Plantar Fasciitis

Plantar Fasciitis Description
Plantar Fasciitis is a common cause of pain in the foot.  It is felt to be related to degenerative changes in the plantar fascia of the foot related to microtears of the plantar fascial origin.

Plantar Fasciitis Anatomy
Plantar Fasciitis is

Plantar Fasciitis Symptoms
Plantar Fasciitis causes pain and swelling in the heel pad of the foot.  The pain is typically worse in the morning when first getting up and walking. 

Plantar Fasciitis Treatment 
Plantar Fasciitis s diagnosed based on a detailed history, physical exam and xrays performed by an orthopaedic surgeon, or sports medicine specialist.

Intial treatment of plantar fasciitis centers around a plantar fascia-specific stretching.  The plantar fascia is stretched by dorsiflexing the MTP joints of the foot and massaging the area of maximal tenderness.  Plantar fascial stretching should be done a total of ten times per session with a least 3 session each day. Gastroc-soleus muscle stretching and viscoelastic heal inserts are also integral parts of the initial treatment for plantar fasciitis.

If planter fasciitis fails to improve within 4 weeks, night-time splints are often added to the treatment program.  A walking casts is occasionally placed in severe cases. 

When plantar fasciitis fails to improve with 6-12 months non-op treatment, surgery is considered.  Surgical treatment for plantar fasciits is center on release of the medial third of planar fascia which can be done through a small incision or with Endoscopic plantar fascia release

Other treatment options for plantar fasciitis include low-energery shockwave treatments and orthotics.  Low-energy shockwave treatment for chronic plantar fasciitis in runners has demonstrated statistically significant improvement at 6 months’ follow-up, but is inferior to a plantar fascia-specific stretching program done consistently.  Prefabricated orthotics may provide short term improvement, custom orthotics have no benefit compared to prefabricated orthotics for plantar fasciitis.

Athletes returning to sports after Plantar Fasciitis should begin with a graduated exercise program. First they should be pain free with daily activities with full range of motion and at least 85% strength in the injured leg compared to the uninjured leg. Exercise begins with light jogging in a straight line, followed by sprinting in a straight line. When these have been done without pain the athlete can proceed to doing agility type drills such as 45º cuts, 90º cuts and jumping. Agility drills should begin at half-speed and proceed to full-speed provided the athlete remains pain free.

Plantar Fasciitis Prevention
Prevention of Plantar Fasciitis is centered on maintaining a healthy active lifestyle.  Plantar fasciitis is more common in obese or overweight individuals and in those that are on there feet on hard concrete all day.

Plantar Fasciitis Risk Factors
Plantar Fasciitis is associated the following sports: Baseball; Basketball;  Dance;   Football; Golf;  Running; Soccer .  Plantar fasciitis is more common in obese or overweight individuals and in those that are on there feet on hard concrete all day.

Plantar Fasciitis Rehab and Exercise Program
Plantar Fasciitis

Plantar Fasciitis Outcomes
Plantar Fasciitis generally responds well to a plantar-fascail stretching program.  90% of patients with plantar fasciitis are satisfied with the program and have a reduction in their symptoms.  75% return to full activity generally by 6 months. 

Similar injuries that can be confused with Plantar Fasciitis include:

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