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.