Plantar fascia


Refers to the thick connective tissue which supports the arch on the bottom of the foot.

This aponeurosis runs from the tuberosity of the calcaneus forward to the heads of the metatarsal bones.

The plantar fascia is a thick fibrous band of connective tissue that originates from the medial tubercle and anterior aspect of the heel bone. 



The fascia then extends along the sole of the foot before inserting at the base of the toes and supports the arch of the foot.

The plantar fascia tightens during walking, and stabilizes the longitudinal arch of the foot.

There are five central plantar aponeurosis bundles.

It is comprised of predominantly longitudinally oriented collagen fibers divided into three distinct structural components: the medial component, the central component and the lateral component.

The plantar fascia is also related to the Achilles tendon, with a continuous fascial connection between the two from the distal aspect of the Achilles to the origin of the plantar fascia at the calcaneal tubercle, in younger individuals.

With age the continuity of this connection decreases with few, if any, connecting fibers.

There is an indirect relationship as the toes are dorsiflexed, the plantar fascia tightens.

Tensile force generated in the Achilles tendon will increase tensile strain in the plantar fascia., and this fact is used in the treatment for plantar fasciitis, with stretches and night stretch splinting being applied to the gastrocnemius/soleus muscle unit.

The plantar fascia contributes to support of arch of the foot as it undergoes tension when the foot bears weight, and is estimated to carry as much as 14% of the total load of the foot.

Plantar fascia failure occurs most commonly at the proximal attachment to the calcaneus.

The proximal attachment to the calcaneus is the usual location of plantar fasciitis symptoms.

In the presence of plantar fascia interruption a decrease in arch stiffness and a significant collapse of the longitudinal arch of the foot occurs.

It has an important role in dynamic function during gait, as it elongates during the contact phase.

Elongation occurring between mid-stance and toe-off it behaves like a spring, which may assist in conserving energy.

When the toes are in the propulsive phase of gait, the plantar fascia becomes tense, resulting in elevation of the longitudinal arch and shortening of the foot.

Plantar fasciitis is an often painful degenerative process of the plantar fascia.

A heel spur is a calcified bone extension located on the inferior aspect of the calcaneus or on the back of the heel at the insertion of the Achilles tendon.

Heel spurs are a response to plantar fasciitis over a period of time.

Plantar fibromatosis is a thickening of the plantar fascia.

Psoriatic arthritis may affect the plantar fascia.

Rupture/tear of the plantar fascia is relatively uncommon.

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