Here I have tried to discuss the most common causes of heel pain which is known as plantar fascitis very much common nowadays

1. PLANTAR FASCITIS
Prepared by : Charmi Kaushik

2. ANATOMY
 The plantar fascia is a thick connective tissue that lies
directly beneath the skin on the bottom of the foot.
 It connects the heel to the front of the foot.
 It supports the arch of the foot.
 It runs from the tuberosity of the calcaneus forward
to the heads of the metatarsal bones.
 It also has an important role in dynamic function during
gait.

3. What is Plantar
Fascitis??
 Also known as “POLICEMAN‘S HEEL”
 It is a degenerative condition of the thick band of
tissue (also called a fascia) that supports the arch of
foot.
 It occurs when this thick and strong band of tissue
becomes irritated and inflamed.
 It is one of the most common causes of pain at the
bottom of the heel.
 Approximately 2 million patients are treated for this
condition every year.

5. MANAGEMENT
1. CONSERVATIVE MANAGEMENT:
 Ultrasound therapy
 Phonophoresis
 Iontophoresis
 Contrast Bath
2. MANUAL THERAPY
 Talocrural joint posterior glide

6.  Subtalar joint lateral glide
 Anterior & Posterior glides of 1st tarsometatarsal joint
 Subtalar joint distraction manipulation

7. 3. STRETCHING
 CALF MUSCLE STRETCH = It can be either 3 times or 2
times a day, sustained (3 min) or intermittent.
 PLANTAR FASCIA SPECIFIC STRETCH = This stretch is
performed in the seated position.
 Cross your affected foot over the knee of your other leg..
 Grasp the toes of your painful foot and slowly pull them
toward you in a controlled fashion.
 If it is difficult to reach your foot, wrap a towel around
your big toe to help pull your toes toward you.
 Place your other hand along the plantar fascia. The fascia
should feel like a tight band along the bottom of your foot
when stretched.
 Hold the stretch for 10 seconds. Repeat it 20 times for
each foot. This exercise is best done in the morning
before standing or walking.

8. 4. Toe curls with towel
 Place a small towel on the floor. Using involved foot, curl
towel toward you, using only your toes. Relax.
 Repeat 10 times, 1-2 times per day.
5. Toe extension
 Sit with involved leg crossed over uninvolved leg. Grasp toes
with one hand and bend the toes and ankle upwards as far as
possible to stretch the arch and calf muscle. With the other
hand, perform deep massage along the arch of your foot.
 Hold 10 seconds. Repeat for 2-3 minutes. Repeat 2-4
sessions per day.
6. Calf stretch on a step

9. 7. Ice massage arch roll
 With involved foot resting on a frozen can or water
bottle, golf ball, or tennis ball, roll your foot back and
forth over the object.
 Repeat for 3-5 minutes, 2 times per day.
8. Towel stretch

10. 9. Taping
 Calcaneal taping for short term pain relief. Taping does
cause improvement in function.
10. Orthotic devices
 Heel cuffs
 Viscous elastic heel pad
 Prefabricated and custom made orthosis = All these
orthosis are used for excessive foot pronation.
11. Trigger point therapy
12. Night splints

11. Other
treatments
 Casting
 Cortisone injections
 Platelet Rich Plasma Injections
 Extracorporeal shock wave therapy
 Ultrasonic tissue repair

12. Surgical
treatment
 Gastrocnemius recession
 Partial plantar fascia release