Plantar fascitis is the inflammation and degeneration of the plantar aponeurosis, presenting as pain worse with weight-bearing. It is diagnosed clinically and treated with activity modification, stretching, and orthotics.

Pathophysiology

• Inflammation and degeneration of the plantar aponeurosis
  • Often due to overuse and repetitive stress

Contextual Factors

• Pes planus
• Obesity
• Working or exercising on hard surfaces
• Middle-aged adult

Clinical Manifestation

• Pain at plantar aspect of heel and hindfoot
• Worse with weight bearing
  • Especially after prolonged rest

Diagnosis

• Clinical
  • Tenderness at insertion of plantar fascia
  • Pain with toe dorsiflexion
• X-ray
  • Heel spurs (low sensitivity and specificity)

Treatment

• Activity modification
• Stretching exercises
• Heel pads/ orthotics