Plantar fascial rupture

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Plantar fascial rupture
Other namesPlantar fascial tear
Plantar aponeurosis - axial view.png
Dissection of the plantar aponeurosis:
LP, lateral part; CP, central part; MP, medial part; L, length; W, width.

A plantar fascial rupture, is a painful tear in the plantar fascia. The plantar fascia is a connective tissue that spans across the bottom of the foot. [1] The condition plantar fasciitis may increase the likelihood of rupture. [2] A plantar fascial rupture may be mistaken for plantar fasciitis or even a calcaneal fracture. To allow for proper diagnosis, an MRI is often needed.

Contents

Causes

The risk for the development of plantar fascia tears can be increased by certain factors which could include:

  1. Overweight  
  2. Non- Supportive footwear
  3. Flat arched feet
  4. High arched feet
  5. A sudden increase in activity/Overuse
  6. Hormone problems
  7. Lack of flexibility of the calf, Achilles tendon and the plantar fascia.
  8. Connective tissue disorders  such as Rheumatoid arthritis.

Types

Complete

Complete tears of the plantar fascia are often due to sudden trauma or injury. [2] Often, the rupture will be accompanied by a popping sound and painful snapping sensation. The bottom of the foot often bruises and swells. Former NFL athlete Peyton Manning suffered a complete rupture in 2015. [3]

The surgical procedure known as a plantar fascia release actually involves the purposeful infliction of a complete tear of the plantar fascia. This is intended to relieve plantar fasciitis symptoms when the tissue recovers by building more tissue, elongating the previously tight plantar fascia. [4]

Partial

Partial tears are seemingly even less common than complete tears. They are more likely to arise from overuse from activities like daily running. The bottom of the foot may be swollen or bruised.

Treatment

Full recovery from both complete and partial tears typically takes 12 weeks or more. However, activities may gradually resume after 6–8 weeks when the plantar fascia will be mostly recovered. [5] Surgery is typically a last resort. At home, it might be advisable to follow the RICE method to reduce inflammation and ease pain.

Immobilization

For the first 2–4 weeks after diagnosis, patients are often instructed to use a walking boot to immobilize and protect the foot.

Physical therapy

During the immobilization period, it is important to keep the foot flexible by lightly stretching the foot and calf regularly.

As the plantar fascia recovers, physical therapy exercises help stabilize the ankle and correct gait patterns that may have contributed to the tear. Stretching and strengthening exercises decrease the chance of reinjury.

Other treatments

Platelet-Rich Plasma injections may be used to help accelerate recovery and decrease the chance of reinjury.

Cortisone injections may ease pain.

Related Research Articles

<span class="mw-page-title-main">Human leg</span> Lower extremity or limb of the human body (foot, lower leg, thigh and hip)

The human leg, in the general word sense, is the entire lower limb of the human body, including the foot, thigh or sometimes even the hip or gluteal region. However, the definition in human anatomy refers only to the section of the lower limb extending from the knee to the ankle, also known as the crus or, especially in non-technical use, the shank. Legs are used for standing, and all forms of locomotion including recreational such as dancing, and constitute a significant portion of a person's mass. Female legs generally have greater hip anteversion and tibiofemoral angles, but shorter femur and tibial lengths than those in males.

<span class="mw-page-title-main">Heel</span> Part of the foot in the back

The heel is the prominence at the posterior end of the foot. It is based on the projection of one bone, the calcaneus or heel bone, behind the articulation of the bones of the lower leg.

<span class="mw-page-title-main">Achilles tendon</span> Tendon at the back of the lower leg

The Achilles tendon or heel cord, also known as the calcaneal tendon, is a tendon at the back of the lower leg, and is the thickest in the human body. It serves to attach the plantaris, gastrocnemius (calf) and soleus muscles to the calcaneus (heel) bone. These muscles, acting via the tendon, cause plantar flexion of the foot at the ankle joint, and flexion at the knee.

<span class="mw-page-title-main">Sprain</span> Damage to one or more ligaments in a joint

A sprain, also known as a torn ligament, is an acute soft tissue injury of the ligaments within a joint, often caused by a sudden movement abruptly forcing the joint to exceed its functional range of motion. Ligaments are tough, inelastic fibers made of collagen that connect two or more bones to form a joint and are important for joint stability and proprioception, which is the body's sense of limb position and movement. Sprains can occur at any joint but most commonly occur in the ankle, knee, or wrist. An equivalent injury to a muscle or tendon is known as a strain.

<span class="mw-page-title-main">Fascia</span> Layer of fibrous connective tissue that surrounds muscles, blood vessels and nerves

A fascia is a band or sheet of connective tissue, primarily collagen, beneath the skin that attaches to, stabilizes, encloses, and separates muscles and other internal organs. Fascia is classified by layer, as superficial fascia, deep fascia, and visceral or parietal fascia, or by its function and anatomical location.

<span class="mw-page-title-main">Plantar fascia</span> Aponeurosis of the sole of the foot

The plantar fascia is the thick connective tissue (aponeurosis) which supports the arch on the bottom of the foot. It runs from the tuberosity of the calcaneus forward to the heads of the metatarsal bones.

<span class="mw-page-title-main">Plantar fasciitis</span> Connective tissue disorder of the heel

Plantar fasciitis or plantar heel pain (PHP) is a disorder of the plantar fascia, which is the connective tissue which supports the arch of the foot. It results in pain in the heel and bottom of the foot that is usually most severe with the first steps of the day or following a period of rest. Pain is also frequently brought on by bending the foot and toes up towards the shin. The pain typically comes on gradually, and it affects both feet in about one-third of cases.

<span class="mw-page-title-main">Diseases of the foot</span>

Diseases of the foot generally are not limited, that is they are related to or manifest elsewhere in the body. However, the foot is often the first place some of these diseases or a sign or symptom of others appear. This is because of the foot's distance from the central circulation, the heart and its constant exposure to pressures from the ground and the weight of the body.

<span class="mw-page-title-main">Achilles tendinitis</span> Medical condition of the ankle and heel

Achilles tendinitis, also known as achilles tendinopathy, occurs when the Achilles tendon, found at the back of the ankle, becomes sore. Achilles tendinopathy is accompanied by alterations in the tendon's structure and mechanical properties. The most common symptoms are pain and swelling around the affected tendon. The pain is typically worse at the start of exercise and decreases thereafter. Stiffness of the ankle may also be present. Onset is generally gradual.

A soft tissue injury is the damage of muscles, ligaments and tendons throughout the body. Common soft tissue injuries usually occur from a sprain, strain, a one-off blow resulting in a contusion or overuse of a particular part of the body. Soft tissue injuries can result in pain, swelling, bruising and loss of function.

<span class="mw-page-title-main">Achilles tendon rupture</span> Medical condition where the tendon at the back of the ankle breaks

Achilles tendon rupture is when the Achilles tendon, at the back of the ankle, breaks. Symptoms include the sudden onset of sharp pain in the heel. A snapping sound may be heard as the tendon breaks and walking becomes difficult.

<span class="mw-page-title-main">Plantar fibromatosis</span> Medical condition

Plantar fascial fibromatosis, also known as Ledderhose's disease, Morbus Ledderhose, and plantar fibromatosis, is a relatively uncommon non-malignant thickening of the feet's deep connective tissue, or fascia. In the beginning, where nodules start growing in the fascia of the foot the disease is minor. Over time walking becomes painful. The disease is named after Georg Ledderhose, a German surgeon who described the condition for the first time in 1894. A similar disease is Dupuytren's disease, which affects the hand and causes bent hand or fingers.

<span class="mw-page-title-main">Plantaris muscle</span> One of the superficial muscles of the superficial posterior compartment of the leg,

The plantaris is one of the superficial muscles of the superficial posterior compartment of the leg, one of the fascial compartments of the leg.

<span class="mw-page-title-main">Calcaneal spur</span> Medical condition of the heel

A calcaneal spur is a bony outgrowth from the calcaneal tuberosity. Calcaneal spurs are typically detected by x-ray examination. It is a form of exostosis.

Davis's law is used in anatomy and physiology to describe how soft tissue models along imposed demands. It is the corollary to Wolff's law, which applies to osseous tissue. It is a physiological principle stating that soft tissue heal according to the manner in which they are mechanically stressed.

Injuries in rock climbing may occur due to falls, or due to overuse. Injuries due to falls are relatively uncommon; the vast majority of injuries result from overuse, most often occurring in the fingers, elbows, and shoulders. Such injuries are often no worse than torn calluses, cuts, burns and bruises. However, overuse symptoms, if ignored, may lead to permanent damage.

Heel pad syndrome is a pain that occurs in the center of the heel. It is typically due to atrophy of the fat pad which makes up the heel. Risk factors include obesity. Other conditions with similar symptoms include plantar fasciitis. Treatment includes rest, pain medication, and heel cups. It becomes more common with age.

Running injuries affect about half of runners annually. The frequencies of various RRI depend on the type of running, such as speed and mileage. Some injuries are acute, caused by sudden overstress, such as side stitch, strains, and sprains. Many of the common injuries that affect runners are chronic, developing over longer periods as the result of overuse. Common overuse injuries include shin splints, stress fractures, Achilles tendinitis, Iliotibial band syndrome, Patellofemoral pain, and plantar fasciitis.

Fascial Manipulation is a manual therapy technique developed by Italian physiotherapist Luigi Stecco in the 1980s, aimed at evaluating and treating global fascial dysfunction by restoring normal motion/gliding to the system.

References

  1. "Plantar Fascial Tears". American Foot & Leg Specialists. 2016-10-17. Retrieved 2018-04-23.
  2. 1 2 "Plantar Fascia: Complete Guide on the Plantar Fascia Ligament | Heel That Pain". Heel That Pain. Retrieved 2018-04-23.
  3. "Sources: Peyton has partial tear of plantar fascia". ESPN.com. Retrieved 2018-04-23.
  4. "Plantar Fasciitis Surgery and Recovery | Heel That Pain". Heel That Pain. Retrieved 2018-04-23.
  5. "The Best Recovery for Partial Plantar Tear". Runner's World. 2014-06-10. Retrieved 2018-04-23.