Plantar Fasciitis

CLINICAL PRESENTATION & EXAM: A patient with plantar fasciitis will often present symptoms of pain isolated to the media tubercle of the calcaneus, or a burning sensation over the inner foot arch. The symptoms usually start as a dull intermittent pain but tend to progress to sharp and more persistent pains. Patients will typically experience pain within the first steps of the morning, after a prolonged resting period, or after continual stress to the plantar fascia. Plantar fasciitis is a degenerative syndrome of the plantar fascia as a result of repetitive trauma on the calcaneus. The plantar fascia stabilizes the foot arch while walking. Frequency and intensity of stress to plantar fascia causes microtrauma and results in heel pain. ANATOMY & PATHOLOGY: Plantar fascia is a thick aponeurosis formed from three bands of dense connective collagen fibers that attach proximally to the medial calcaneal tuberosity and span down to the proximal phalanges. Plantar fascia provides support to the longitudinal arch of the foot by distributing force between the heel and the forefoot during weight bearing activities. The plantar fascia acts as a shock absorber for the foot, protecting nerves, vessels, muscles, and tendons, along with maintenance of the plantar arch of the foot during weight bearing activities. Plantar fasciitis was traditionally considered an inflammatory process, but recent research points primarily to a degenerative process. Plantar Fasciitis is characterized by thickening of fibrous tissue, swelling, edema, increased pain sensitivity, or rupture of plantar fascia. DIAGNOSTIC TESTING & CONSIDERATIONS: Plantar Fasciitis can be diagnosed through patient history of signs & symptoms, along with a series of examinations. Foot palpation exams can be done on the medial tuberosity of the calcaneus and the proximal portion of the plantar fascia. Other manual examinations include ankle passive supination and the Windlass test. An X-ray can show possible bone spurs, which are asymptomatic. Bone scans can be used to rule out a stress fracture. An Ultrasound can show thickening of the fascial regions, and magnetic resonance imaging can be used to show swelling of the fascia, indicating plantar fasciitis. TREATMENT & RETURN TO ACTIVITY: There are a variety of treatment methods for plantar fasciitis that focus on functional improvement and reducing pain & swelling. Physical treatment methods include physical therapy, massage/manual treatments of soft tissue, stretching exercises, orthotic devices, kinesiotaping, dry needling, and osteopathic or manipulative treatments. Kinesiotaping has been found to reduce pain, swelling, and provide arch support. However, effects of kinesotaping lessen during prolonged running/activity. Along with improved running mechanics, a reduction of running frequency and running on uneven or inclined surfaces will reduce strain on plantar fascia thereby allowing the body to heal. Dry-cupping and electrical stimulation have been shown to reduce pain and increase function in patients with plantar fasciitis. Other treatment methods include laser therapy, iontophoresis, ultrasound, cryoultrasound, low-dose radiotherapy, and extracorporeal shock waves therapy (ESWT). ESWT is a process of creating high pressure waves, generated outside the body, that focus on a certain point inside the body. Pharmacological treatment includes the use of non-steroidal anti-inflammatory drugs (NSAIDS). More serious treatment methods involve surgery for chronic and severe cases of plantar fasciitis

Modeling eddy current analysis data to determine depth of weld penetration

The Applied Engineering Technology Croup in the Engineering Sciences and Applications Division at Los Alamos National Laboratory is currently providing the design, engineering, assembly, and testing of an eddy current instrument for weld inspection. This instrument is designed to provide an in situ weld depth measurement of nuclear weapons primary components during fabrication. The goal of this effort is to improve the accuracy and reliability of the measurement of the weld joint depth and provide a mechanism for inspection without removing the part from the fixture. This feature is essential to accommodate the re-welding process if the inspection fails. The production system consists of a commercially available eddy current instrument and eddy current probe connected to a portable PC. The objective of the system software is acquire and analyze voltage and phase angle data to produce a near-real time estimate of weld depth. The data obtained from the instrument are perfectly suited for analysis by a neural network technique. This paper compares the effectiveness of a neural network application with traditional mathematical models for the analysis of weld depth information

The Lantern Vol. 60, No. 2, Summer 1993

• Wake • Misconception • Cliche • Standard Oil • Lake Effect • Charlotte • Psychedelic Iridescent Infidelity • A Playground in Winter • Shooting Pool with Angels • The Blood Through Our Veins • Iced Coffee • Buzz Kill • Immortality • Cathodic Union • Crush • Mushrooms • Conversing • Eggplant • A Letter to the Civil Rights Movement • Still Sitting, Contemplating • Sensible Love • Monsters Under the Bed • Poison Rock • Waiting at the Dentist • Fate • Static • The Three C\u27s • As We Frolic • Nest • A Bottle of Wine and Patsy Cline • Bottoms of Pages, Backs of Bookshttps://digitalcommons.ursinus.edu/lantern/1143/thumbnail.jp

Long Range Plan: Dense matter theory for heavy-ion collisions and neutron stars

Since the release of the 2015 Long Range Plan in Nuclear Physics, major events have occurred that reshaped our understanding of quantum chromodynamics (QCD) and nuclear matter at large densities, in and out of equilibrium. The US nuclear community has an opportunity to capitalize on advances in astrophysical observations and nuclear experiments and engage in an interdisciplinary effort in the theory of dense baryonic matter that connects low- and high-energy nuclear physics, astrophysics, gravitational waves physics, and data scienceComment: 70 pages, 3 figures, White Paper for the Long Range Plan for Nuclear Scienc

Acupuncture or low frequency infrared treatment for low back pain in Chinese patients: a discrete choice experiment

Acupuncture is a popular but controversial treatment option for low back pain. In China, it is practised as traditional Chinese medicine; other treatment strategies for low back pain are commonly practised as Western medicine. Research on patient preference for low back-pain treatment options has been mainly conducted in Western countries and is limited to a willingness-to-pay approach. A stated-preference, discrete choice experiment was conducted to determine Chinese patient preferences and trade-offs for acupuncture and low frequency infrared treatment in low back pain from September 2011 to August 2012 after approval from the Department of Scientific Research in the study settings. Eight-six adult outpatients who visited the ‘traditional medicine department’ at a traditional Chinese medicine hospital and the ‘rehabilitation department’ at a Western medicine hospital in Guangdong Province of China for chronic low back pain during study period participated in an interview survey. A questionnaire containing 10 scenarios (5 attributes in each scenario) was used to ask participants' preference for acupuncture, low frequency infrared treatment or neither option. Validated responses were analysed using a nested-logit model. The decision on whether to receive a therapy was not associated with the expected utility of receiving therapy, female gender and higher out-of-pocket payment significantly decreased chance to receive treatments. Of the utility of receiving either acupuncture or low frequency infrared treatment, the treatment sensation was the most important attribute as an indicator of treatment efficacy, followed by the maximum efficacy, maintenance duration and onset of efficacy, and the out-of-pocket payment. The willingness-to-pay for acupuncture and low frequency infrared treatment were about $618.6 and$592.4 USD per course respectively, demonstrated patients' demand of pain management. The treatment sensation was regarded as an indicator of treatment efficacy and the most important attribute for choosing acupuncture or low frequency infrared treatment. The high willingness-to-pay demonstrated patients' demand of pain management. However, there may be other factors influencing patients' preference to receive treatments