Fascia of foot, planter aponeurosis, planter comprtments and planter fasciitis.

1. FASCIA OF FOOT
Dr. SAMAH FATIMA
8/8/2021

2. Skin and Fascia of Foot
8/8/2021
Marked variations occur in the thickness
(strength) and texture of skin,
subcutaneous tissue (superficial fascia),
and deep
fascia in relationship to weight-bearing and
distribution, ground contact (grip,
abrasion), and the need for containment or
compartmentalization.

3. Skin and sub cutaneous tissue
8/8/2021
The skin of the dorsum of the foot is much thinner
and less sensitive than skin on most of the sole.
The subcutaneous tissue is loose deep to the
dorsal skin; therefore, edema (swelling) is most
marked over this surface, especially anterior to and
around the medial malleolus.
The skin over the major weight-bearing areas of the
sole—the heel, lateral margin, an ball of the foot is
thick. The subcutaneous tissue in the sole
is more fibrous than in other areas of the foot.

4. Skin and sub cutaneous tissue
8/8/2021
Fibrous septa,highly developed skin ligaments
(retinacula cutis)—divide this tissue into fat-filled
areas, making it a
shock-absorbing pad, especially over the heel. The
skin ligaments also anchor the skin to the underlying
deep fascia (plantar aponeurosis), improving the
“grip” of the sole. The skin of the sole is hairless and
sweat glands are numerous; the entire sole is
sensitive (“ticklish”),especially the thinner-
skinnedarea underlying the arch of the foot.

5. Deep Fascia of Foot
(Dorsum of foot)
8/8/2021
The deep fascia of the dorsum of the foot is thin where
it is
continuous proximally with the inferior extensor
retinaculum.

6. DEEP FASCIA OF FOOT
(Planter fascia)
8/8/2021
Over the lateral and
posterior aspects of the foot,
the deep fascia is
continuous with the plantar
fascia, the deep fascia of
the sole. The plantar fascia
has a thick central part and
weaker medial and lateral
parts.

7. PLANTER FASCIA
(Planter aponeurosis)
8/8/2021
The thick, central part
plantar fascia forms the
strong plantar aponeurosis,
longitudinally arranged
bundles of dense
fibrous connective tissue
investing the central plantar
muscles. It resembles the
palmar aponeurosis of the
palm of the hand but is
tougher, denser, and
elongated

8. Planter Aponeurosis
8/8/2021
The plantar aponeurosis arises posteriorly from the
calcaneus and functions like a superficial ligament.
Distally, the longitudinal bundles of collagen fibers of
the aponeurosis divide into five bands that become
continuous with the fibrous digital sheaths that
enclose the flexor tendons that pass to the toes.
At the anterior end of the sole, inferior to the heads of
the metatarsals, the aponeurosis is reinforced by
transverse fibers forming the superficial transverse
metatarsal ligament.

9. Planter Fascia (Function)
8/8/2021
The plantar fascia
holds the parts of
the foot together,
helps protect the
sole from injury,
and helps support
the longitudinal
arches of the foot.

10. COMPARTMENTS OF FOOT
8/8/2021
In the midfoot and
forefoot, vertical
intermuscular septa
extend deeply
(superiorly) from the
margins of the plantar
aponeurosis toward the
1st and 5th
metatarsals, forming
the three
compartments of the
sole.

11. COMPARTMENTS OF FOOT
8/8/2021
1. The medial compartment of the sole is covered
superficially by thinner medial plantar fascia. It contains the
abductor hallucis, flexor hallucis brevis, the tendon of the
flexor hallucis longus, and the medial plantar nerve and
vessels.
2. The central compartment of the sole is covered
superficially by the dense plantar aponeurosis. It contains
the
flexor digitorum brevis, the tendons of the flexor hallucis
longus and flexor digitorum longus plus the muscles
associated with the latter, the quadratus plantae and
lumbricals, and the adductor hallucis. The lateral plantar
nerve
and vessels are also located here.
3. The lateral compartment of the sole is covered
superficially by the thinner lateral plantar fascia and contains

12. 8/8/2021

13. COMPARTMENTS OF FOOT
8/8/2021
In the forefoot only, a fourth compartment, the interosseous
compartment of the foot, is surrounded by the plantar and
dorsal interosseous fascias.
It contains the metatarsals, the dorsal and plantar interosseous
muscles, and the deep plantar and metatarsal vessels. Whereas
the plantar interossei and plantar metatarsal vessels are
distinctly plantar in position, the remaining structures of the
compartment are located intermediate between the plantar and
dorsal aspects of the foot.

14. COMPARTMENTS OF FOOT
8/8/2021
A fifth compartment, the dorsal
compartment of the
foot, lies between the dorsal
fascia of the foot and the tarsal
bones and the dorsal
interosseous fascia of the
midfoot and
forefoot. It contains the muscles
(extensors hallucis brevis and
extensor digitorum brevis) and
neurovascular structures of
the dorsum of the foot.

15. PLANTER FASCIITIS
8/8/2021
Inflammation of the plantar fascia—plantar fasciitis—is often
caused by an overuse mechanism. It may result from running
and high-impact aerobics, especially when inappropriate
footwear is worn. Plantar fasciitis is the most common hindfoot
problem in runners. It
causes pain on the plantar surface of the foot and heel. The
pain is often most severe after sitting and when beginning to
walk in the morning. It usually dissipates after 5–10 minutes
of activity and often recurs again following rest.
Point tenderness is located at the proximal attachment of
the aponeurosis to the medial tubercle of the calcaneus and
on the medial surface of this bone.

16. PLANTER FASCIITIS
8/8/2021
The pain increases with
passive extension of the great toe and may
be further exacerbated by dorsiflexion of
the ankle and/or weight-bearing.

17. 8/8/2021