Plantar fasciitis : radiological findings and evidence-based treatment approaches

Abstract

The plantar fascia is a fibrous aponeurosis superficial to the intrinsic muscles of the foot, originating from the medial calcaneal tuberosity, and is integral to supporting the longitudinal arch. Anterior to the calcaneus, it extends forward and separates into medial, central, and lateral portions, and at the midsole level, it then splits into five bands which ultimately insert onto the bases of all five proximal phalanges as the plantar plates, respectively. Plantar fasciitis, more accurately termed insertional plantar fasciopathy, is the most common cause of chronic plantar heel pain in adults, with a lifetime prevalence of 7-10%. It is primarily an overuse injury with repetitive strain causing microtears of the plantar fascia. Predisposing factors include prolonged standing or jumping, obesity, gastrocnemius-soleus tightness, pes planus and pes cavus, and limited ankle dorsiflexion. Most cases are self-limiting and resolve within 6-12 months, yet symptoms can be prolonged and functionally limiting. [excerpt]