Plantar Fasciitis

Question 1

What is the plantar fascia

Answer 1

Supportive tissue for the foot
*tends to tighten with Ambulation causing elevation of the arch

Question 2

What is the most common cause of heel pain

Answer 2

1. Plantar fasciitis (heel spur)

Question 3

How will a patient present with plantar fasciitis?

Answer 3

1. Heel/foot pain
2. Worst in the AM or after sitting for a while

Question 4

What will be found on the PE?

Answer 4

1. Tender over the heel (medial surface)
   *may have pain with passive Dorsiflexion
   *may have tenderness in the arch

Question 5

What are the tests to order?

Answer 5

1. Radiographs (look for bone spurs)
   **try treatment first then MRI and bone scan
2. MRI
3. Bone scan

Question 6

What is the treatment

Answer 6

1. Conservative (do for several months)
   *stretching!!!!
   *heel inserts
   *night splinting (in extension)
   *CI (last resort)
2. Surgical
   *partial release of plantar fascia

Question 7

Where does plantar fasciitis usually occur?

Answer 7

1. Near the proximal attachment of the heel
   *Can spread through the arch

Question 8

Where should you inject?

Answer 8

1. From the side (proximal, medial)
   ***never from the bottom