Causes, Etiologies, and Pathologies related to Plantar Fasciitis

Basically, what plantar fasciitis is a strain on the plantar fascia that is painful. Typically, the pain is located on the inside surface of the heel (medial tubercle of the calcaneous). Anatomically, that is where the plantar fascia attaches to the heel bone (calcaneous) (Hellman and Imboden, 2007). “Strain” on the plantar fascia usually is due to over activity and results in small rips in the ligament, often referred to as microtears. Other causes of plantar fasciitis include collagen degeneration, loss of collagen continuity, and increase of connective tissue surrounding the plantar fascia (Young, Rutherford & Niedfeldt, 2001).

There are a few conditions that co-occur with plantar fasciitis. Sometimes clients develop an inflammatory disorder, such as a seronegative spondyloarthropathy, prior to developing plantar fasciitis. Heel spurs can sometimes be co-occuring with plantar fasciitis. Heel spurs, however, are not seen as indicative of plantar fasciitis. Certain anatomical features of a foot, such as having a cavus arch (high arch), or having legs of different lengths, can add stress to the plantar fascia. This in itself does not always indicate plantar fasciitis, but may predispose for the condition (Hellman & Imboden, 2007; Young, Rutherford & Niefeldt, 2001; Wilson & Pengel, 2007).

There are also behavior factors that may increase the likelihood of developing plantar fasciitis. These preventable risk factors include excessive standing, wearing shoes that do not fit correctly, running over 30 miles per week, being overweight, and improper stretching of the calf muscles (gastrucnemius and soleus) and Achilles tendon. All these things potentially put stress on the plantar fascia and can increase the amount of microtears in that fascia (Hellman & Imboden, 2007; Young, Rutherford & Niefeldt, 2001; Wilson & Pengel, 2007).