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Plantar fasciitis

  • What is the plantar fasciitis
    • The condition occurs due to overuse and stress on the plantar fascia, which can result in tissue fatigue and microtearing at the calcaneal attachment.
  • Cause of plantar fasciitis
    • Primary cause
      • Overuse : Running, Prolonged standing, dancing
    • Secondary cause
      • Pes cavus OR pes planus deformities
      • Shor and tight : gastrocnemius and soleus
      • Improper footwear
      • weight gain
  • Medical treatment
    • Non-steroidal anti-inflammatories
    • Corticosteroid injection
  • SOAP
    1. Symptomes
      1. Pain occurs with the first feww steps after non-weight bearing
        1. Pain wre worse during the pre-swing phase or during stair climbing or bearfoot on hard surface
        2. Pain is usually relieved by rest
      2. Tenderness to the anterior medial heel
      3. Limited dorsiflexion
      4. Tight achilles tendon
    2. Objective
      1. Observation : gait
      2. Palpation
      3. Testing
        1. ROM : Gastrocnemius and soleus reveal shortness, weak intrinsic muscles.
        2. Special test
          1. Windlass test
    3. Assessment
      1. Differentiagting
        1. Contusion of the fat pad
        2. Stress fractures of the calcaneus
        3. Tarsal tunnel syndrome
    4. Treatment Plan
      1. Acute
        1. Cold application to the affected fascia
        2. Trigger point : gastrocnemius, soleus, tibialis posterior and flesor digitorum
      2. Chronic
        1. Deep moist heat
        2. Shortened muscles : Gastrocnemius, soleus, tibialis posterior and flesor digitorum
          1. Fascial technique
          2. Petrrisage
          3. Trigger point
          4. Cross-fiber friction : on adhesion in the plantar fascia, particularly near the calcaneal attachments. on the Achilles tendon with any associated tendinitis
          5. Passive stretch or PNF : include plantar fascia
        3. Joint play
          1. Subtalar joint distraction
          2. Posteior talocrural joint mobilization
      3. Remedial exercise
        1. Acute
          1. rest
          2. Ice
          3. Elevate the affected foot
        2. Chronic
          1. Ice is applied three or four times per day to control the inflammation and after activities that cause pain
          2. Heat is applied to the posterior leg compartment befor activity
          3. Self massage : postiror compartment and plantar fascia
          4. Self stretching
            1. Gastrocnemius and soleus
            2. Plantar fascia
          5. Strengthening
            1. Intrinsic muscles : scrunching up a towel, picking pencil with toes
          6.  Foot orthoses

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