Plantar fasciitis Survey

Question Title

1. Where is your heel pain?

Underneath the heel.

Under the arch

Underneath the heel and the arch

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2. If you have a diagnosis for your heel pain, please identify

Plantar fascitiis

Heel spur

Both

Other (please specify)

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3. Please score your current pain level

No pain 0

Moderate pain 5

Worst pain you can imagine 10

No pain 0

Moderate pain 5

Worst pain you can imagine 10

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4. How does your pain affect your normal activities / sport (Required.)

I have no problems with performing my usual activities / sport

I have some problems with performing my usual activities / sport

I am unable to perform my usual activities / sport

Other (please specify)

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5. What is your gender? (Required.)

Female

Male

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6. What is your age? (Required.)

18 to 24

25 to 34

35 to 44

45 to 54

55 to 64

65 to 74

75 or older

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7. How was your diagnosis made?

Self diagnosis

Clinical diagnosis only

X-ray

Ultrasound scan

CT scan

MRI scan

Other (please specify)

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8. What healthcare practitioners have you seen?

None

Chiropractor

Orthopaedic Surgeon

Osteopath

Physiotherpist

Podiatrist

Podiatric Surgeon

Rheumatologist

Sports medicine doctor

Other (please specify)

Question Title

9. How long have you had your problem (2 months = 8 weeks, 1 year = 52 weeks)?

Weeks

	1 - No help	2	3	4	5 - Moderately helpful	6	7	8	9	10 - Extremley helpful
Acupuncture	Acupuncture 1 - No help	Acupuncture 2	Acupuncture 3	Acupuncture 4	Acupuncture 5 - Moderately helpful	Acupuncture 6	Acupuncture 7	Acupuncture 8	Acupuncture 9	Acupuncture 10 - Extremley helpful
Ice	Ice 1 - No help	Ice 2	Ice 3	Ice 4	Ice 5 - Moderately helpful	Ice 6	Ice 7	Ice 8	Ice 9	Ice 10 - Extremley helpful
Injection - steroid	Injection - steroid 1 - No help	Injection - steroid 2	Injection - steroid 3	Injection - steroid 4	Injection - steroid 5 - Moderately helpful	Injection - steroid 6	Injection - steroid 7	Injection - steroid 8	Injection - steroid 9	Injection - steroid 10 - Extremley helpful
Night splint	Night splint 1 - No help	Night splint 2	Night splint 3	Night splint 4	Night splint 5 - Moderately helpful	Night splint 6	Night splint 7	Night splint 8	Night splint 9	Night splint 10 - Extremley helpful
Orthotic / insert brought in a shop	Orthotic / insert brought in a shop 1 - No help	Orthotic / insert brought in a shop 2	Orthotic / insert brought in a shop 3	Orthotic / insert brought in a shop 4	Orthotic / insert brought in a shop 5 - Moderately helpful	Orthotic / insert brought in a shop 6	Orthotic / insert brought in a shop 7	Orthotic / insert brought in a shop 8	Orthotic / insert brought in a shop 9	Orthotic / insert brought in a shop 10 - Extremley helpful
Orthtoic / insole bought on the internet	Orthtoic / insole bought on the internet 1 - No help	Orthtoic / insole bought on the internet 2	Orthtoic / insole bought on the internet 3	Orthtoic / insole bought on the internet 4	Orthtoic / insole bought on the internet 5 - Moderately helpful	Orthtoic / insole bought on the internet 6	Orthtoic / insole bought on the internet 7	Orthtoic / insole bought on the internet 8	Orthtoic / insole bought on the internet 9	Orthtoic / insole bought on the internet 10 - Extremley helpful
Orthotic / insole not custome made to a mould but provided by specialist	Orthotic / insole not custome made to a mould but provided by specialist 1 - No help	Orthotic / insole not custome made to a mould but provided by specialist 2	Orthotic / insole not custome made to a mould but provided by specialist 3	Orthotic / insole not custome made to a mould but provided by specialist 4	Orthotic / insole not custome made to a mould but provided by specialist 5 - Moderately helpful	Orthotic / insole not custome made to a mould but provided by specialist 6	Orthotic / insole not custome made to a mould but provided by specialist 7	Orthotic / insole not custome made to a mould but provided by specialist 8	Orthotic / insole not custome made to a mould but provided by specialist 9	Orthotic / insole not custome made to a mould but provided by specialist 10 - Extremley helpful
Orthotic / insole custom made to a mould	Orthotic / insole custom made to a mould 1 - No help	Orthotic / insole custom made to a mould 2	Orthotic / insole custom made to a mould 3	Orthotic / insole custom made to a mould 4	Orthotic / insole custom made to a mould 5 - Moderately helpful	Orthotic / insole custom made to a mould 6	Orthotic / insole custom made to a mould 7	Orthotic / insole custom made to a mould 8	Orthotic / insole custom made to a mould 9	Orthotic / insole custom made to a mould 10 - Extremley helpful
Physiotherapy	Physiotherapy 1 - No help	Physiotherapy 2	Physiotherapy 3	Physiotherapy 4	Physiotherapy 5 - Moderately helpful	Physiotherapy 6	Physiotherapy 7	Physiotherapy 8	Physiotherapy 9	Physiotherapy 10 - Extremley helpful
FS6 Sock	FS6 Sock 1 - No help	FS6 Sock 2	FS6 Sock 3	FS6 Sock 4	FS6 Sock 5 - Moderately helpful	FS6 Sock 6	FS6 Sock 7	FS6 Sock 8	FS6 Sock 9	FS6 Sock 10 - Extremley helpful
Shockwave therapy	Shockwave therapy 1 - No help	Shockwave therapy 2	Shockwave therapy 3	Shockwave therapy 4	Shockwave therapy 5 - Moderately helpful	Shockwave therapy 6	Shockwave therapy 7	Shockwave therapy 8	Shockwave therapy 9	Shockwave therapy 10 - Extremley helpful
Shoe change	Shoe change 1 - No help	Shoe change 2	Shoe change 3	Shoe change 4	Shoe change 5 - Moderately helpful	Shoe change 6	Shoe change 7	Shoe change 8	Shoe change 9	Shoe change 10 - Extremley helpful
Trainer / running shoe	Trainer / running shoe 1 - No help	Trainer / running shoe 2	Trainer / running shoe 3	Trainer / running shoe 4	Trainer / running shoe 5 - Moderately helpful	Trainer / running shoe 6	Trainer / running shoe 7	Trainer / running shoe 8	Trainer / running shoe 9	Trainer / running shoe 10 - Extremley helpful
Softer sole shoe	Softer sole shoe 1 - No help	Softer sole shoe 2	Softer sole shoe 3	Softer sole shoe 4	Softer sole shoe 5 - Moderately helpful	Softer sole shoe 6	Softer sole shoe 7	Softer sole shoe 8	Softer sole shoe 9	Softer sole shoe 10 - Extremley helpful
Stretching - calf	Stretching - calf 1 - No help	Stretching - calf 2	Stretching - calf 3	Stretching - calf 4	Stretching - calf 5 - Moderately helpful	Stretching - calf 6	Stretching - calf 7	Stretching - calf 8	Stretching - calf 9	Stretching - calf 10 - Extremley helpful
Stretching - plantar fascia	Stretching - plantar fascia 1 - No help	Stretching - plantar fascia 2	Stretching - plantar fascia 3	Stretching - plantar fascia 4	Stretching - plantar fascia 5 - Moderately helpful	Stretching - plantar fascia 6	Stretching - plantar fascia 7	Stretching - plantar fascia 8	Stretching - plantar fascia 9	Stretching - plantar fascia 10 - Extremley helpful
Taping	Taping 1 - No help	Taping 2	Taping 3	Taping 4	Taping 5 - Moderately helpful	Taping 6	Taping 7	Taping 8	Taping 9	Taping 10 - Extremley helpful

1 - No help

5 - Moderately helpful

10 - Extremley helpful

Acupuncture

Acupuncture 1 - No help

Acupuncture 2

Acupuncture 3

Acupuncture 4

Acupuncture 5 - Moderately helpful

Acupuncture 6

Acupuncture 7

Acupuncture 8

Acupuncture 9

Acupuncture 10 - Extremley helpful

Ice

Ice 1 - No help

Ice 2

Ice 3

Ice 4

Ice 5 - Moderately helpful

Ice 6

Ice 7

Ice 8

Ice 9

Ice 10 - Extremley helpful

Injection - steroid

Injection - steroid 1 - No help

Injection - steroid 2

Injection - steroid 3

Injection - steroid 4

Injection - steroid 5 - Moderately helpful

Injection - steroid 6

Injection - steroid 7

Injection - steroid 8

Injection - steroid 9

Injection - steroid 10 - Extremley helpful

Night splint

Night splint 1 - No help

Night splint 2

Night splint 3

Night splint 4

Night splint 5 - Moderately helpful

Night splint 6

Night splint 7

Night splint 8

Night splint 9

Night splint 10 - Extremley helpful

Orthotic / insert brought in a shop

Orthotic / insert brought in a shop 1 - No help

Orthotic / insert brought in a shop 2

Orthotic / insert brought in a shop 3

Orthotic / insert brought in a shop 4

Orthotic / insert brought in a shop 5 - Moderately helpful

Orthotic / insert brought in a shop 6

Orthotic / insert brought in a shop 7

Orthotic / insert brought in a shop 8

Orthotic / insert brought in a shop 9

Orthotic / insert brought in a shop 10 - Extremley helpful

Orthtoic / insole bought on the internet

Orthtoic / insole bought on the internet 1 - No help

Orthtoic / insole bought on the internet 2

Orthtoic / insole bought on the internet 3

Orthtoic / insole bought on the internet 4

Orthtoic / insole bought on the internet 5 - Moderately helpful

Orthtoic / insole bought on the internet 6

Orthtoic / insole bought on the internet 7

Orthtoic / insole bought on the internet 8

Orthtoic / insole bought on the internet 9

Orthtoic / insole bought on the internet 10 - Extremley helpful

Orthotic / insole not custome made to a mould but provided by specialist

Orthotic / insole not custome made to a mould but provided by specialist 1 - No help

Orthotic / insole not custome made to a mould but provided by specialist 2

Orthotic / insole not custome made to a mould but provided by specialist 3

Orthotic / insole not custome made to a mould but provided by specialist 4

Orthotic / insole not custome made to a mould but provided by specialist 5 - Moderately helpful

Orthotic / insole not custome made to a mould but provided by specialist 6

Orthotic / insole not custome made to a mould but provided by specialist 7

Orthotic / insole not custome made to a mould but provided by specialist 8

Orthotic / insole not custome made to a mould but provided by specialist 9

Orthotic / insole not custome made to a mould but provided by specialist 10 - Extremley helpful

Orthotic / insole custom made to a mould

Orthotic / insole custom made to a mould 1 - No help

Orthotic / insole custom made to a mould 2

Orthotic / insole custom made to a mould 3

Orthotic / insole custom made to a mould 4

Orthotic / insole custom made to a mould 5 - Moderately helpful

Orthotic / insole custom made to a mould 6

Orthotic / insole custom made to a mould 7

Orthotic / insole custom made to a mould 8

Orthotic / insole custom made to a mould 9

Orthotic / insole custom made to a mould 10 - Extremley helpful

Physiotherapy

Physiotherapy 1 - No help

Physiotherapy 2

Physiotherapy 3

Physiotherapy 4

Physiotherapy 5 - Moderately helpful

Physiotherapy 6

Physiotherapy 7

Physiotherapy 8

Physiotherapy 9

Physiotherapy 10 - Extremley helpful

FS6 Sock

FS6 Sock 1 - No help

FS6 Sock 2

FS6 Sock 3

FS6 Sock 4

FS6 Sock 5 - Moderately helpful

FS6 Sock 6

FS6 Sock 7

FS6 Sock 8

FS6 Sock 9

FS6 Sock 10 - Extremley helpful

Shockwave therapy

Shockwave therapy 1 - No help

Shockwave therapy 2

Shockwave therapy 3

Shockwave therapy 4

Shockwave therapy 5 - Moderately helpful

Shockwave therapy 6

Shockwave therapy 7

Shockwave therapy 8

Shockwave therapy 9

Shockwave therapy 10 - Extremley helpful

Shoe change

Shoe change 1 - No help

Shoe change 2

Shoe change 3

Shoe change 4

Shoe change 5 - Moderately helpful

Shoe change 6

Shoe change 7

Shoe change 8

Shoe change 9

Shoe change 10 - Extremley helpful

Trainer / running shoe

Trainer / running shoe 1 - No help

Trainer / running shoe 2

Trainer / running shoe 3

Trainer / running shoe 4

Trainer / running shoe 5 - Moderately helpful

Trainer / running shoe 6

Trainer / running shoe 7

Trainer / running shoe 8

Trainer / running shoe 9

Trainer / running shoe 10 - Extremley helpful

Softer sole shoe

Softer sole shoe 1 - No help

Softer sole shoe 2

Softer sole shoe 3

Softer sole shoe 4

Softer sole shoe 5 - Moderately helpful

Softer sole shoe 6

Softer sole shoe 7

Softer sole shoe 8

Softer sole shoe 9

Softer sole shoe 10 - Extremley helpful

Stretching - calf

Stretching - calf 1 - No help

Stretching - calf 2

Stretching - calf 3

Stretching - calf 4

Stretching - calf 5 - Moderately helpful

Stretching - calf 6

Stretching - calf 7

Stretching - calf 8

Stretching - calf 9

Stretching - calf 10 - Extremley helpful

Stretching - plantar fascia

Stretching - plantar fascia 1 - No help

Stretching - plantar fascia 2

Stretching - plantar fascia 3

Stretching - plantar fascia 4

Stretching - plantar fascia 5 - Moderately helpful

Stretching - plantar fascia 6

Stretching - plantar fascia 7

Stretching - plantar fascia 8

Stretching - plantar fascia 9

Stretching - plantar fascia 10 - Extremley helpful

Taping

Taping 1 - No help

Taping 2

Taping 3

Taping 4

Taping 5 - Moderately helpful

Taping 6

Taping 7

Taping 8

Taping 9

Taping 10 - Extremley helpful

Question Title

* 1. Where is your heel pain?

Question Title

* 2. If you have a diagnosis for your heel pain, please identify

Question Title

* 3. Please score your current pain level

Question Title

* 4. How does your pain affect your normal activities / sport (Required.)

Question Title

* 5. What is your gender? (Required.)

Question Title

* 6. What is your age? (Required.)

Question Title

* 7. How was your diagnosis made?

Question Title

* 8. What healthcare practitioners have you seen?

Question Title

* 9. How long have you had your problem (2 months = 8 weeks, 1 year = 52 weeks)?

Question Title

* 10. Select the treatments you have had and rate them (only rate those that you have had)?

1. Where is your heel pain?

2. If you have a diagnosis for your heel pain, please identify

3. Please score your current pain level

4. How does your pain affect your normal activities / sport (Required.)

5. What is your gender? (Required.)

6. What is your age? (Required.)

7. How was your diagnosis made?

8. What healthcare practitioners have you seen?

9. How long have you had your problem (2 months = 8 weeks, 1 year = 52 weeks)?

10. Select the treatments you have had and rate them (only rate those that you have had)?