Which mobilization has NOT been shown to improve heel pain symptoms in plantar fasciitis?

Which mobilization has NOT been shown to improve heel pain symptoms in plantar fasciitis?

• A. Cuboid thrust manipulation
• B. Proximal tibiofibular joint thrust manipulation
• C. Midtarsal pronation/supination nonthrust manipulation
• D. Distal tibiofibular joint posterior nonthrust manipulation

Answer: (C)

Manual therapy for plantar fasciitis aims to modify foot and ankle mechanics to reduce strain on the plantar fascia. Not all mobilizations have proven benefits, and the evidence differs by the joint being treated. The midtarsal joint mobilization focused on pronation and supination, done without thrust, has not consistently shown relief of heel pain in plantar fasciitis. In other words, nonthrust mobilization of the midtarsal joints does not appear to reliably reduce symptoms, even though it may improve midfoot mobility in other conditions. By contrast, mobilizations at nearby joints can influence overall foot mechanics and loading patterns in ways that the plantar fascia responds to more favorably. Techniques like cuboid thrust manipulation and thrust-like or posterior, nonthrust mobilizations at distal and proximal tibiofibular joints have been associated with symptom improvements in this condition, likely because they help restore more optimal alignment and load distribution across the hindfoot and lower leg. So, the mobilization that has not been shown to improve heel pain symptoms is the midtarsal pronation/supination nonthrust manipulation.

Manual therapy for plantar fasciitis aims to modify foot and ankle mechanics to reduce strain on the plantar fascia. Not all mobilizations have proven benefits, and the evidence differs by the joint being treated.

The midtarsal joint mobilization focused on pronation and supination, done without thrust, has not consistently shown relief of heel pain in plantar fasciitis. In other words, nonthrust mobilization of the midtarsal joints does not appear to reliably reduce symptoms, even though it may improve midfoot mobility in other conditions. By contrast, mobilizations at nearby joints can influence overall foot mechanics and loading patterns in ways that the plantar fascia responds to more favorably. Techniques like cuboid thrust manipulation and thrust-like or posterior, nonthrust mobilizations at distal and proximal tibiofibular joints have been associated with symptom improvements in this condition, likely because they help restore more optimal alignment and load distribution across the hindfoot and lower leg.

So, the mobilization that has not been shown to improve heel pain symptoms is the midtarsal pronation/supination nonthrust manipulation.