Plantar fascia is a strong aponeurosis located at the base of the foot, starting from the anterior edge of the medial calcaneal tubercle and extending to the metatarsophalangeal joint.
Inclusion criteria were as follows: being between 18 and 65 years, presence of heel pain, tenderness at the insertion site of the plantar fascia on the anteromedial aspect of the calcaneal tubercle elicited by palpation, and unresponsiveness to medical treatment.
The thickness of the plantar fascia was measured in the sagittal plane at the insertion site of the plantar fascia on medial calcaneal tubercle (Figure 2).
The patients who did not show the classic symptoms and signs of proximal plantar fasciitis as well as tenderness localized to the medial calcaneal tubercle
and pain with the first steps in the morning they were disqualified from the study.
It originates at the medial calcaneal tubercle, attaches to the phalanges, and provides stability and arch support to the foot.
(2) Initially the pain presents diffusely, but over time it localizes to the area of the medial calcaneal tubercle. Pain typically subsides with activity but may return with prolonged weight bearing, as it did with the patient in the opening case.
(4,6) Look for heel pad swelling, inflammation, or atrophy, and palpate the heel, plantar fascia, and calcaneal tubercle. Lastly, evaluate for gait abnormalities and the presence of sensory deficits or hypesthesias.
(12) Lateral radiographs are usually unremarkable; however a small percentage of patients will have a bony spur located at the medial calcaneal tubercle. (13) Hiss sites that the physiological reaction to constant excessive stress loads will cause the formation of new connective tissues progressing from fibrocartilagenous fibers to cartilaginous to bone.
After a period of 1 year, she reported that her pain was characterized as a constant, dull ache localized over the medial calcaneal tubercle with an intensity of 5/10.
Corticosteroid therapy consisted of one dose of 80 mg of methylprednisolone and 2 mL of bupivacaine, injected directly into the point of tenderness at the medial calcaneal tubercle
. They also wore heel cups and exercised the gastrocnemius-soleus complex by holding a stretch for 30 seconds, 10-15 times, twice a day for 14 days.
It is on the plantar surface of the heel, sometimes radiating to the arch, and may localize to the insertion of the plantar fascia on the medial calcaneal tubercle
The tender spot is the medial calcaneal tubercle
, with pain radiating through the arch.