Plantar Fasciitis

Plantar fasciitis (plantar fasciosis, jogger's heel, tennis heel, policeman's heel, gonorrheal heel) is the pain caused by inflammation of the insertion of the plantar fascia on the medial process of the calcaneal tuberosity; not to be confused with a heel spur.

Causes and Risk Factors

 * Plantar Fascia Microtrauma
 * Plantar Fascia Over Stressing
 * Pes Planus Foot Structure
 * Pes Cavus Foot Structure
 * Overpronation
 * Training Errors
 * Leg-Length Discrepancy
 * Infectious Conditions
 * Neoplastic Conditions
 * Arthritic Conditions
 * Neurologic Conditions

Incidence

 * Accounts for 11-15% of all foot symptoms requiring professional care
 * May occur in as much as 10% of the general population
 * Women are affected twice as often as men

Symptoms and Signs

 * Sharp Heel Pain With First Steps After Long Periods of Rest

Tests

 * Palpation at the Calcaneal Insertion of the Plantar Fascia to Reproduce Pain
 * Palpation Along the Course of the Plantar Fascia to Reproduce Pain

Treatment

 * Icing
 * Rest
 * Activity Modification
 * Night Splint to Apply Constant Stretch
 * Foot Orthoses to Limit Causes and Risk Factors
 * Physical Therapy
 * Fasciotomy

Prognosis
About 80% of plantar fascia cases resolve spontaneously by 12 months. Generally, pain resolves with conservative treatment. 5% of patients undergo plantar fascia release due to failure of conservative treatment.