Chapter 7: Understanding Plantar Fasciitis: A Multidisciplinary Approach 2 Contact Hours Expiration Date : May 29, 2028 Learning outcomes
After completing this course, the learner will be able to: Identify the anatomical structure and function of the plantar fascia. Identify the causes, pathology, and symptoms of plantar fasciitis. Course overview The purpose of this course is to identify what plantar fasciitis is and what methods we can use to treat it in our clients. We will examine the anatomy of the plantar fascia, its role in the movement of the foot and ankle, and what happens when
Examine methods of treating plantar fasciitis with therapeutic techniques to improve patient outcomes and performance. Discuss self-care practices to educate patients on treating plantar fasciitis. it becomes inflamed. We will also examine techniques that can be used to treat it when our clients present with either an acute or chronic plantar fasciitis, as well as some self-care tools they can use at home.
INTRODUCTION
Sometime in your therapy career, especially if you specialize in working with athletes, you will encounter a condition known as plantar fasciitis. While it is more common in athletes, particularly runners, anyone can be afflicted with plantar fasciitis. The Mayo Clinic estimates it to be one of the most common sources of heel pain, especially in people over 40-60 years old (Mayo Clinic, 2023). In this course, we will look at some common risk factors and lifestyle choices that may make certain clients more prone to this condition. Some clients will have recurring episodes and know what they are experiencing, and others might present with sudden heel pain that they have never had before. Though there are several other conditions that can mimic plantar fasciitis, we will limit our discussion to treating plantar fasciitis that has already been diagnosed, as it is outside of our scope of practice to diagnose any conditions, including plantar fasciitis. There are several ways we can help relieve their pain as well as reduce the frequency and severity of future episodes. To effectively treat plantar fasciitis, we need to understand what the plantar fascia is, what it does, and why it can become inflamed. There will be simple self-exam tools throughout this course to help you gain a practical understanding of the plantar fascia. We will discuss common symptoms and common demographics for plantar fasciitis. We will also discuss therapy techniques for the lower leg, ankle, and foot to treat the inflammation, reduce pain, and reduce the likelihood of recurrence. We can also provide some self-care methods to recommend to our clients to help them manage their symptoms in between sessions.
Humans are the only primates to walk completely upright and exclusively on two feet as mature adults. When you consider the muscular and skeletal systems of the human body as mechanical structures, few components rival the engineering marvel of the foot. The average surface area of the sole of an adult human foot is only 15.5 square inches, yet it is enough to sustain the full weight of the body when standing. We can then propel our bodies forward with only that small surface area making contact with the ground beneath our feet. However, our feet are often stuffed into shoes and taken for granted—until they hurt. When the feet hurt, the pain can be impossible to ignore. Pain in the feet can be caused by many conditions, which we can become more prone to with age, and that pain can alter the gait enough to lead to problems in the knees, hips, and spine as well as many of the muscular and connective tissue structures in between. Our feet are the first point of contact with the ground we walk on and are partly responsible for translating the vibration of that contact into the rest of the body. Caring for the feet is also a way of caring for the whole body, as an instability in one can greatly affect the stability of the other. As therapists, we have a unique ability to provide care for the feet as well as teaching our clients self-care tools to use at home in between sessions. Focusing on the feet and, as we will learn, the lower leg, can help to undo some of the cruel things we do to our feet every day.
SECTION 1: UNDERSTANDING THE PLANTAR FASCIA
What is the plantar fascia? The plantar fascia is the thick, fibrous band of connective tissue that supports the sole and the arch of the foot and is largely responsible for the structural and mechanical integrity of the foot. It extends from the front of the heel bone (calcaneus) to the base of the toes (metatarsals) and functions as a “tension bridge” on the underside of the foot, providing support and shock absorption when the foot is weight bearing and during contact with the ground in a walking or running gait. The plantar fascia is a unique soft tissue in that it has the structural properties of a tendon and the functional properties of a ligament, but it is, technically, neither. It is made up of dense collagen fibers and has three
distinct structural components. The medial plantar fascia is in the arch of the foot, creating the tension that lifts the arch. The central plantar fascia, or plantar aponeurosis, is the longest and thickest part of the plantar fascia, providing the most stability to the underside of the foot (see Figure 1). The lateral plantar fascia is on the outside aspect of the sole of the foot, which typically bears more weight than the inner aspect (or arch) of the foot when standing still. When the foot moves through its normal range of motion when walking, the weight of the body shifts from the heel to the ball of the foot, then to the toes. The plantar fascia creates the tension that allows the foot to bend and move through
EliteLearning.com/Physical-Therapy
Page 125
Powered by FlippingBook