Plantar fasciitis by Charmi Kaushik(BPT)

Here I have tried to discuss the most common causes of heel pain which is known as plantar fascitis very much common nowadays

1. PLANTAR FASCITIS Prepared by : Charmi Kaushik

2. ANATOMY The plantar fascia is a thick connective tissue that lies directly beneath the skin on the bottom of the foot. It connects the heel to the front of the foot. It supports the arch of the foot. It runs from the tuberosity of the calcaneus forward to the heads of the metatarsal bones. It also has an important role in dynamic function during gait.

3. What is Plantar Fascitis?? Also known as “POLICEMAN‘S HEEL” It is a degenerative condition of the thick band of tissue (also called a fascia) that supports the arch of foot. It occurs when this thick and strong band of tissue becomes irritated and inflamed. It is one of the most common causes of pain at the bottom of the heel. Approximately 2 million patients are treated for this condition every year.

4. MANAGEMENT CONSERVATIVE MANAGEMENT: Ultrasound therapy Phonophoresis Iontophoresis Contrast Bath MANUAL THERAPY Talocrural joint posterior glide

5. Subtalar joint lateral glide Anterior & Posterior glides of 1 st tarsometatarsal joint Subtalar joint distraction manipulation

6. 3. STRETCHING CALF MUSCLE STRETCH = It can be either 3 times or 2 times a day, sustained (3 min) or intermittent. PLANTAR FASCIA SPECIFIC STRETCH = This stretch is performed in the seated position. Cross your affected foot over the knee of your other leg .. Grasp the toes of your painful foot and slowly pull them toward you in a controlled fashion. If it is difficult to reach your foot, wrap a towel around your big toe to help pull your toes toward you. Place your other hand along the plantar fascia. The fascia should feel like a tight band along the bottom of your foot when stretched. Hold the stretch for 10 seconds. Repeat it 20 times for each foot. This exercise is best done in the morning before standing or walking.

7. 4. Toe curls with towel Place a small towel on the floor. Using involved foot, curl towel toward you, using only your toes. Relax. Repeat 10 times, 1-2 times per day. 5. Toe extension Sit with involved leg crossed over uninvolved leg. Grasp toes with one hand and bend the toes and ankle upwards as far as possible to stretch the arch and calf muscle. With the other hand, perform deep massage along the arch of your foot. Hold 10 seconds. Repeat for 2-3 minutes. Repeat 2-4 sessions per day. 6. Calf stretch on a step

8. 7. Ice massage arch roll With involved foot resting on a frozen can or water bottle, golf ball, or tennis ball, roll your foot back and forth over the object. Repeat for 3-5 minutes, 2 times per day. 8. Towel stretch

9. 9. Taping Calcaneal taping for short term pain relief. Taping does cause improvement in function. 10. Orthotic devices Heel cuffs Viscous elastic heel pad Prefabricated and custom made orthosis = All these orthosis are used for excessive foot pronation. 11. Trigger point therapy 12. Night splints

10. Other treatments Casting Cortisone injections Platelet Rich Plasma Injections Extracorporeal shock wave therapy Ultrasonic tissue repair

11. Surgical treatment Gastrocnemius recession Partial plantar fascia release