2. INTRODUCTION
● Plantar fasciitis is one of the
most common causes of heel
pain.
● Structure of foot allows to sustain
the large weight bearing stress
under a variety of surface and
activities .
4. Anatomy :-
● Plantar fascia is a dense , fibrous Connective tissue
structure originating from the medial tuberosity of the
calcaneus.
● The actual purpose of Plantar fascia is :-
■ Support for the arch
■ Act as shock absorber
■ Dynamic function during gait
5. Epidemiology/Incidence:-
● Most common in sports that involve , long distance walking,
dancers , tennis players, basket ball players.
● Non-athelets whose occupation requires prolong weight
bearing.
7. Pathophysiology:-
Plantar fasciitis injury :-
● Repetitive impact on the feet for long time cause flexor
Muscles/tendons to become short and tight.
● Micro tearing at the point of attachment cause
progressive scarring of tissue,
inflammation and pain.
● Over a period of time heel spur
may develop.
8. Clinical Features :-
● Pain at base of heel
● Pain severe on getting out bed /mornings & in the
beginning of a run .
● Tenderness bottom of foot ,
burning pain , often sharp pain
● Swelling of bottom of foot
● Limp may be present
9. Differential diagnosis:-
● Plantar fasciitis is most common cause of chronic
plantar heel pain there are multiple differential
diagnosis :
■ plantar fascia rupture
■ Heel fat pad syndrome
■ Calcaneal stress fracture
■ Calcaneal bursitis
■ Achilles tendonitis
14. CONSERVATIVE MANAGEMENT :-
● Anti inflammatory drugs , cortisone
injections
● NSAIDS
○ IBUPROFEN
○ NAPROXEN
■ Medical management:-
15. ● Surgical release with plantar fasciotomy: done
open or arthroscopically
● Surgical release with plantar fasciotomy and
distal tarsal tunnel
Surgical management :-
17. Subjective assessment :-
■ Demographic data/patient profile:-
● Name :-
● Age :- PF is most common between the ages of 40
& 60 years old
● Gender:-
● Occupation:-
Assessment :-
18. Chief complaints:-
● Pain at the bottom of heel
● Pain can be dull or sharp
● Pain is usually worse on getting out bed .
19. ● Pain site :- Inferomedial heel pain
● Depth :- deep
● Onset :- gradual & insidious
● Severity :- unbearable , moderate
Aggravating factors:-
● Exercises such as running .
● Excessive pronation .
21. Objective assessment:-
1. Swelling :- At the bottom of heel
2. Colour changes :- redness
3. Posture :- poor posture
4. Attitude of limb :- foot is overpronated
■ On observation
22. ● Temperature :- warmth
● Swelling
● Tenderness:- Anterior medial heel
On palpation:-
23. On Examination :-
● Pain reproduced by palpating the plantar medial
calcaneal tubercle at the site of the plantar fascial
insertion on the heel bone .
● Weight-bearing is difficult ,& swelling and
ecchymosis in the plantar aspect of foot
● Windlass test
● Squeeze test
