Description

• Inflammation of plantar fascia insertion into the heel bone (calcaneus) resulting from repeated injury or stress.
• May occasionally be associated with a heel spun (Lenoir Spun), which results from calcification but is not necessarily symptomatic.
• Without proper treatment, this condition can develop into a chronic and recurring problem. The presence of a partial or complete tear of the plantar fascia is possible.

Presentation

• Begin with a dull, intermittent pain in the heel that can progress to persistent, severe pain.
• Pain may also be present in the middle of the sole of the foot or near the toes.
• Pain usually not present in the morning during the first steps, after an extended sitting period or at the beginning of a sports activity.
• May cause lower back or knee pain due to walking adaptation.

Causes

• Flat feet in pronation
• Rigid legs with high vault
• Prolonged standing
• Unsuitable, inadequate or worn shoes
• Abuse of exercise (syndrome “too much effort, too early”)
• Soft ground (running on sand)
• Activities involving stops and sudden changes of direction
• Achilles tendon and calf muscle stiffness
• Obesity
• Aging

Treatments

• Reduction of inflammation with ice (20 minutes / 2 hours) and complementary therapies such as neurocryotherapy and kinesio taping.
• Joint manipulations and soft tissue work (Active Release Techniques and Graston) to correct foot biomechanics and reduce scar tissue
• Exercises for softening the plantar fascia and Achilles tendon
• Exercises to strengthen and stabilize the foot
• Plantar orthoses to treat or prevent condition
• Modification of activities
• Medications (anti-inflammatories) as needed
• Injections of cortisone as needed
• Very rare surgical procedures
• Plasma rich in platelets