Plantar Fasciitis

Definition

(Show Disclaimer) Note: I copy the "definition" of something straight from the book. I find it's best to have an all-encompassing definition in order to better orient myself when I am studying.

(Show Definition) Plantar fasciitis is an inflammatory condition in the plantar fascia (foot) that causes pain in the arch of the foot and radiates to the heel. The plantar fascia connective tissue runs across the bottom of the foot and connects the bottom of the tuberosity of the calcaneous to the heads of the metatarsal bones.

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Incidence/Prevalance

The most common cause of heel pain in Canada.

Pathogenesis

Reptitive tears in the fascia cause collagen breakdown, and inflammation.

Predisposing factors

Overuse (athletes), poor muscle strength (gastrocnemius, heel cord), poor arch support (footwear), obesity, anatomic (flat foot).

Common Findings

• Stabbing foot pain, worse in the morning, improves throughout the day. The pain does improve with walking/use, but then worsens towards the end of the day with prolonged standing.
• Burning, stiffness

Other Signs and Symptoms

May be bilateral, and may present with heel spurs.

History

1. HPI: is the pain with walking/running/standings? Does the pain radiate? What brings on the pain - pain worsened usually by dorsiflexion
2. ROS:
3. ALL/MEDS/HIITS: (What are HIITS? - Click to expand)
4. PMH/FAMHx/OBGYN:
5. SOCHx:

Physical Exam

Coming soon.

Diagnostic Tests

Only perform xray if fracture, tumor, or spurs. MRI is warranted if fascial thickening is noted or fascial rupture.

DDx

Heel spur, arthritis, fracture.

Plan

• General: rest, avoid overuse, may need orthotic support.
• Rx: NSAIDs

Follow-up

4 weeks. Watch for change of gait.

Consultation/Referral

Watch for neurologic symptoms, refer. May refer to podiatrist.

Individual Considerations

None.