The plantar fascia is a long band of fibrous tissue on the bottom of the foot that extends from the heel to the bases of the toes. It supports the joints, bones, and muscles under the foot during midstep and creates a rigid lever for push-off. It also maintains the longitudinal arch of the foot.
Plantar fasciitis (PF) is considered a chronic inflammatory syndrome rather than a post-traumatic disorder and is common in runners and dancers who use a repetitive, maximal plantar flexion of the ankle or dorsiflexion of the MTP joints. It is cause by repetitive stretching of a tight plantar fascial band leading to microtears at its origin on the heel.
Dull pain on the bottom of the heel, worst with the first steps of the morning, is the hallmark. The pain usually subsides after 30-45 minutes of activity.
Pain also occurs with the onset activity such as walking or running and may decrease as activity progresses but usually returns after resting and then resuming activity. In severe cases, pain may occur with any weight bearing. While pain usually occurs in the heel, it can radiate throughout the bottom of the foot towards the toes.
If treatment begins early, most cases resolve in 6 weeks, however, PF can be a chronic and frustrating problems that resists treatment efforts. Surgical release of the plantar fascia and removal of the bone spur may be considered if symptoms persist longer than 6-12 months.
This MediFocus Guide contains an extensive listing of citations and abstracts of recent journal articles that have been published about this condition in trustworthy medical journals. This is the same type of information that is available to physicians and other health care professionals. A partial selection of journal articles that are abstracted in this MediFocus Guide includes:
Sports and other soft tissue injuries, tendinitis, bursitis, and occupation-related syndromes. Current Opinion in Rheumatology. 2000
The use of ultrasound in the foot and ankle. Journal of the American Podiatric Medical Association. 1999
Plantar fasciitis and other causes of heel pain. American Family Physician. 1999
Diagnosing and treating plantar fasciitis: a conservative approach to plantar heel pain. Cleveland Clinic Journal of Medicine. 1999
Plantar fasciitis. Lippincott's Primary Care Practice. 1999
Plantar fasciitis: etiology and treatment. Journal of Orthopaedic & Sports Physical Therapy. 1999
A systematic review of treatments for the painful heel. Rheumatology (Oxford). 1999
Fortnightly review. Plantar fasciitis. BMJ. 1997
Plantar fascia rupture: diagnosis and treatment. Journal of Foot & Ankle Surgery. 1997
Defective running shoes as a contributing factor in plantar fasciitis in a triathlete. Journal of Orthopaedic & Sports Physical Therapy. 2000
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