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PLANTAR FASCIITIS

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About Plantar Fasciitis

- Possible Causes / Aggravating Factors

- Treatment

PF Stretching / Strengthening Exercises

PLANTAR FASCIITIS

Plantar Fasciitis

About?

Plantar Fasciitis (aka. plantar heel pain syndrome, heel spur syndrome, runner's heel or painful heel syndrome) is a degenerative, commonly inflammatory condition of the plantar fascia felt as discomfort / pain under the heel of the foot.

–   The plantar fascia is a non-elastic ligament, comprised of thick fibrous connective tissue (fascia) extending from heel to toes - which creates the arch of the foot and hasan important role in the mechanical function of the foot affecting gait

–   Collagen is the main component of the plantar fascia which contains closely packed bundles of collagen fibers forming a wavy pattern parallel to the direction of pull having great tensile strength

–   Pain is consequential to an abnormality or injury to the plantar fascia - causing traction beyond its stretching ability, usually where it is attached to and pulls away from the heel bone (calcaneus). The otherend of the plantar fascia splays and attaches to the metatarsal bones at the ball of the foot

As the foot flattens, the plantar fascia stretches and begins to pull away from the heel causing pain.

Symptoms

✔  Dull, intermittent pain may progress to a sharp, but sustained knife-like pain

✔  Pain is typically worse immediately after getting out of bed, after sitting, when climbing stairs or after intense activity usually eases off throughout the day, but returns after intense or increased physical activity or prolonged weight-bearing

✔  Pain can be sufficient to cause sufferer to limp with heel lifted off the ground in the long-term, this can worsen the problem by affecting gait

The mechanics of walking

After the heel makes contact with the ground, the tibia turns inward and the foot pronates (rolls inward), stretching the plantar fascia and flattening the arch to accommodate irregularities in the walking surface.

Tension in the plantar fasciitis is critical to maintaining foot arch and serves as a shock absorber for foot and leg

With aggravating factors, repetitive movements (E.g. walking / running) cause multiple micro-tears in the plantar fascia, weakening the foot arch which further increases strain on the plantar fascia

Possible Causes / Aggravating Factors

Plantar fasciitis typically occurs only in one foot

Plantar fasciitis can dramatically affect physical mobility and also lead to heel spurs microscopic tearing of plantar fascia can cause inflammation of the heel bone (calcaneus) leading to the production of bone growths (spurs), which may or may not be painful

Plantar fasciitis is the most common cause of heel pain

✔  An estimated 10% of U.S. population will experience plantar heel pain in their lifetime

Crawford F, Atkins D, Edwards J. Interventions for treating plantar heel pain. Cochrane Database Syst Rev 2000;(3):CD000416. Update in: Cochrane Database Syst Rev 2003;(3):CD000416.

✔  Accounts for 11-15 % of all foot symptoms

Pfeffer G, Bacchetti P, Deland J, et al. Comparison of custom and prefabricated orthoses in the initial treatment of proximal plantar fasciitis. Foot Ankle Int 1999;20:214-221.

✔  2 million people in the U.S. are treated for plantar fasciitis on an annual basis

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