The plantar fascia runs from the medial calcaneal tubercle to the proximal phalanges, forming the primary structural support of the medial longitudinal arch and acting as a windlass mechanism during push-off.
Tightens with toe dorsiflexion during push-off to raise the arch and supinate the foot — transforming the foot from a shock absorber to a rigid lever.
Plantar fasciopathy is the most common cause of heel pain in adults, worst with first steps after sleep. Load management, foot strengthening, and calf stretching are first-line treatments.
Degenerative overload at the medial calcaneal attachment producing stabbing heel pain worst with first morning steps — typically responsive to graduated loading over 3–6 months.
Sudden complete or partial tear during explosive movement or following steroid injection, producing acute midarch pain with subsequent arch collapse.
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