The plantar fascia (plantar aponeurosis) is the strong fibrous sheet covering the plantar surface of the foot, with a central band, medial band, and lateral band running from the calcaneal tuberosity to the base of the proximal phalanges and plantar plates of each digit.
The primary static tensioning structure of the medial longitudinal arch via the windlass mechanism, distributes calcaneal weight to the forefoot during loading, and provides the plantar floor for the intrinsic foot muscles.
Plantar fasciitis at the calcaneal origin is the most common cause of inferior heel pain, affecting 1 in 10 people. The windlass test (dorsiflexion of the great toe recreating heel pain) is highly specific. Ninety percent resolve with conservative management within 12 months.
Enthesopathy at the calcaneal origin of the plantar fascia producing first-step morning pain, treated by stretching, orthotic support, shockwave therapy, and rarely surgical partial release.
Acute plantar fascia tear from sudden overload producing a pop and immediate arch pain, managed by non-weight-bearing followed by progressive loading rehabilitation.
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