![]() ![]() It also links to the connective tissues that run deep between the muscles under the foot to the ligaments attached to the bones. It links the heel to the forefoot providing foot ‘arch’ reinforcement and tightens when the toes bend upwards. The muscle of the foot lies under the plantar fascia attached to its deep surface working closely with the plantar fascia to control arch motion. A picture to show the plantar fascia (or aponeurosis) revealing its complex linkages with other important foot anatomy. The reason for this is the plantar aponeurosis has complex anatomy and function (Fig. The common explanation is that the causes of plantar fasciitis are multifactorial, which is a nice clinical way of saying there is no one way to develop the condition, but rather there are many ways. Both motions are critically important for normal walking and running and keeping a good range of these motions helps resolve plantar fasciitis and also prevent it. Ankle flexion (plantarflexion) is the movement downward of the foot, which should be a powerful motion (B). Ankle extension (dorsiflexion) is the motion of moving the foot towards the front of the leg (A). It is not caused by a particular foot type, such as flat feet (pes planus) or high arched feet (pes cavus), turning up in any foot type.įigure1. Yet it can also occur without any of these problems. 1), decreased big toe joint extension motions upwards, and prolonged periods of occupational standing (1,6). ![]() It is associated with increased body weight, the presence of a bony spur (spurs are not the actual cause of the pain), decreased ankle extension range (bending the ankle to move the foot towards the front of the leg, see Fig. In runners, it tends to occur at an earlier age but is still unusual before the age of 30. However, it is a common running injury (3,4) reported to account for 7% of running injuries (3) and reported slightly more commonly in women than men (4,5). Unlike most running injuries, this is a problem that isn’t unique to athletic and sports communities and is most common in the age group 40-60 years of age (1). The condition is more a degenerative change in soft tissues under the foot rather than inflammatory injury (2). Often activity is initially pain-free or the pain can be ‘run-through’ but as the condition worsens the pain-free time may shorten. It can be most painful shortly after exercise or on the following morning after running when rising from bed or from sitting. The symptoms of plantar fasciitis are felt as pain or initially discomfort under the heel, most noticeable on initial weight-bearing in the morning or on standing after prolonged sitting, and immediately after exercise (1). Plantar fasciitis is an injury around the attachment point of a reinforced fibrous band in the underside of the foot known as the plantar aponeurosis, which is commonly called the plantar fascia. ![]()
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