Anatomical diagrams illustrating the components of the plantar fascia.Dissection of the plantar aponeurosis: LP, lateral part; CP, central part; MP, medial part; L, length; W, width.Five central part plantar aponeurosis bundles.
The plantar fascia is the thick central portion of the fascia investing the plantar muscles. It extends between the medial process of the tuber calcanei[1] and the proximal phalanges of[citation needed] the toes. It provides some attachment to the flexor muscles of the toes.[1]
Distally, the plantar fascia becomes continuous with the fibrous sheaths enveloping the flexor tendons passing to the toes. At the anterior extremity of the sole - inferior to the heads of the metatarsal bones - the plantar aponeurosis forms the superficial transverse metatarsal ligament.[2]
StructureEdit
The plantar fascia is made up of predominantly longitudinally oriented collagen fibers. There are three distinct structural components: the medial component, the central component (plantar aponeurosis), and the lateral component (see diagram at right). The central component is the largest and most prominent.
DevelopmentEdit
In younger people the plantar fascia is also intimately 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. However, the continuity of this connection decreases with age to a point that in the elderly there are few, if any, connecting fibers. There are also distinct attachments of the plantar fascia and the Achilles tendon to the calcaneus so the two do not directly contact each other. Nevertheless, there is an indirect relationship whereby if the toes are dorsiflexed, the plantar fascia tightens via the windlass mechanism. If a tensile force is then generated in the Achilles tendon it will increase tensile strain in the plantar fascia. Clinically, this relationship has been used as a basis for treatment for plantar fasciitis, with stretches and night stretch splinting being applied to the gastrocnemius/soleus muscle unit.
FunctionEdit
The effect of dorsiflexing the toes on arch height (A). The windlass mechanism (B).
The plantar fascia contributes to support of arch of the foot by acting as a tie-rod, where it undergoes tension when the foot bears weight. One biomechanical model estimated it carries as much as 14% of the total load of the foot. In an experiment using cadavers, it was found that failure of the plantar fascia averaged at loads of 1189 ± 244 newtons[3] (121 ± 24 kgf or 267 ± 55 lbf). Failure most often occurred at the proximal attachment to the calcaneus, which is consistent with the usual location of symptoms (i.e. in plantar fasciitis). Complete rupture or surgical release of the plantar fascia leads to a decrease in arch stiffness and a significant collapse of the longitudinal arch of the foot. By modeling it was predicted such conditions would result in a 17% increase in vertical displacement and a 15% increase in horizontal elongation of the foot when it was loaded at 683 newtons (154 lbf).[4] Surgical release also significantly increases both stress in the plantar ligaments and plantar pressures under the metatarsal heads. Although most of the figures mentioned above are from either cadaver studies or investigations using models, they highlight the relatively large load the plantar fascia is subjected to while contributing to the structural integrity of the foot.
GaitEdit
The plantar fascia also has an important role in dynamic function during gait. It was found the plantar fascia continuously elongated during the contact phase of gait. It went through rapid elongation before and immediately after mid-stance, reaching a maximum of 9% to 12% elongation between mid-stance and toe-off.[5] During this phase the plantar fascia behaves like a spring, which may assist in conserving energy. In addition, the plantar fascia has a critical role in normal mechanical function of the foot, contributing to the "windlass mechanism". When the toes are dorsiflexed in the propulsive phase of gait, the plantar fascia becomes tense, resulting in elevation of the longitudinal arch and shortening of the foot (see 3A). One can liken this mechanism to a cable being wound around the drum of a windlass (see 3B); the plantar fascia being the cable, the metatarsal head the drum, and the handle, the proximal phalanx.
Plantar fasciitis is an often painful degenerative process of the plantar fascia.
Calcaneal spur (heel spur) is a small calcified bone extension (osteophyte) located on the inferior aspect of the calcaneus or on the back of the heel at the insertion of the Achilles tendon. The condition is typically a response to plantar fasciitis over a period of time. It may also be related to ankylosing spondylitis, typically in children.
OtherEdit
Plantar fibromatosis is a relatively uncommon non-malignant thickening of the plantar fascia.
Psoriatic arthritis is a type of inflammatory arthritis that may affect the plantar fascia.
Plantar fascial rupture/tear is a relatively uncommon painful tearing of the plantar fascia. The tear can be full or partial.[6]
Additional imagesEdit
The plantar fascia (also known as the plantar aponeurosis) is located superficially plantar side of the foot.
See alsoEdit
Wikimedia Commons has media related to Plantar fascia.
^Moore, Keith L.; Dalley, Arthur F.; Agur, Anne M. R. (2017). Essential Clinical Anatomy. Lippincott Williams & Wilkins. p. 769. ISBN978-1496347213.
^H. B. Kitaoka; Z. P. Luo; E. S. Growney; L. J. Berglund; K. N. An (October 1994). "Material properties of the plantar aponeurosis". Foot & Ankle International. 15 (10): 557–560. doi:10.1177/107110079401501007. PMID 7834064. S2CID 45264072.
^G. A. Arangio, C. Chen and W. Kim (June 1997). "Effect of cutting the plantar fascia on mechanical properties of the foot". Clinical Orthopaedics and Related Research. 339 (339): 227–231. doi:10.1097/00003086-199706000-00031. PMID 9186224. S2CID 19194412.
^Amit Gefen (March 2003). "The in vivo elastic properties of the plantar fascia during the contact phase of walking". Foot & Ankle International. 24 (3): 238–244. doi:10.1177/107110070302400307. PMID 12793487. S2CID 2829705.
^"Plantar Fascial Tears". American Foot & Leg Specialists. 2016-10-17. Retrieved 2018-04-23.
External linksEdit
Look up plantar fascia in Wiktionary, the free dictionary.
soleoffoot at The Anatomy Lesson by Wesley Norman (Georgetown University) (soleoffoot1)
Heel Pain Symptoms. Plantar Fasciitis diagnosis and treatment | Patient; plantar fasciitis at Patient.info
October 15, 2023
plantar, fascia, plantar, fascia, plantar, aponeurosis, thick, connective, tissue, aponeurosis, which, supports, arch, bottom, plantar, side, foot, recent, studies, suggest, that, plantar, fascia, actually, aponeurosis, rather, than, true, fascia, citation, ne. The plantar fascia or plantar aponeurosis 1 is the thick connective tissue aponeurosis which supports the arch on the bottom plantar side of the foot Recent studies suggest that the plantar fascia is actually an aponeurosis rather than true fascia citation needed It runs from the tuberosity of the calcaneus heel bone forward to the heads of the metatarsal bones the bone between each toe and the bones of the mid foot Plantar fasciaMuscles of the sole of the foot First layer closest to the skin on the sole of the foot Plantar aponeurosis visible at top center DetailsIdentifiersLatinaponeurosis plantarisTA98A04 7 03 031TA22718FMA45171Anatomical terminology edit on Wikidata Contents 1 Anatomy 1 1 Structure 1 2 Development 2 Function 2 1 Gait 3 Clinical significance 3 1 Plantar fasciitis 3 2 Other 4 Additional images 5 See also 6 References 7 External linksAnatomy Edit nbsp Anatomical diagrams illustrating the components of the plantar fascia nbsp Dissection of the plantar aponeurosis LP lateral part CP central part MP medial part L length W width nbsp Five central part plantar aponeurosis bundles The plantar fascia is the thick central portion of the fascia investing the plantar muscles It extends between the medial process of the tuber calcanei 1 and the proximal phalanges of citation needed the toes It provides some attachment to the flexor muscles of the toes 1 Distally the plantar fascia becomes continuous with the fibrous sheaths enveloping the flexor tendons passing to the toes At the anterior extremity of the sole inferior to the heads of the metatarsal bones the plantar aponeurosis forms the superficial transverse metatarsal ligament 2 Structure Edit The plantar fascia is made up of predominantly longitudinally oriented collagen fibers There are three distinct structural components the medial component the central component plantar aponeurosis and the lateral component see diagram at right The central component is the largest and most prominent Development Edit In younger people the plantar fascia is also intimately 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 However the continuity of this connection decreases with age to a point that in the elderly there are few if any connecting fibers There are also distinct attachments of the plantar fascia and the Achilles tendon to the calcaneus so the two do not directly contact each other Nevertheless there is an indirect relationship whereby if the toes are dorsiflexed the plantar fascia tightens via the windlass mechanism If a tensile force is then generated in the Achilles tendon it will increase tensile strain in the plantar fascia Clinically this relationship has been used as a basis for treatment for plantar fasciitis with stretches and night stretch splinting being applied to the gastrocnemius soleus muscle unit Function Edit nbsp The effect of dorsiflexing the toes on arch height A The windlass mechanism B The plantar fascia contributes to support of arch of the foot by acting as a tie rod where it undergoes tension when the foot bears weight One biomechanical model estimated it carries as much as 14 of the total load of the foot In an experiment using cadavers it was found that failure of the plantar fascia averaged at loads of 1189 244 newtons 3 121 24 kgf or 267 55 lbf Failure most often occurred at the proximal attachment to the calcaneus which is consistent with the usual location of symptoms i e in plantar fasciitis Complete rupture or surgical release of the plantar fascia leads to a decrease in arch stiffness and a significant collapse of the longitudinal arch of the foot By modeling it was predicted such conditions would result in a 17 increase in vertical displacement and a 15 increase in horizontal elongation of the foot when it was loaded at 683 newtons 154 lbf 4 Surgical release also significantly increases both stress in the plantar ligaments and plantar pressures under the metatarsal heads Although most of the figures mentioned above are from either cadaver studies or investigations using models they highlight the relatively large load the plantar fascia is subjected to while contributing to the structural integrity of the foot Gait Edit The plantar fascia also has an important role in dynamic function during gait It was found the plantar fascia continuously elongated during the contact phase of gait It went through rapid elongation before and immediately after mid stance reaching a maximum of 9 to 12 elongation between mid stance and toe off 5 During this phase the plantar fascia behaves like a spring which may assist in conserving energy In addition the plantar fascia has a critical role in normal mechanical function of the foot contributing to the windlass mechanism When the toes are dorsiflexed in the propulsive phase of gait the plantar fascia becomes tense resulting in elevation of the longitudinal arch and shortening of the foot see 3A One can liken this mechanism to a cable being wound around the drum of a windlass see 3B the plantar fascia being the cable the metatarsal head the drum and the handle the proximal phalanx Clinical significance EditPlantar fasciitis Edit Main article Plantar fasciitis Plantar fasciitis is an often painful degenerative process of the plantar fascia Calcaneal spur heel spur is a small calcified bone extension osteophyte located on the inferior aspect of the calcaneus or on the back of the heel at the insertion of the Achilles tendon The condition is typically a response to plantar fasciitis over a period of time It may also be related to ankylosing spondylitis typically in children Other Edit Plantar fibromatosis is a relatively uncommon non malignant thickening of the plantar fascia Psoriatic arthritis is a type of inflammatory arthritis that may affect the plantar fascia Plantar fascial rupture tear is a relatively uncommon painful tearing of the plantar fascia The tear can be full or partial 6 Additional images Edit nbsp The plantar fascia also known as the plantar aponeurosis is located superficially plantar side of the foot See also Edit nbsp Wikimedia Commons has media related to Plantar fascia This article uses anatomical terminology References Edit a b c aponeurosis plantaris TheFreeDictionary com Retrieved 2023 06 10 Moore Keith L Dalley Arthur F Agur Anne M R 2017 Essential Clinical Anatomy Lippincott Williams amp Wilkins p 769 ISBN 978 1496347213 H B Kitaoka Z P Luo E S Growney L J Berglund K N An October 1994 Material properties of the plantar aponeurosis Foot amp Ankle International 15 10 557 560 doi 10 1177 107110079401501007 PMID 7834064 S2CID 45264072 G A Arangio C Chen and W Kim June 1997 Effect of cutting the plantar fascia on mechanical properties of the foot Clinical Orthopaedics and Related Research 339 339 227 231 doi 10 1097 00003086 199706000 00031 PMID 9186224 S2CID 19194412 Amit Gefen March 2003 The in vivo elastic properties of the plantar fascia during the contact phase of walking Foot amp Ankle International 24 3 238 244 doi 10 1177 107110070302400307 PMID 12793487 S2CID 2829705 Plantar Fascial Tears American Foot amp Leg Specialists 2016 10 17 Retrieved 2018 04 23 External links Edit nbsp Look up plantar fascia in Wiktionary the free dictionary Plantar fascia at the Duke University Health System s Orthopedics program soleoffoot at The Anatomy Lesson by Wesley Norman Georgetown University soleoffoot1 Heel Pain Symptoms Plantar Fasciitis diagnosis and treatment Patient plantar fasciitis at Patient info Retrieved from https en wikipedia org w index php title Plantar fascia amp oldid 1178680957, wikipedia, wiki, book, books, library,
