planter fasciitis

8/7/2019 PLANTER FASCIITIS

http://slidepdf.com/reader/full/planter-fasciitis 1/7

PLANTER FASCIITIS

Planter fasciitis is a musculoskeletal disorder affecting the

fascialenthesis (planter fascia). It is the inflammation of

the planter fascia caused due the excessive stretching of

the planter fascia. In pescaplanus and lowered

longitudinal arch foot, excessive tensile strain within

fascia produces microscopic tears and chronicinflammation. Stress shielding and metabolic

disturbance, formation of free radicals, hyperthermia

and genetic factor are other related factor of planter

fasciitis. If left untreated then there isdevelopment of

boney out growth from the calcaneus known as heel

spur. It is not the part of the inflammation but bodys

natural mechanism of preventing the fascia from

detaching.

Planter fascia is a broad band of tissue run along the planter

surface of the foot. It is attached to calcaneus and support

archby acting bow string. When stretched excessively cause

fascia to tear andresult in inflammation and pain known as

planter fasciitis.

BIOMECHANICAL AETIOLOGY



Planter fasciitis is caused due to excessive sub tallar joint

pronation, also in addition to this the tightening of claf

muscle cause restriction of dorsiflexion at ankle joint

.when these factor are added to excess result in foot dorsiflexion at mid tarsal joint which places extra stress

on planter fascia.

RISK FACTORS

Obesity.

Pesplanus.Pescavus.

Repeated shock to the fascia.

Running on the hard ground.

Active after a period of relative inactivity.

SYMPTOM

Sharp pain at morning in heel.

Stiffness and aching.

Planter fascia inflexible during initial walking.

Tenderness in the medial part of the heel.

Pain in walking.

INVESTIGATION AND EXAMINATION

Blood test: - Are not helpful.

X-ray: - Helps to indicate hell spur.



Ultrasound: - Shows swelling and thickening of aponurosis

in fascia.

Bone scan or M.R.I: - done to investigate the site of

inflammation.

DIFFERIANTIAL DIAGNOSIS

MOST COMMONLY

Achillies tendonitis: - inflammation of the achillies

tendon.

Tarsal tunnel syndrome: - Posterior tibial nerve passes

under flexor retinaculum which runs between the

medial malleolus and calcaneum. Depression of the

tibial nerve at this site produces pain, numbness,

burning on medial side of foot ankle or calf known as

tarsal tunnel syndrome.

Mortonsnuroma: - Pain in the metatarsal region due

to fallantranserve arch with pressure on lateral

planter nerve.

Seversdisease : - Aphophysitis of calcaneus in

adolescents and children who are actively engaged in

sport, they are treated with icing, Achilles tendon

stretching, NSAIDs.

Stress fracture of metatarsal.



RARELY

Fibro sarcoma.

Metastasis.

Foreign body.

Pagets disease of bone.

Osteomyelitis Tuberculosis

Gout

MANAGEMENT AND TREATMENT

CONSERVATIVE

Losing weight.

Rest of foot.

Correction of arch of foot by orthotics.

Splinting and casting.

Using night splint.



Fiber glass walking cast.

MEDICAL

Use of NSAIDs : -Use of these drugs help to reduce pain

and inflammation. Drugs used are ibuprofen,

paracetamol etc.

Corticosteroid injections are used for short term pain

relief.

OTHER MODALITIES

Extracorporel shock wave therapy.

Botulibnum toxin A injection

Radiotherapy.

SURGERY

It is done to release heel spur and is done in the last

sytage of the condition.

PHYSIOTHERAPY

Calf muscle, planter fascia and Achilles tendon

stretching exercise are done.

Deep massage of sole of foot stretches planter

fascia.



Ultrasound, LASER treatment or iontoporosiswiith

dexamethasone for pain relief and reduce

inflammation.



PLANTER FASCIITISTOPIC ON : -

SUBMITTED BY : -

MOHAN JOSHI

B.P.T 3

RD

YR

SUBMITTED TO: -

DR.BIBEK CHAUHAN(mptortho)

planter fasciitis

Documents