question 27

What is the progression for achilles tendinopathy rehab

Answer 27

Start with isometrics -> eccentric -> energy storage

Question 28

What intervention has grade A evidence for achilles tendinopathy

Answer 28

Eccentric loading heavy load and slow speed eccentric/concentric

Question 29

What level of evidence does PF stretching have for achilles tendinopathy

Answer 29

C level, weak evidence

Question 30

Loss of arch height, forefoot abduction, rear foot valgus painful plantarflexion

Answer 30

Posterior Tibialis Tendon Dysfunction

Question 31

Weak/painful single leg heel raise, assymetrical bilateral heel raise, weakness with inversion and plantarflexion. Decreased push off during gait

Answer 31

Posterior tibialis tendon dysfunction

Question 32

Which way does the cuboid most commonly sublux

Answer 32

Plantar

Question 33

Overuse injury with flat pronated foot, pain along the medial ankle and along the PTT, swelling at medial posterior ankle, weakness with push off, difficulty and/or pain with heel raise

Answer 33

posterior tibialis tendon dyfunction

Question 34

When is a plantar cuboid dyslocation most common in dancers

Answer 34

during transition from foot-flat to demipointe

Question 35

How good is the evidence for corticosteroid injection for SHORT TERM relief of pain in the plantar heel

Answer 35

limited evidence

Question 36

How good is the evidence for night splints for reducing pain in CHRONIC conditions of the plantar heel

Answer 36

limited evidence

Question 37

What is the evidence like for manual therapy for plantar heel pain?

Answer 37

Young et al JOSPT found that manual therapy works and cured all patients to 0/10 pain at discharge and short term follow up

Question 37

How helpful are Orthoses for plantar fascitis

Answer 37

only for short term relief Grade B evidence NOT to use isolated foot orthoses

Question 38

how helpful is plantar fascia stretching for plantar fascitis

Answer 38

good

Question 39

is manual therapy + Therex better than therex alone for plantar fascitis?

Answer 39

yes

Question 40

Is ultrasound helpful for plantar fascitis?

Answer 40

no, dont use it!

Question 41

are night splints helpful for plantar fascitis?

Answer 41

Yes, grade A evidence especially for people who have consistent pain with first step in the morning perscribe for 1-3 months

Question 42

what has strong evidence for plantar fascitis?

Answer 42

Manual + Stretching (plantar fascia and gastroc/soleus) + Taping + Night splints

Question 43

What has moderate evidence for plantar fascitis

Answer 43

Therex Low level laser therapy Dry needling

Question 44

How much great toe ext is needed for gait

Answer 44

65-70

Question 45

how do we treat hallux rigidus

Answer 45

Mobilization Rigid insert Rocker bottom shoe