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Introduction

Plantar fasciitis is one of the leading causes of foot and heel pain.  It is most common in middle-aged individuals (age 40-60) and younger individuals who participate in high-impact sports (eg, running).  It is a degenerative condition of the deep plantar fascia (ie, plantar aponeurosis) at its insertion at the calcaneus and is caused by overuse.

Pathophysiology

Contrary to what its name implies, plantar fasciitis is not an inflammatory disorder but rather a degenerative disorder.

The deep plantar fascia is a fibrous band that extends from the calcaneus to the metatarsal heads and supports the longitudinal arch of the foot ( Figure 1).  Stress on the plantar fascia (eg, prolonged standing, running, or jumping) causes microtears, which are repaired overnight when the feet are held in a rigid and slightly flexed position during sleep (allowing the fascia to relax).  When the amount of microtrauma exceeds the body's repair capabilities, gradual degeneration of the fascia begins at its insertion point on the calcaneus, resulting in corresponding pain in the medial anterior plantar heel.

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