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What is Plantar Fasciitis?!

You will see Plantar Fasciitis (PF) called many things! There is an open

debate about the term Plantar Fasciitis; it is argued that there isn’t

inflammation in chronic cases (therefore not an “itits”), however this is

yet to be confirmed.

What is happening on a celluar level is still under investigation, we are

learning more and more all the time, so therefore you see many

differently and interchangeable names (Plantar Fasciosis, Plantar

Fasciopathy, Plantar Heel Pain, Plantar Apotheitsis) for which is

essentially the same this. Pain in the heel!! We are sticking to the better

known “Plantar Fasciitis” in this text as it’s the better known term.

Plantar Fasciitis is characterised by degenerative changes at the plantar

fascia enthesis- where the plantar fascia connects to the heel bone.

It is thought the happen due to an imbalance in collagen production and

degradation, which causes disorganization in the structure. This

disorganized structure then becomes inefficient at absorbing shock. To

absorb shock you need long collagen fibers which align with the force that

the tissue is designed to take. If the tissue becomes disorganized then

those forces can not translate through the collagen fibers, it’s like pulling

on a hose pipe which crisscrosses across the garden and trying to get the

other end to move, compared to healthy tissues which would behave like

a tight tow rope.

On ultrasound, individuals with plantar fasciitis are 105 times more likely

to have a fascial thickness, this represents the degenerative changes;

and up to 50% have an inferior calcaneal spur and bone edema on the

heel is common. However these findings are not predictive of pain,

function and tissue integrity. Which makes diagnosis via scans alone

complicated!! Diagnosis is more based on a combination of symptoms

and a scan.

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