CCGI Best Practice Collaborators
CCGI Best Practice Collaborators
CCGI Best Practice Collaborators
In April 2016, CCGI Opinion Leaders were joined by a new team of CCGI Best Practice Collaborators. These are influential evidence-informed clinicians recently nominated by their colleagues in a nationwide survey. They are assisting Opinion Leaders in their area with reaching out to other chiropractors and teaching them about critical thinking, proper interpretation of evidence-informed clinical practice guidelines, and evidence-informed practice in general.
CCGI is delighted to have them on board and looks forward to collaborating with them to take the best practices forward in Canada.
Roles and Activities of CCGI Best Practice Collaborators
-
understanding how clinical practice guidelines are developed;
-
discussing best practices and guidelines with colleagues;
-
having a presence on social media to raise awareness of resources on evidence-informed practice;
-
encouraging clinicians and patients to use the CCGI website and resources;
-
making presentations on evidence-informed practice at continuing education events and conferences in collaboration with their local opinion leaders team.
In April 2016, CCGI Opinion Leaders were joined by a new team of CCGI Best Practice Collaborators. These are influential evidence-informed clinicians recently nominated by their colleagues in a nationwide survey. They are assisting Opinion Leaders in their area with reaching out to other chiropractors and teaching them about critical thinking, proper interpretation of evidence-informed clinical practice guidelines, and evidence-informed practice in general.
CCGI is delighted to have them on board and looks forward to collaborating with them to take the best practices forward in Canada.
Roles and Activities of CCGI Best Practice Collaborators
-
understanding how clinical practice guidelines are developed;
-
discussing best practices and guidelines with colleagues;
-
having a presence on social media to raise awareness of resources on evidence-informed practice;
-
encouraging clinicians and patients to use the CCGI website and resources;
-
making presentations on evidence-informed practice at continuing education events and conferences in collaboration with their local opinion leaders team.
In April 2016, CCGI Opinion Leaders were joined by a new team of CCGI Best Practice Collaborators. These are influential evidence-informed clinicians recently nominated by their colleagues in a nationwide survey. They are assisting Opinion Leaders in their area with reaching out to other chiropractors and teaching them about critical thinking, proper interpretation of evidence-informed clinical practice guidelines, and evidence-informed practice in general.
CCGI is delighted to have them on board and looks forward to collaborating with them to take the best practices forward in Canada.
Roles and Activities of CCGI Best Practice Collaborators
-
understanding how clinical practice guidelines are developed;
-
discussing best practices and guidelines with colleagues;
-
having a presence on social media to raise awareness of resources on evidence-informed practice;
-
encouraging clinicians and patients to use the CCGI website and resources;
-
making presentations on evidence-informed practice at continuing education events and conferences in collaboration with their local opinion leaders team.
Are you interested in getting involved with CCGI?
We are always looking to get people involved in our projects. No experience necessary - we provide training!
Contact us today!
Are you interested in getting involved with CCGI?
We are always looking to get people involved in our projects. No experience necessary - we provide training!
Contact us today!
Plantar Heel Pain
This tool provides information to facilitate the management of plantar heel pain in adults.
Plantar heel pain is associated with impaired health-related quality of life including social isolation, a poor perception of health status and reduced functional capabilities.
Focused examination
1. Patient History
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Assess level of concern for major structural or other pathologies. If required, refer to an appropriate healthcare provider
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Identify and assess other conditions and co-morbidities. Manage using appropriate care pathways
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Understand the patient’s beliefs and expectations about plantar heel pain
Major structural or other pathologies may be suspected with certain signs and symptoms (red flags):
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Positive Ottawa Ankle Rules, children <12 years of age, elderly patients, erythema, warmth, fever, chills, prolonged pain, swelling, catching and/or instability of the ankle joint, pain at rest, awakening due to pain at night, bilateral pain
Examples of other conditions/co-morbidities:
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Physical conditions: patellofemoral pain, lumbar strain
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Psychological conditions: depression, anxiety
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Co-morbidities: diabetes (peripheral neuropathy), chronic venous insufficiency
2. Physical Examination
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Assess levels of concern regarding major structural or other pathologies
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Assess for differential diagnoses (i.e., tarsal tunnel syndrome, stress fracture, Achilles tendinitis, retrocalcaneal bursitis)
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Identify patient's baseline status relative to pain, function and disability, determine the patient's readiness to return to activities using appropriate assessments
3. Management
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Offer individualized education in conjunction with low dye taping and plantar fascia stretching
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Discuss the range of effective interventions with the patient and, together, select a therapeutic intervention
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Utilize a stepped care approach for patients progressing slowly or inadequately
4. Reevaluation and discharge
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Reassess the patient at every visit to determine if: (1) additional care is necessary; (2) the condition is worsening; or (3) the patient has recovered
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Monitor for any emerging factors that may delay recovery
Therapeutic Recommendations
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Provide a core approach of plantar fascia stretching, taping to support the plantar fascia, and individualized education.
Individualized education¹ may include:
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Load management to break up long periods of static loading or rapid training changes in more athletic populations
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Pain education
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Address related conditions (i.e., Type 2 diabetes)
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Footwear advice to ensure comfort in shoes that allow rearfoot to forefoot (RF/FF) drop while also considering social acceptability to improve adherence
Consider dry needling as an adjunct intervention to the core approach²
Consider extracorporeal shockwave therapy (focused or radial) for people with non-resolving, persistent symptoms (at 4 weeks)
Consider custom foot orthoses if patients do not respond to core approach or shockwave therapy (at 12 weeks)
¹The educational delivery should adopt a realistic tone as recovery may take several weeks or months but is important to stress the positive prognosis.
²Dry needling should not be a first-line treatment but may be considered to influence pain and muscle tension when combined with other interventions
Care Pathway for the management of plantar heel pain
