🔍 What Is Plantar Fasciitis? Plantar fasciitis is inflammation of the plantar fascia, a thick band of connective tissue running from the heel to the toes, supporting the arch of the foot. It’s one of the most common causes of heel pain, especially in adults between 40–60 years. ⚠️ Causes & Risk Factors Mechanism: * Chronic overload leads to microtears in the fascia, typically at its origin on the medial calcaneal tubercle. * More of a degenerative (fasciosis) process than true inflammation in chronic cases. Risk Factors: * Overuse (running, long standing) * Tight calf muscles / limited ankle dorsiflexion * Flat feet (pes planus) or high arches (pes cavus) * Improper footwear or sudden change in activity * Obesity * Prolonged standing occupations 🔎 Symptoms * Sharp, stabbing pain in the heel, especially: * First step in the morning * After prolonged sitting or standing * After activity (not usually during) * Tenderness at medial calcaneus * Pain often improves with movement as fascia warms up 🧪 Diagnosis Clinical Diagnosis * History + physical exam (no imaging typically required initially) Exam Findings: * Point tenderness at medial calcaneal tuberosity * Pain with dorsiflexion of the toes (Windlass test) * Rule out other causes: tarsal tunnel syndrome, fat pad atrophy, calcaneal stress fracture Imaging (if chronic or atypical): * X-ray: may show a heel spur (not causative) * Ultrasound: thickened plantar fascia * MRI: if suspect rupture or other pathology 💉 Treatment Conservative (First-line; 90% success): 1. Rest / Activity Modification 2. Ice therapy 3. Stretching: especially calf stretches & plantar fascia-specific stretches 4. Footwear: cushioned heel pads, arch supports 5. Orthotics (prefabricated or custom) 6. NSAIDs (short-term for pain) Advanced Conservative Options: * Night splints (keeps fascia elongated during sleep) * Physical therapy * Taping or low-dye strapping * Shockwave therapy (ESWT) * Iontophoresis / phonophoresis Injections: * Corticosteroid injections can help short-term but carry risk of: * Plantar fascia rupture * Fat pad atrophy * PRP (platelet-rich plasma) injections increasingly used in chronic cases 🦶 Surgical Options (Rare; less than 5% need it): * Consider only after 6–12 months of failed conservative treatment * Partial plantar fasciotomy (release of fascia) * Risks: arch instability, nerve damage, prolonged recovery ⏱️ Prognosis: * Most patients improve within 6–12 months * Recurrence possible if underlying biomechanical issues aren’t addressed #PlantarFasciitis #HeelPain #FootHealth #Orthopedics #Podiatry #SportsMedicine #Fasciitis #FootPainRelief #RunningInjury #PhysicalTherapy #InjuryPrevention #MobilityMatters #StretchAndStrengthen #PainFreeSteps #RehabJourney #HealthyFeet #StepStrong #MorningHeelPain #NoMoreHeelPain #TakeCareOfYourFeet - @matthewharbmd