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plantar_fasciitis

plantar fasciitis

Introduction

  • one of the most common causes of foot pain and it is often bilateral
  • it is usually caused either by:
    • repeatedly overstretched
    • blunt trauma such as landing on an object causing bruising to the sole of the foot

Clinical features

  • pain under the heel or foot arch often present on waking and worse with initial walking but often improves with activity as it warms up

severity

  • stage 1 - no pain, normal
  • stage 2 - pain after exercise
  • stage 3 - pain before and after exercise
  • stage 4 - pain before, during and after exercise
  • stage 5 - pain at all times even during rest

Risk factors

  • over-use activities especially if new activity, have tight calf muscles, ankle injury limitation or poor shoes:
    • hiking, running, aerobics, ballet
    • excessive walking on hard surfaces eg. factory workers, police, teachers and waitresses
  • obesity
  • pregnancy - loss of ligament supports
  • poor biomechanics and foot issues - flat feet or high arch
  • age - middle age or elderly tend to lose arch in foot
  • shoes with poor supports
  • weak foot arch muscles
  • diabetes

Mx

  • consider foot XR to exclude stress fracture metatarsals if tenderness is in mid foot rather than heel area
  • 90% will resolve within 2 months of Rx
    • consider plantar fascia brace, heel cups
    • physiotherapy options
      • joint mobilisations to loosen stiff joints
      • soft tissue massage or release
      • muscle flexibility or stretches
      • foot taping
      • active foot stabilisation exercises
      • lower limb strengthening exercises
    • orthotics
plantar_fasciitis.txt · Last modified: 2026/01/22 06:39 by gary1

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