Plantar Fasciitis Case Study

Diagnosis of plantar fasciitis is based upon the patient’s history and on results of the physical examination typically present with inferior heel pain on weight bearing and pain often continue for months to years [5].The patient usually has tenderness around the medial calcaneal ligaments at the plantar aponeurosis[4] .Some risk factors of plantar fasciitis include faulty mechanics of the foot due to structural abnormalities, age-related degenerative changes, overweight and occupations involving standing for a long time such as falling into this category include teachers, construction workers, cooks, nurses, military personnel and athletes training for long distance running events[6] .Many treatment options exist, including stretching and strengthening, shoes modification, arch supports and orthotics such as night splints, anti inflammatory agents and surgery [7,8] .

The rearfoot consists of four bones the distal side of the tibia and fibula (leg bones), the calcaneus (heel bone), and the talus. The plantar fascia originates from the medial calcaneal ligaments, dividing into a medial, central and lateral band that attaches to the superior surface of the abductor hallucis, flexor digitorum brevis, and abductor digiti minimi musculature, respectively. The medial longitudinal arch (MLA) of the foot aids in distributing the force attributed to the weight bearing. The MLA of the foot resembles two rods a rear rod consisting of the calcaneus, talus and an anterior rod consisting of the navicular, three cuneiforms, and the first three metatarsals. These rods are connected at their base by the plantar fascia. When force is applied to the apex of the MLA, the arch depresses and the two rods separate then the tension is distributed throughout the plantar fascia. The main ligaments that aid in supporting the MLA are the long and short plantar ligaments and the calcaneonavicular ligament.