Fascia Plantaris
Arne Nyholm Gam
Brønshøj
Årsmøde 2004
14-01-2017
Fracture/stressfrakture
Diagnose ?
Consequence ?
Bleeding in muscle
Rupture of ligaments in mid-food
Bursitis
Apofysis calcanei
Achillestendonitis
A. Localization
Tenosynovitis
B. Pain description
C. Palpation
 Fasciitis plantaris
 Heelpad affection
Billed Bladet: Mary knust; Frederik gik alene på toilettet
Localisation
Heel-spur
Fasciitis plantaris
Rupture of fascia
plantaris
Heel-pad lesions
Fasciosis
?
Fasciitis
?
Periostal
rupture ?
Entrapment
?
Billed Bladet: Frederik viser sin kærlighed: Fjerner Montell-tatovering
Årsmøde 2004
14-01-2017
Histology



The authors review histologic findings from 50 cases of heel spur
surgery for chronic plantar fasciitis. Findings include myxoid
degeneration with fragmentation and degeneration of the plantar
fascia and bone marrow vascular ectasia.
Histologic findings are presented to support the thesis that "plantar
fasciitis" is a degenerative fasciosis without inflammation, not a
fasciitis.
These findings suggest that treatment regimens such as serial corticosteroid injections into
the plantar fascia should be revaluated in the absence of inflammation and in light of their
potential to induce plantar fascial rupture.
Lemont H, Ammirati KM, Usen N.
2003
Årsmøde 2004
Kig ind: Marys store overraskelse: Får Montell tatovering
14-01-2017
Ultrasound
o
o
o
o
The fascial thickness
symptomatic heels: 3.9–9.1 mm (mean: 4.75±1.52 mm)
asymptomatic heels: 2.0–5.9 mm (mean: 3.37±1.0 mm)
control group:
2.1–4.7 mm (3.62±0.68 mm)
o
Symptomatic heels echogenity of plantar fascia and
biconvexity.
o
Subcalcaneal spur was encountered sonographically indepent of
symptoms
Årsmøde 2004
SE og Hør: Frederik jaloux: Mary køber Robbie Williams video
14-01-2017
Scintigrafi


Type I imaging pattern:
Focal increased activity in the heel region
or

Focal increased activity at the inferior calcaneal bone

Type II imaging pattern:
Diffuse increased activity along the plantar fascia

Ozdemir H, Ozdemir A, Soyucu Y, Urguden M.
2002
Kig Ind: Marys vilde nat i byen: Så fadøl vælte.
Årsmøde 2004
14-01-2017
Risk-factors



The risk of plantar fasciitis increases as the range of ankle
dorsiflexion decreases.
Individuals who spend the majority of their workday on their
feet
Those whose body-mass index is >30 kg/m (2)
Riddle DL, Pulisic M, Pidcoe P, Johnson RE.
2003
Pes Cavus-hulfod
Gam AN
2004
Kig Ind: Margrethe taler over sig: Mary er et pigenavn.
Årsmøde 2004
14-01-2017
My Personal Treatment Guidelines
(MPTG)
Fasciitis plantaris
No improvement
Limit offending activities
Wear supportive footware
Lose weight
Stretching the calf muscle
NSAID
Orthose
Steroid injection
Lesion of the
heelpad
Stop offending
activities
Steroid injection
Viscoelastic heel
cups
Taping
Exercise
Cont. exercise
No improvement
Surgery ?
Taping
Improvement
Never steroid
Cont. exercise
Årsmøde 2004
Her & Nu: Hoffet bekræfter: Frederik sover på slottet
14-01-2017
Taping and exercise
Årsmøde 2004
Se og Hør: Marys veninde til Se og Hør: Skrid.
14-01-2017
Conclusion







Foot arc
Training level
Supportive shoes
Steroid injection – heel spur (max. 3)
Exercise
Taping
Lose weight
Se og Hør: Frederik begår fodfejl
Årsmøde 2004
14-01-2017
Arne Gam
Brønshøj