The plantar fascia has many functions. It provides support and structure to the longitudinal arch of the foot. It provides an attachment for the intrinsic foot musculature. It integrates skin and toe mobility into the gait cycle. And, it protects the distal neurovascular bundle, tendons and muscles from the metatarsal heads during gait.
Inflammation of the plantar fascia is termed plantar fasciitis. This inflammation can be the result of excessive stretch of the plantar fascia resulting in microtrauma, which can become repetitive and chronic resulting in inflammation and degeneration of the fibers. It is very common for persons with plantar fasciitis to also have a heel spur. Barrett & O’Malley state “there is no correlation between heel pain and the presence or absence of exostoses,” or heel spur. Plantar fasciitis is a common problem and can be the result of one or more of the following factors: errors in exercise training, a sudden increase or change in physical activity, unsupportive or highly flexible footwear, exercising or prolonged activity on a hard surface, obesity or sudden weight gain as with pregnancy, occupational influences, pes cavus deformity, pes planus deformity, excessive pronation of the foot, lower extremity malalignments particularly in the foot and/or ankle, biomechanical faults, previous trauma to the foot, avascularity, and decreased plantarflexion strength or flexibility. When plantar fasciitis is caused by excessive pronation, there is a flexible rearfoot varus, the talus plantarflexes and adducts during weight bearing, and then the calcaneus everts, causing pronation and tension on the plantar fascia. Other conditions that can cause pronation are tibia vara, ankle equines, forefoot varus, compensated forefoot valgus, and limb length discrepancies.
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