Introduction-
Plantar fasciitis is the result of collagen degeneration of the plantar fascia , tuberosity of the heel and also surrounding perifascial structures.
Functions of the plantar fascia-
- To maintain normal biomechanics of the foot
- To provide arch support
- providing shock absorption.
Etiology-
This is often an overuse injury. It occurs primarily due to a repetitive strain causing micro-tears of the plantar fascia. However it can also occur as a result of trauma or other multifactorial causes.
Risk factors of plantar fascitis-
- Loss of ankle dorsiflexion
- Pes cavus OR pes planus
- Excessive foot pronation
- prolonged standing, running, etc
- Improper shoe fit
- Elevated BMI
- Diabetes Mellitus
- Tightness and/or weakness of muscles of the leg.
Epidemiology–
Plantar fasciitis is the most common cause of heel pain. It Accounts for about 10% of runner-related injuries. Most patients affected being active working adults between the ages of 25 and 65 years old. Moreover, It may present bilaterally. Females present more commonly than males.
Clinical features of plantar fascitis-
- local point tenderness along the calcaneum
- pain on walking
- walking barefoot, climbing stairs, or toe walking can worsen the pain
- Heel pain after prolonged periods of non-weight bearing
- Tenderness to the heel
- Limited dorsiflexion
- Tight calf
- A limp may be present
Secondary findings may include-
- Tight achillis heel cord
- Pes planus or pes cavus
- Work-related weight-bearing
- obesity
Conservative measures are the first choice-
- Relative rest
- ice after activity
- Deep massage of the arch and insertion.
- Shoe inserts and night splints or orthotics
- stretching and rehab
- the symptoms may take weeks or even months to improve (depending on severity of injury).
Risk factors and biomechanics-
- Overpronation: Overpronation results in weakness of the posterior tibialis muscle. This muscle normally functions to reduce tension applied to the plantar aponeurosis. Weakness in tibialis posterior will result in an increase in tensile forces and lead to collagen degradation.
- High-Arched Feet: A high arch causes the plantar aponeurosis in a continuously shortened state.
- Leg length discrepancy- this results in uneven distribution and transmission of ground reaction forces to the feet. Compensatory mechanisms like excessive hip and knee flexion, and excessive hip circumduction all increase the stress on the plantar aponeurosis. As greater forces are transmitted to the foot on the longer limb, it is more affected.
- Footwear: The sole and heel of old shoes can begin to wear down with continual use. This decreases the ability of the shoe to absorb ground reaction forces. Thus, the foot and the plantar aponeurosis will experience more stress.
Also read- https://vcurehealthcare.com/the-concept-of-neuroplasticity/