Anatomy of Plantar Fasciitis

The plantar fascia is a crucial part of the foot that plays a vital role in supporting the arch. This thick layer of connective tissue is located on the bottom of the foot and is responsible for maintaining the stability of the medial longitudinal arch. The plantar fascia is made up of several components, including an extensive central portion and thinner medial and lateral parts. These components work together and are organized into five bundles, ensuring the proper functioning and flexibility of the foot.

The foot’s arch is supported and protected by a unique structure known as the plantar fascia. Similar to a rubber band, this flexible ligament plays a crucial role in maintaining the arch’s integrity and absorbing shock during standing or walking activities. By providing tension and stability, the plantar fascia promotes foot health and helps to distribute weight evenly across the foot.

The Anatomy of Plantar Fasciitis

The Plantar Fascia, a crucial component of your foot structure, stretches from the heel to the toes. This band of tissue plays a vital role in ensuring the even distribution of weight while you walk and run, ultimately enhancing your comfort level and preventing any discomfort or pain.

The plantar fascia can become damaged from overuse, injury or medical conditions like arthritis. While it’s most common in people aged 40-60 years old, anyone is susceptible to developing this condition.

Plantar fasciitis symptoms include pain on the bottom of your heel, usually in either the centre or inner side. This discomfort may feel like a stabbing or bruise-like sensation and is worse when you first wake up in the morning or after sitting for an extended period.

Typically, this condition is self-limiting, with conservative treatment usually leading to resolution of symptoms within 12 months. However, if symptoms are severe and non-prescription treatments don’t help alleviate them, your doctor may suggest a cortisone injection for pain reduction. Other treatment options may include dry needling, joint mobilization or platelet rich plasma (PRP) injections.

The Medial Component

The plantar fascia is a fibrous aponeurosis that originates from the medial calcaneal tubercle and runs forward to form the longitudinal arch of the foot. This structure provides both static support and dynamic shock absorption for your feet.

Repetitive stress on this area of the foot can cause it to become damaged and inflamed (plantar fasciitis). The pain usually starts at the bottom of the heel but may radiate proximally, often through the arch.

Patients with this condition often experience a sharp and burning pain in the arch of their foot when they stand up, or after prolonged standing or sitting. Additionally, they may feel an intense throbbing sensation on the bottom of their foot while walking or lying down.

A common condition among athletes, tendonitis is thought to be caused by running, high impact aerobics or inappropriate footwear. While stretching and icing the heel and arch may provide temporary relief, orthotics may provide long lasting benefit if these do not help alleviate symptoms.

The Lateral Component

The plantar fascia is the thick connective tissue running from your heel bone (calcaneus) to your toe bones on the bottom of your foot, dividing into three main parts: lateral, medial and central elements.

The lateral component is the thinner and less prominent of the three elements. It starts from the calcaneus bone and continues through the tendons of abductor and flexor digiti minimi muscles.

The lateral plantar fascia consists primarily of type I collagen fibers arranged in a proximal-distal direction, with some transversal and vertical collagen fibers. It is extensively innervated by Pacini and Ruffini corpuscles.

The Central Component

The plantar fascia is a thickened and fibrous aponeurosis that arises from the medial tubercle of the calcaneus (heel bone), running forward to form an arch in the foot.

It functions both as static support for the arch and dynamic shock absorber for the heel. If exposed to repeated stress, plantar fascia may degenerate and cause pain.

Obesity and sedentary occupations that require standing or walking on hard surfaces for extended periods of time are both known risk factors for developing plantar fasciitis. Obese people usually have tight calf muscles which can pull on the Achilles tendon, increasing tension and strain on this part of the foot.

Treatment for heel pain typically includes rest from activities that cause it, ice and calf-strengthening exercises. Depending on the severity of your condition, your doctor may also suggest wearing a shoe insert, getting a cortisone shot or having surgery to release tight tissue in the heel. Other non-surgical solutions like stretching and night stretch splints may also help.