Applied aspect regarding the sole of foot

1. Applied Aspect Regarding The
Sole of Foot

2. Plantar Fasciitis

3. Plantar Fasciitis
 Plantar Fasciitis is the inflammation of the Plantar
Fascia
 It is often caused by an overuse mechanism
 Plantar Fasciitis is the most common hind foot
problem in runners
 It causes pain on the plantar surface of the foot and
heel
 The pain is often more severe when after sitting and
when beginning to walk in the morning
 The pain dissipates after 5-10 mins of activity and
recurs after inactivity

4.  Point tenderness is located at the proximal
attachment of aponeurosis to the medial tubercle of
calcaneum and on the medial surface of the bone
 Exacerbated by dorsiflexion of the ankle and weight
bearing.

5. Calcaneal Spur
 An abnormal bony process that protrudes from the
medial tubercle, if present along with pain on the
medial side of the foot when walking may indicate
plantar fasciitis.

6. Palpating the Dorsalis Pedis
Artery

7. Palpation of the Dorsalis Pedis Pulse
 Evaluated during a physical exam of the peripheral
vascular system.
 Palpated with the feet slightly dorsiflexed.
 It is easily palpated as it lies subcutaneously along a
line from extensor retinaculum to a point just lateral
to the EHL tendons.

8.  A diminshed or absent dorsalis pedis pulse suggests
vascular insufficiency resulting from arterial disease.
 The Five P signs of acute arterial occlusion are
pain, pallor, paresthesia, paralysis and
pulselessness.

9.  Some times the dorsalis pedis artery is
completely replaced by an enlarged
perforating fibular artery.
 Therefore some healthy adults and
children have congenitally non-palpable
dorsalis pedis pulses.
 This condition is usually bilateral.

10. Plantar Reflex

11. Plantar Reflex
 Nerve roots involved are L4, L5, S1 and S2
 It is a myotic reflex routinely tested during
nerological examinations
 Lateral aspect of the sole of the foot is stroked
beginning at heel and crossing to the base of big toe
 Motion should be firm and continuous but neither
painful nor ticklish.

12.  Flexion of the toe is normal response
 Fanning of the lateral four toes and dorsiflexion of
the great toe is an abnormal response (The
Babinski Sign)
 A positive babinski’s sign is indicative of brain injury
or cerebral disease except in infants.
 As the corticospinal tracts are not fully developed in
newborns, a Babinski sign is usually elicited and
may be present until children are 4 years of age.
 Except for Children with brain injury or cerebral
disease

13. Neuromas

14. Morton’s Neuroma
 A Neuroma is a growth of nerve tissue.
 A Neroma May be formed on the branch of medial
plantar nerve between 3rd and 4th metatarsal bones
 This Neuroma is termed as Morton’s Neuroma
 This causes pain between 3rd and 4th metatarsals
 Usually results from wearing tight shoes and
repeated irritation of the Nerve.