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Plantar fasciitis

Overuse condition resulting in inflammation of the plantar fascia

Cause

Overuse, poor biomechanics, short gastrocnemius and soles mxl, improper footwear, Wt gain

SXS

unilateral or bilateral
mild to severe pain in the heel no hx of injury or trauma
Repetitive mvt of plantar fascia causing inflammation
Pain occurs with the first steps after non-wt bearing such as getting out of the bed first in the morning
Pes planes, pes cavus and achilles tendinitis are often present
Bone spur may develop on the medial aspect of the calcaneus

Assessment

Postural assessment, Palpation of anteromedial aspect of the plantar surface of the calcaneus is painful, palpable adhesions may present


Testing

AROM of metatarsophalangeal jt is painful, mxl length test for soles and gastrocnemius, Contusion of base of the heel may occur d/t overuse, Tarsal tunnel syndrome, stress fx may occur


Treatment

Acute: cold hydrotherapy,NM tech, TrP make sure to work on calf mxl

Chronic: Deep moist heat hydrotherapy, passive stretch to calf mxl, mxl stripping, ischemic compression, cross fibre friction, Jt play 

Self care

Acute: RICE
Chronic:Rest if aggravating after activities, Ice 3-4 times/day to prevent from inflammation, Stretch plantar fascia, stretch calf mxl

TX frequency

weekly tx for 4-6 wks is appropriate


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