Plantar fasciitis : proximal instability

Plantar fasciitis (PF) is the most common foot condition treated by health care providers.This painful condition can cause impairment of activity and disability.Patients usually report pain after palpation of the proximal insertion of the plantar fascia and plantar medial heel, and the pain is most noticeable when patients begin walking after a period of inactivity.Clinicians have used many approaches for treating pain and enhancing function.

Weakness in the gluteus region causes instability to your trunk that leads to excessive motion . The gluteus medius and gluteus minimus muscles control the sagittal plane motion of the body.

An anterior pelvic tilt : tight back extensors, weak glutes and hamstrings, weak abdominals, and tight hip flexors all commonly caused by prolonged sitting which activate reciprocal inhibition .  This anterior pelvic tilt leads to your body weight being shifted forward causing higher stress on Achilles’ tendon and plantar fascia.

A muscular imbalance cause a shift of weight but it also causes a misalignment the kinetic chain. Weak glutes and tight hip flexors lead to an internal rotation of the femur, causes a valgus position of the knee, tibial internal rotation, and ultimately excessive pronation which may loads the plantar fascia.

So include gluteus assessment in your plantar fascia patient . It’s not always plantar fasciitis is due to hip problem , but 70% cases it affect. Proper clinical reasoning give you better idea.

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pic coutsey: Wikipedia.org