Inflammation at the origin of the plantar fascia. Over-stretching of the fascia leads to excess
traction and inflammation. The development of scar tissue makes the fascia less flexible and causes further traction from other
parts of the foot.
The patient presents with a dull to sharp pain occurring about the medial plantar calcaneal area when arising
from rest and continuing during the initial periods of weight bearing. The pain is more severe in the morning when getting out of
bed as the plantar fascia is more inflexible at those times.Biomechanical
Excess subtalar joint pronation lowers the arch structure, elongates the foot and places a tractional force on
the plantar fascia. Over time, these tractional forces result in inflammation of the fascia and surrounding tissues, causing pain
in the arch and heel. This may lead to the development of a bony growth on the calcaneal tuberosity - referred to as a 'heel
spur' - causing a sharp pain right in the center of the heel. Tight calf muscles can add to plantar fascial pain if the foot
cannot dorsiflex at the level of the ankle during the propulsive phase of gait. This results in the foot dorsiflexing at the
midtarsal joint which in turn places extra strain on the plantar fascia.
Biomechanical plantar fasciitis is best treated mechanically by correcting abnormal foot mechanics. Orthotics
designed to control excess subtalar joint pronation will, via the Windlass mechanism, assist the arch in rising and plantar
fascial tension will be reduced. Surgery is seldom required and should be avoided whenever possible.
Additional treatment: Ice therapy (20 minutes, several times per day), anti inflammatory drugs,
electrotherapeutic modalities, night splint.
- Plantar fascia stretch
- Toes raises
- Calf muscles stretch