Plantar Fasciitis

WHAT IS IT?

Plantar fasciitis is a degenerative/inflammatory condition that involves the plantar fascia.

WHAT CAUSES IT?

This condition is thought to be caused by the overuse of the foot/by repetitive microtrauma of the plantar fascia. Bone spurs on the heel may also develop.

Micro-tears to the plantar fascia are thought to be responsible for this condition (source)
Micro-tears to the plantar fascia are thought to be responsible for this condition (source)
WHY IS IT A PROBLEM?

This condition can be very painful to patients.

WHAT MAKES US SUSPECT IT?

Risk factors

Persons who spend a great deal of time standing/walking, obesity, flat feet (yes planus)

Common Chief Complaints:

  • Heel pain

History Of Present Illness

Length of symptoms: often patients will have symptoms for a long period of time before seeking treatment.

Physical Exam Findings

Musculoskeletal exam: tenderness on the underside of the heel.

Positive windlass test: with the patient’s foot in the weight-bearing position, the examiner disiflexkes the hallux on the first metatarsal (which in turn stretches the plantar fascia). The test is considered positive if the patient reports pain with this maneuver.

The basic windlass test will stretch the plantar fascia to assess for pain (source)
The basic windlass test will stretch the plantar fascia to assess for pain (source)
CLINICAL WORKUP

 

AT WHAT POINT DO WE CONFIDENT IN MAKING THE DIAGNOSIS?

 

WHAT ELSE ARE WE WORRIED ABOUT?

 

HOW DO WE TREAT IT? 

 

HOW WELL DO THE PATIENTS DO?

 

WAS THERE A WAY TO PREVENT IT?

 

OTHER FACTS?

Policemen’s heel is another term used to describe this condition.

FURTHER READING

DynaMed

UpToDate

 

Page Updated: 08.31.2016