Plantar Fasciitis CAT

Question 1

What is plantar fasciitis?

Answer 1

• Inflammatory process of the plantar fascia at its origin (calcaneus)
• Develops secondary to repetitive stretching of the plantar fascia

Question 2

Mechanism for repetitive stretching of fascia

Answer 2

Excessive foot pronation during loading phase of gait

Question 3

Factors contributing to onset of plantar fasciitis

Answer 3

• Excessive pronation during gait
• Tightness of foot and calf muscles
• Obesity
• High arches
• Endurance sports
• Prolonged walking or standing

Question 4

Clinical presentation for plantar fasciitis

Answer 4

• Severe pain in heel w/ standing in morning
• Pain radiating up calf and/or distally to toes
• Pain subsides after a few hours, returns w/ prolonged activity
• TTP at calcaneal insertion
• Usually unilateral
• Tightness in Achilles

Question 5

Labs/imaging for plantar fasciitis

Answer 5

• MRI after 6-8 weeks to confirm diagnosis
• X-ray to rule out fracture
• EMG to rule out nerve entrapment

Question 6

Additional potential findings

Answer 6

Bony hypertrophy

Question 7

Medical management of plantar fasciitis

Answer 7

• Local corticosteroid injection
• Anti-inflammatory meds

Question 8

PT management of plantar fasciitis

Answer 8

• Massage
• Shoe mods
• Orthotics
• Exercise
• Stretching
• Casting