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The document discusses the anatomy and causes of plantar fasciitis. It notes that the human foot contains 26 bones organized into the hindfoot, midfoot and forefoot. The bones are stabilized by ligaments and muscles, including intrinsic and extrinsic foot muscles. Plantar fasciitis is caused by inflammation of the plantar fascia, a thick fibrous band that runs along the bottom of the foot. Risk factors include age, weight, physical activity, abnormal foot mechanics, and improper footwear. Treatment involves rest, stretching, orthotics, night splints, anti-inflammatory medications, corticosteroid injections into the plantar fascia, and surgery if necessary.
Исходное описание:
anatomy, definition, etiology, treatment, rehabilitation of plantar fasciitis.
The document discusses the anatomy and causes of plantar fasciitis. It notes that the human foot contains 26 bones organized into the hindfoot, midfoot and forefoot. The bones are stabilized by ligaments and muscles, including intrinsic and extrinsic foot muscles. Plantar fasciitis is caused by inflammation of the plantar fascia, a thick fibrous band that runs along the bottom of the foot. Risk factors include age, weight, physical activity, abnormal foot mechanics, and improper footwear. Treatment involves rest, stretching, orthotics, night splints, anti-inflammatory medications, corticosteroid injections into the plantar fascia, and surgery if necessary.
The document discusses the anatomy and causes of plantar fasciitis. It notes that the human foot contains 26 bones organized into the hindfoot, midfoot and forefoot. The bones are stabilized by ligaments and muscles, including intrinsic and extrinsic foot muscles. Plantar fasciitis is caused by inflammation of the plantar fascia, a thick fibrous band that runs along the bottom of the foot. Risk factors include age, weight, physical activity, abnormal foot mechanics, and improper footwear. Treatment involves rest, stretching, orthotics, night splints, anti-inflammatory medications, corticosteroid injections into the plantar fascia, and surgery if necessary.
SpS(K), MSc. Human foot is a complex unit It consists of 26 bones: 14 phalanges 5 metatarsals 7 tarsals Can be divided into 3 functional segments: Hindfoot Midfoot Forefoot
The bones are stabilized by the ligaments There are extrinsic muscles and intrinsic muscles Those that the origin is away from the foot called extrinsic foot muscles Whereas those that originate and insert within the foot called intrinsic foot muscles E x t r i n s i c
1 st layer Abductor digiti quinti Abductor hallucis Fleksor digitorum brevis. 2 nd layer Quadrates plantae, Lumbricales Fleksor digitorum longus. 3 rd layer Abductor hallucis, transverse head Abductor hallucis, oblique head Fleksor hallucis brevis, Fleksor digiti quinti brevis. 4 th layer Interosseus plantaris, Interosseus dorsalis.
Plantar fascia is a continuation of the plantaris tendon
Its origin is upon the medial tubercle of the calcaneus then splits into five bands to attach to each digit Plantar fascia is a thick fibrous band of tissue that runs along the bottom of the foot.
This tissue connects the heel to the base of the toes and stretched with every step Plantar fascia acts as a shock-absorbing bowstring within the arc of the foot.
Plantar fasciitis is inflammation of the thick fibrous band of tissue (plantar fascia) that runs along the bottom of the foot.
About 2 million people in US seek for medical treatment because of plantar fasciitis annually Plantar fasciitis is presented by a sharp stabbing pain at the bottom or front of the heel bone.
The pain of plantar fasciitis is usually located close to where the fascia attaches to the calcaneous, also known as the heel bone. Pain is often most intense with your first steps when getting out of bed in the morning.
Heel pain is more severe following periods of inactivity (resting or sleeping) when getting up and then subsides, turning into a dull ache.
Abnormalities of plantar anatomy: flat foot, high arches Overload physical activities or exercises
Wearing incorrect shoes
Overweight
Plantar Fasciitis Tear and Inflammation of the Plantar Fascia Spur
Age
Plantar fasciitis is also influenced by the mechanics of the foot.
Having conditions such as flat feet, high arches feet made the fascia tissue become overworked or stretched abnormally, resulting in tears and inflammation. Shoes that are too worn, thin- soled, loose, lack arch support or lack shock absorption provide inadequate protection of the foot
Frequent use of high heeled shoes shortens the Achilles tendon which stresses the plantar fascia Activity in sports and regular exercises can place significant stress on the heel and surrounding tissue.
Overload tear of the fascia Plantar Fasciitis Weight plays a huge role in damage to the heel.
Since our heels absorb much of our body's pressure when we walk, being overweight can easily lead to damage and plantar fasciitis.
Pregnancy can also add a few extra pounds. However, the hormonal changes in pregnant women can also cause ligaments and other tissue to relax and become more pliable could lead to plantar fasciitis Age also plays a factor.
As we age, tissue tends to become weaker and more prone to damage. A bony prominence or spur may develop at the attachment of the plantar fascia to the calcaneus.
Spur is an ossification and calcification resulting from traction of the plantar fascia upon the periosteum and occur commonly without pain. A spur is probably a coincidental finding as they are often found in asymptomatic feet and often not found in patient with symptom Mortons Neuroma Sesamoiditis
The characteristic pain on dorsiflexion of the toes associated with plantar fasciitis should help distinguish these painful condition of the foot. Resting : prolonged and continued irritation can delay the healing process
Stretching and Strengthening Exercises : muscles and tendon stretching and also strengthening of the intrinsic muscles can improve biomechanics of the foot and reduce stress Pain and Inflammation management Ice cube massage 2-3 times/day for 5 min Anti inflammation and analgetics Surgical treatment if necessary, e.g. plantar fasciitis because of spur Improve foot biomechanics Use of well fitting, appropriate shoes Night splint
Site Syringe Needle Anesthetic Corticosteroid Hydrocortis one equivalents per injection (mg) Plantar fascia 5 mL 25 gauge, 1.5 inch 2 mL of 1% lidocaine (Xylocaine) or 0.25% or 0.5% bupivacaine (Marcaine) 1 mL of Celestone* 150 or 1 mL of 40 mg per mL of methylprednisolone (Solumedrol) 200 The patient is placed in the lateral recumbent position with the affected side down. The physician identifies the medial aspect of the foot and palpates the soft tissue just distal to the calcaneus, locating the point of maximal tenderness or swelling. The needle should be inserted directly down past the midline of the width of the foot. The physician should avoid injecting through the base of the foot, because this approach can result in the complications of pharmaceutical leakage and fat pad atrophy.
The patient should remain in the supine position for several minutes after the injection. The patient should remain in the office for 30 minutes after the injection to be monitored for adverse reactions. In general, patients should avoid any strenuous activity involving the injected region for at least 48 hours. Patients should be cautioned that they may experience worsening symptoms during the first 24 to 48 hours. This is related to a possible steroid flair, which can be treated with ice and NSAIDs (e.g., ibuprofen, naproxen). A follow-up examination within three weeks should be arranged