The plantar fascia is the thick fibrous band maintaining the medial arch passively and dynamically via the windlass mechanism. The central band is the largest and most clinically important component. Its medial calcaneal tuberosity origin is the site of plantar fasciitis. The windlass mechanism (first MTP dorsiflexion tightening the fascia) is essential for toe-off, loss of the windlass effect from plantar fascia attenuation produces the 'windlass failure' of severe flatfoot.
An expanded entry for Plantar Fascia.
| Origin | Medial calcaneal tuberosity (all three bands: medial, central, and lateral) |
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| Insertion | Bases of the proximal phalanges of all five toes via the plantar plates and pretendinous fibres |
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Supports the medial longitudinal arch and tightens with toe dorsiflexion to stiffen the foot for push-off.
Plantar fasciitis (plantar heel pain) is the most common foot complaint, affecting 10% of the population. First-step morning pain that warms up is the pathognomonic symptom from plantar fascia tightening overnight. First-line: stretching (plantar fascia and calf), night splints, orthotics, shoe modification. Second-line: corticosteroid injection (short-term relief, risk of fascia rupture), PRP (better long-term). Third-line: ultrasound-guided needle fasciotomy or plantar fasciotomy.
Calcaneal enthesopathy from plantar fascial overload producing morning first-step heel pain managed with stretching, orthotics, injection, and progressive loading.
Other versions of this entry: Plantar Fascia · Plantar Fascia (Complete)
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