Heel pain and Plantar Fasciitis: latest update (2014)

Plantar fasciitis is a common injury with an incidence rate of between 4,5% and 10% in runners.

Plantar fasciitis is the most common foot condition and accounting for up to 15% of all adult foot complaints requir­ing professional care.

Increased plantar fascia thickness is associ­ated with symptoms (altered pain levels) and altered compressive proper­ties of the fat pad in those with plantar heel pain. Heel pain/plantar fasciitis is often see as a chronic con­dition, with symptom duration greater than 1 year.

Risk factors may include limited ankle dorsiflexion ROM, high BMI in nonathletic individuals, running, and work-related weight-bearing activities. The ICD catego­ry of plantar fasciitis and the associated ICF impair­ment-based category of heel pain (b28015 Pain in lower limb, b2804 Radiating pain in a segment or region).

 History and physical examination findings should include:

  •   Plantar medial heel pain: especially the first steps after a period of inactivity and      prolonged weight bearing
  •   Heel pain provoked by a recent increase in weightbearing activity
  •   Pain with palpation at the proximal insertion of the plantar fascia
  •   Positive windlass test
  •   Negative tarsal tunnel tests
  •   Limited active and passive talocrural joint dorsiflexion ROM
  •   Abnormal foot posture index (FPI) score
  •   High BMI in nonathletic individuals

Diagnostic ultrasound may be used to assess plan­tar fascia thickness.

These guidelines are not intended to serve as a standard of medical care, but should be considered as a guideline.  Clinical procedure or treatment plans must be based on clinician experience and expertise and on the clinical presentation of the patient; the available evidence; the available diagnostic and treatment options; and the patient’s values, expectations, and preferences. 

> From: Martin et al., J Orthop Sports Phys Ther 44 (2014-12-08 09:02:28) A1-A23 . All rights reserved to Orthopaedic Section, American Physical Therapy Association (APTA), Inc, and the Journal of Orthopaedic & Sports Physical Therapy®. Click here for the online summary.

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