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Karl B Landorf - One of the best experts on this subject based on the ideXlab platform.
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Lived experience and attitudes of people with plantar Heel Pain: a qualitative exploration
Journal of Foot and Ankle Research, 2020Co-Authors: Matthew P. Cotchett, Karl B Landorf, Michael Skovdal Rathleff, Matthew Dilnot, Dylan Morrissey, Christian BartonAbstract:Background Plantar Heel Pain is a common source of Pain and disability. Evidence-based treatment decisions for people with plantar Heel Pain should be guided by the best available evidence, expert clinical reasoning, and consider the needs of the patient. Education is a key component of care for any patient and needs to be tailored to the patient and their condition. However, no previous work has identified, far less evaluated, the approaches and content required for optimal education for people with plantar Heel Pain. The aim of this study was to gather the patients’ perspective regarding their lived experience, attitudes and educational needs in order to inform the content and provision of meaningful education delivery approaches. Methods Using a qualitative descriptive design, semi-structured interviews were conducted with participants with a clinical diagnosis of plantar Heel Pain. A topic guide was utilised that focused on the experience of living with plantar Heel Pain and attitudes regarding treatment and educational needs. Interviews were audio recorded, transcribed verbatim and analysed using the Framework approach. Each transcription, and the initial findings, were reported back to participants to invite respondent validation. Results Eighteen people with plantar Heel Pain were interviewed. Descriptive analysis revealed eight themes including perceptions of plantar Heel Pain, impact on self, dealing with plantar Heel Pain, source of information, patient needs, patient unmet needs, advice to others and interest in online education. Participants revealed doubt about the cause, treatment and prognosis of plantar Heel Pain. They also expressed a desire to have their Pain eliminated and education individually tailored to their condition and needs. Respondent validation revealed that the transcripts were accurate, and participants were able to recognise their own experiences in the synthesised themes. Conclusion Plantar Heel Pain has a negative impact on health-related quality of life. Participants wanted their Pain eliminated and reported that their expectations and needs were frequently unmet. Health professionals have an important role to be responsive to the needs of the patient to improve their knowledge and influence Pain and behaviour. Our study informs the content needed to help educate people with plantar Heel Pain.
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Lived Experience and Attitudes of People With Plantar Heel Pain: A Qualitative Exploration
Journal of Foot and Ankle Research, 2020Co-Authors: Matthew P. Cotchett, Karl B Landorf, Michael Skovdal Rathleff, Matthew Dilnot, Dylan Morrissey, Christian J. BartonAbstract:Plantar Heel Pain is a common source of Pain and disability. Evidence-based treatment decisions for people with plantar Heel Pain should be guided by the best available evidence, expert clinical reasoning, and consider the needs of the patient. Education is a key component of care for any patient and needs to be tailored to the patient and their condition. However, no previous work has identified, far less evaluated, the approaches and content required for optimal education for people with plantar Heel Pain. The aim of this study was to gather the patients’ perspective regarding their lived experience, attitudes and educational needs in order to inform the content and provision of meaningful education delivery approaches. Using a qualitative descriptive design, semi-structured interviews were conducted with participants with a clinical diagnosis of plantar Heel Pain. A topic guide was utilised that focused on the experience of living with plantar Heel Pain and attitudes regarding treatment and educational needs. Interviews were audio recorded, transcribed verbatim and analysed using the Framework approach. Each transcription, and the initial findings, were reported back to participants to invite respondent validation. Eighteen people with plantar Heel Pain were interviewed. Descriptive analysis revealed eight themes including perceptions of plantar Heel Pain, impact on self, dealing with plantar Heel Pain, source of information, patient needs, patient unmet needs, advice to others and interest in online education. Participants revealed doubt about the cause, treatment and prognosis of plantar Heel Pain. They also expressed a desire to have their Pain eliminated and education individually tailored to their condition and needs. Respondent validation revealed that the transcripts were accurate, and participants were able to recognise their own experiences in the synthesised themes. Plantar Heel Pain has a negative impact on health-related quality of life. Participants wanted their Pain eliminated and reported that their expectations and needs were frequently unmet. Health professionals have an important role to be responsive to the needs of the patient to improve their knowledge and influence Pain and behaviour. Our study informs the content needed to help educate people with plantar Heel Pain.
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Should foot orthoses be used for plantar Heel Pain
British Journal of Sports Medicine, 2018Co-Authors: Glen A. Whittaker, Hylton B Menz, Shannon E Munteanu, Karl B LandorfAbstract:The authors of this systematic review1 found that foot orthoses are not effective for plantar Heel Pain (when compared with sham devices) and suggest ‘that clinicians should be reserved in prescribing foot orthoses in all patients with plantar Heel Pain’. This finding is in contrast to a similar systematic review and meta-analysis that we recently published in the British Journal of Sports Medicine that concluded foot orthoses are effective at reducing Pain in those with plantar Heel Pain and that ‘health practitioners may consider using foot orthoses … but the reduction in Pain may not be sufficient for some people’.2 The publication of these meta-analyses in the same journal, within a short time-period may create uncertainty for health practitioners regarding the effectiveness of foot orthoses for plantar Heel Pain. Furthermore, there may be a loss of trust by health practitioners and members of the public in the process of conducting and reporting systematic reviews and meta-analyses, as reviews by different authors can arrive at contrasting findings. Therefore, it is important to provide context to the different conclusions reached in these meta-analyses in …
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Depression, Anxiety, and Stress in People With and Without Plantar Heel Pain:
Foot & Ankle International, 2016Co-Authors: Matthew P. Cotchett, Shannon E Munteanu, Karl B LandorfAbstract:Background:Depression, anxiety, and stress are prevalent in patients with musculoskeletal Pain, but the impact of these emotional states has not been evaluated in people with plantar Heel Pain. The aim of this study was to evaluate the association between depression, anxiety, and stress with plantar Heel Pain.Methods:Forty-five participants with plantar Heel Pain were matched by sex and age (±2 years) to 45 participants without plantar Heel Pain. Levels of depression, anxiety, and stress were measured using the Depression, Anxiety and Stress Scale (short version) in participants with and without plantar Heel Pain. Logistic regression was conducted to determine if levels of depression, anxiety, or stress were associated with having plantar Heel Pain.Results:Univariate analysis indicated that participants with plantar Heel Pain had greater levels of depression (mean difference = 4.4, 95% CI 2.3 to 6.5), anxiety (mean difference = 2.6, 95% CI 0.9 to 4.3), and stress (mean difference = 4.8, 95% CI 1.9 to 7.8)...
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plantar Heel Pain and plantar fasciitis
BMJ clinical evidence, 2015Co-Authors: Karl B LandorfAbstract:Introduction Plantar Heel Pain, also known as plantar fasciitis, causes soreness or tenderness of the sole of the foot under the Heel, which sometimes extends into the medial arch. Pain associated with the condition may cause substantial disability and poor health-related quality of life. The prevalence and prognosis are unclear, but the symptoms seem to resolve over time in most people. Methods and outcomes We conducted a systematic overview, aiming to answer the following clinical questions: What are the effects of conservative treatments for plantar Heel Pain? What are the effects of non-conservative treatments for plantar Heel Pain? We searched: Medline, Embase, The Cochrane Library and other important databases up to November 2013 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). Results At this update, searching of electronic databases retrieved 162 studies. After deduplication and removal of conference abstracts, 84 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 39 studies and the further review of 45 full articles. Of the 45 full articles evaluated, five systematic reviews and nine RCTs were included at this update. We performed a GRADE evaluation for 30 PICO combinations. Conclusions In this systematic overview, we categorised the efficacy for 12 interventions based on information relating to the effectiveness and safety of corticosteroid injection alone (both short-term and longer-term effects), corticosteroid injections plus local anaesthetic injection (both short-term and longer-term effects), customised foot orthoses, extracorporeal shock wave therapy, Heel pads and cups, local anaesthetic injection alone, night splints, stretching exercises, surgery, and taping.
S. D. Karr - One of the best experts on this subject based on the ideXlab platform.
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Subcalcaneal Heel Pain
Orthop Clin North Am, 1994Co-Authors: S. D. KarrAbstract:Subcalcaneal Heel Pain is a very common presenting complaint. Careful evaluation is necessary to guide treatment decisions. By far, most subcalcaneal Heel Pain resolves with appropriate conservative treatment over a period of weeks to months. Occasionally, when surgery is necessary, the goal of the procedure is adequate decompression in the area of the origin of the plantar fascia and medial calcaneal tubercle.
Justin Sullivan - One of the best experts on this subject based on the ideXlab platform.
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Role of mechanical factors in the clinical presentation of plantar Heel Pain: Implications for management.
The Foot, 2020Co-Authors: Justin Sullivan, Evangelos Pappas, Joshua BurnsAbstract:Plantar Heel Pain is a common musculoskeletal foot disorder that can have a negative impact on activities of daily living and it is of multifactorial etiology. A variety of mechanical factors, which result in excessive load at the plantar fascia insertion, are thought to contribute to the onset of the condition. This review presents the evidence for associations between commonly assessed mechanical factors and plantar Heel Pain, which could guide management. Plantar Heel Pain is associated with a higher BMI in non-athletic groups, reduced dorsiflexion range of motion, as well as reduced strength in specific foot and ankle muscle groups. There is conflicting, or insufficient evidence regarding the importance of foot alignment and first metatarsophalangeal joint range of motion. Plantar Heel Pain appears to be common in runners, with limited evidence for greater risk being associated with higher mileage or previous injuries. Conflicting evidence exists regarding the relationship between work-related standing and plantar Heel Pain, however, longer standing duration may be associated with plantar Heel Pain in specific worker groups. The evidence presented has been generated through studies with cross-sectional designs, therefore it is not known whether any of these associated factors have a causative relationship with plantar Heel Pain. Longitudinal studies are needed to ascertain whether the strength and flexibility impairments associated with plantar Heel Pain are a cause or consequence of the condition, as well as to establish activity thresholds that increase risk. Intervention approaches should consider strategies that improve strength and flexibility, as well as those that influence plantar fascia loading such as body weight reduction, orthoses and management of athletic and occupational workload.
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Clinical and Functional Characteristics of People With Chronic and Recent-Onset Plantar Heel Pain
PM&R, 2017Co-Authors: Allegra Barnes, Justin Sullivan, Roger Adams, Evangelos Pappas, Joshua BurnsAbstract:Abstract Background Plantar Heel Pain is a common condition that reduces health-related quality of life. Recovery usually occurs within 12 months; however, up to 20% of people remain symptomatic beyond this time frame. The level of Pain and function in this chronic Heel Pain group is not well described. Objective To identify clinical and functional characteristics associated with chronic plantar Heel Pain compared with Heel Pain of recent onset. Design Cross-sectional study. Setting University research laboratory and private physiotherapy clinic. Participants A total of 71 people with plantar Heel Pain for longer than 12 months and 64 people with plantar Heel Pain for less than 6 months were recruited from the general public. Methods Functional characteristics of participants in both Heel Pain groups were assessed with a variety of clinical measures and the Foot Health Status Questionnaire. Clinical measures included body mass index, foot and ankle muscle strength using hand-held dynamometry, as well as ankle and first metatarsophalangeal joint range of motion. The Foot Health Status Questionnaire was used to collect self-reported measures of foot Pain severity, foot function and physical activity. Main Outcome Measurements Univariate analyses of variance were performed to detect differences between the 2 groups for each of the variables measured. Results The chronic Heel Pain group exhibited reduced ankle dorsiflexor and toe flexor strength yet better self-reported foot function. There was no difference between groups for body mass index, ankle and first metatarsophalangeal joint range of motion, inversion strength, eversion strength, calf endurance, self-reported foot Pain, and physical activity. Conclusions Chronic plantar Heel Pain is associated with selective weakness of foot and ankle muscle groups but less affected foot function compared with Heel Pain of recent onset. Those with chronic symptoms may moderate or make adaptations to their daily activities, or simply accept their condition, enabling more effective coping. Strength deficits, although possibly a cause or consequence of chronic symptoms, suggest a need to include resistance exercise in the management of plantar Heel Pain. Level of Evidence IV
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Determinants of footwear difficulties in people with plantar Heel Pain
Journal of Foot and Ankle Research, 2015Co-Authors: Justin Sullivan, Jack Crosbie, Roger Adams, Evangelos Pappas, Joshua BurnsAbstract:Plantar Heel Pain is a common foot disorder aggravated by weight-bearing activity. Despite considerable focus on therapeutic interventions such as orthoses, there has been limited investigation of footwear-related issues in people with plantar Heel Pain. The aim of this study was to investigate whether people with plantar Heel Pain experience footwear-related difficulties compared to asymptomatic individuals, as well as identifying factors associated with footwear comfort, fit and choice. The footwear domain of the Foot Health Status Questionnaire (FHSQ) was assessed in 192 people with plantar Heel Pain and 69 asymptomatic controls. The plantar Heel Pain group was also assessed on a variety of measures including: foot posture, foot strength and flexibility, pedobarography and Pain level. A univariate analysis of covariance, with age as the covariate, was used to compare the Heel Pain and control groups on the FHSQ footwear domain score. A multiple regression model was then constructed to investigate factors associated with footwear scores among participants with plantar Heel Pain. When compared to asymptomatic participants, people with plantar Heel Pain reported lower FHSQ footwear domain scores (mean difference −24.4; p
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Plantar Heel Pain and foot loading during normal walking
Gait and Posture, 2015Co-Authors: Justin Sullivan, Joshua Burns, Roger Adams, Evangelos Pappas, Jack CrosbieAbstract:Plantar Heel Pain is aggravated by weight-bearing, yet limited evidence exists regarding how people with Heel Pain load their feet during walking. Knowledge of loading patterns in people with plantar Heel Pain would enhance the understanding of their foot function and assist in developing intervention strategies. Plantar pressure using the Emed-AT platform (Novel Gmbh, Germany) was collected from 198 people with plantar Heel Pain and 70 asymptomatic controls during normal walking. Maximum force, force-time integral, peak pressure, pressure-time integral and contact time were measured in four quadrants of the Heel, the midfoot and the medial and lateral forefoot. The symptomatic group was sub-divided into equal low-Pain and high-Pain groups using the Foot Health Status Questionnaire Pain score. Following age and body mass comparison, multivariate analyses of covariance were performed to compare the Heel Pain group to the controls, and the low-Pain group to the high-Pain group, for each loading variable. The Heel Pain group displayed lower maximum force beneath the Heel, lower peak pressure beneath the postero-lateral Heel and lower maximum force beneath the medial forefoot. Force-time integrals were lower beneath the posterior Heel regions and higher at the lateral forefoot. People with Heel Pain also had longer midfoot and forefoot contact time. Higher Pain level was associated with lower peak pressure and maximum force beneath regions of the Heel. Compared to the controls, people with plantar Heel Pain demonstrated reduced Heel loading and modified forefoot loading consistent with a strategy to offload the Painful Heel.
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Musculoskeletal and Activity-Related Factors Associated With Plantar Heel Pain:
Foot & Ankle International, 2014Co-Authors: Justin Sullivan, Joshua Burns, Roger Adams, Evangelos Pappas, Jack CrosbieAbstract:Background:Despite the prevalence and impact of plantar Heel Pain, its etiology remains poorly understood, and there is no consensus regarding optimum management. The identification of musculoskeletal factors related to the presence of plantar Heel Pain could lead to the development of better targeted intervention strategies and potentially improve clinical outcomes. The aim of this study was to investigate relationships between a number of musculoskeletal and activity-related measures and plantar Heel Pain.Methods:In total, 202 people with plantar Heel Pain and 70 asymptomatic control participants were compared on a variety of musculoskeletal and activity-related measures, including body mass index (BMI), foot and ankle muscle strength, calf endurance, ankle and first metatarsophalangeal (MTP) joint range of motion, foot alignment, occupational standing time, exercise level, and generalized hypermobility. Following a comparison of groups for parity of age, analyses of covariance were performed to detect ...
Chungli Wang - One of the best experts on this subject based on the ideXlab platform.
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Heel pad stiffness in plantar Heel Pain by shear wave elastography
Ultrasound in Medicine and Biology, 2015Co-Authors: Cheyu Lin, Chenchiang Lin, Yangchen Chou, Peiyu Chen, Chungli WangAbstract:The goal of the study was to evaluate the reliability of supersonic shear wave elastography in measuring Heel pad stiffness and the change in Heel pad stiffness in patients with plantar Heel Pain. In the reliability test involving 12 normal participants, each Heel pad was tested six times in succession, and adequate reliability was reflected in the intraclass correlation coefficients (0.95, 0.93 and 0.96 for the microchambers, macrochambers and bulk Heel pad, respectively). In the clinical assessment involving 20 normal participants and 16 unilateral plantar Heel Pain patients, diseased Heel pads (86.8 ± 22.9, 36.8 ± 7.7 and 46.6 ± 10.9 kPa for the microchambers, macrochambers and bulk Heel pad, respectively) were significantly stiffer than unaffected Heel pads (66.8 ± 14.1, 25.2 ± 5.7, 34.2 ± 6.6 kPa) and those of normal participants (60.9 ± 11.4, 26.3 ± 6.1, 31.8 ± 6.3 kPa), suggesting that the Heel pad with plantar Heel Pain was associated with loss of elasticity.
Joshua Burns - One of the best experts on this subject based on the ideXlab platform.
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Role of mechanical factors in the clinical presentation of plantar Heel Pain: Implications for management.
The Foot, 2020Co-Authors: Justin Sullivan, Evangelos Pappas, Joshua BurnsAbstract:Plantar Heel Pain is a common musculoskeletal foot disorder that can have a negative impact on activities of daily living and it is of multifactorial etiology. A variety of mechanical factors, which result in excessive load at the plantar fascia insertion, are thought to contribute to the onset of the condition. This review presents the evidence for associations between commonly assessed mechanical factors and plantar Heel Pain, which could guide management. Plantar Heel Pain is associated with a higher BMI in non-athletic groups, reduced dorsiflexion range of motion, as well as reduced strength in specific foot and ankle muscle groups. There is conflicting, or insufficient evidence regarding the importance of foot alignment and first metatarsophalangeal joint range of motion. Plantar Heel Pain appears to be common in runners, with limited evidence for greater risk being associated with higher mileage or previous injuries. Conflicting evidence exists regarding the relationship between work-related standing and plantar Heel Pain, however, longer standing duration may be associated with plantar Heel Pain in specific worker groups. The evidence presented has been generated through studies with cross-sectional designs, therefore it is not known whether any of these associated factors have a causative relationship with plantar Heel Pain. Longitudinal studies are needed to ascertain whether the strength and flexibility impairments associated with plantar Heel Pain are a cause or consequence of the condition, as well as to establish activity thresholds that increase risk. Intervention approaches should consider strategies that improve strength and flexibility, as well as those that influence plantar fascia loading such as body weight reduction, orthoses and management of athletic and occupational workload.
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Clinical and Functional Characteristics of People With Chronic and Recent-Onset Plantar Heel Pain
PM&R, 2017Co-Authors: Allegra Barnes, Justin Sullivan, Roger Adams, Evangelos Pappas, Joshua BurnsAbstract:Abstract Background Plantar Heel Pain is a common condition that reduces health-related quality of life. Recovery usually occurs within 12 months; however, up to 20% of people remain symptomatic beyond this time frame. The level of Pain and function in this chronic Heel Pain group is not well described. Objective To identify clinical and functional characteristics associated with chronic plantar Heel Pain compared with Heel Pain of recent onset. Design Cross-sectional study. Setting University research laboratory and private physiotherapy clinic. Participants A total of 71 people with plantar Heel Pain for longer than 12 months and 64 people with plantar Heel Pain for less than 6 months were recruited from the general public. Methods Functional characteristics of participants in both Heel Pain groups were assessed with a variety of clinical measures and the Foot Health Status Questionnaire. Clinical measures included body mass index, foot and ankle muscle strength using hand-held dynamometry, as well as ankle and first metatarsophalangeal joint range of motion. The Foot Health Status Questionnaire was used to collect self-reported measures of foot Pain severity, foot function and physical activity. Main Outcome Measurements Univariate analyses of variance were performed to detect differences between the 2 groups for each of the variables measured. Results The chronic Heel Pain group exhibited reduced ankle dorsiflexor and toe flexor strength yet better self-reported foot function. There was no difference between groups for body mass index, ankle and first metatarsophalangeal joint range of motion, inversion strength, eversion strength, calf endurance, self-reported foot Pain, and physical activity. Conclusions Chronic plantar Heel Pain is associated with selective weakness of foot and ankle muscle groups but less affected foot function compared with Heel Pain of recent onset. Those with chronic symptoms may moderate or make adaptations to their daily activities, or simply accept their condition, enabling more effective coping. Strength deficits, although possibly a cause or consequence of chronic symptoms, suggest a need to include resistance exercise in the management of plantar Heel Pain. Level of Evidence IV
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Determinants of footwear difficulties in people with plantar Heel Pain
Journal of Foot and Ankle Research, 2015Co-Authors: Justin Sullivan, Jack Crosbie, Roger Adams, Evangelos Pappas, Joshua BurnsAbstract:Plantar Heel Pain is a common foot disorder aggravated by weight-bearing activity. Despite considerable focus on therapeutic interventions such as orthoses, there has been limited investigation of footwear-related issues in people with plantar Heel Pain. The aim of this study was to investigate whether people with plantar Heel Pain experience footwear-related difficulties compared to asymptomatic individuals, as well as identifying factors associated with footwear comfort, fit and choice. The footwear domain of the Foot Health Status Questionnaire (FHSQ) was assessed in 192 people with plantar Heel Pain and 69 asymptomatic controls. The plantar Heel Pain group was also assessed on a variety of measures including: foot posture, foot strength and flexibility, pedobarography and Pain level. A univariate analysis of covariance, with age as the covariate, was used to compare the Heel Pain and control groups on the FHSQ footwear domain score. A multiple regression model was then constructed to investigate factors associated with footwear scores among participants with plantar Heel Pain. When compared to asymptomatic participants, people with plantar Heel Pain reported lower FHSQ footwear domain scores (mean difference −24.4; p
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Plantar Heel Pain and foot loading during normal walking
Gait and Posture, 2015Co-Authors: Justin Sullivan, Joshua Burns, Roger Adams, Evangelos Pappas, Jack CrosbieAbstract:Plantar Heel Pain is aggravated by weight-bearing, yet limited evidence exists regarding how people with Heel Pain load their feet during walking. Knowledge of loading patterns in people with plantar Heel Pain would enhance the understanding of their foot function and assist in developing intervention strategies. Plantar pressure using the Emed-AT platform (Novel Gmbh, Germany) was collected from 198 people with plantar Heel Pain and 70 asymptomatic controls during normal walking. Maximum force, force-time integral, peak pressure, pressure-time integral and contact time were measured in four quadrants of the Heel, the midfoot and the medial and lateral forefoot. The symptomatic group was sub-divided into equal low-Pain and high-Pain groups using the Foot Health Status Questionnaire Pain score. Following age and body mass comparison, multivariate analyses of covariance were performed to compare the Heel Pain group to the controls, and the low-Pain group to the high-Pain group, for each loading variable. The Heel Pain group displayed lower maximum force beneath the Heel, lower peak pressure beneath the postero-lateral Heel and lower maximum force beneath the medial forefoot. Force-time integrals were lower beneath the posterior Heel regions and higher at the lateral forefoot. People with Heel Pain also had longer midfoot and forefoot contact time. Higher Pain level was associated with lower peak pressure and maximum force beneath regions of the Heel. Compared to the controls, people with plantar Heel Pain demonstrated reduced Heel loading and modified forefoot loading consistent with a strategy to offload the Painful Heel.
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Musculoskeletal and Activity-Related Factors Associated With Plantar Heel Pain:
Foot & Ankle International, 2014Co-Authors: Justin Sullivan, Joshua Burns, Roger Adams, Evangelos Pappas, Jack CrosbieAbstract:Background:Despite the prevalence and impact of plantar Heel Pain, its etiology remains poorly understood, and there is no consensus regarding optimum management. The identification of musculoskeletal factors related to the presence of plantar Heel Pain could lead to the development of better targeted intervention strategies and potentially improve clinical outcomes. The aim of this study was to investigate relationships between a number of musculoskeletal and activity-related measures and plantar Heel Pain.Methods:In total, 202 people with plantar Heel Pain and 70 asymptomatic control participants were compared on a variety of musculoskeletal and activity-related measures, including body mass index (BMI), foot and ankle muscle strength, calf endurance, ankle and first metatarsophalangeal (MTP) joint range of motion, foot alignment, occupational standing time, exercise level, and generalized hypermobility. Following a comparison of groups for parity of age, analyses of covariance were performed to detect ...
