Plantar Fasciitis Series
Part 5 Case Study for Plantar Fasciitis
Patient Profile
Sarah, a 47-year-old elementary school teacher, presented with persistent heel pain that was most severe during her first steps in the morning. As her work required long hours of standing, the discomfort often returned by evening, affecting her ability to stay active and focus at her work.
Clinical Background
Sarah had recently developed a habit of walking barefoot at home on hardwood floors or using soft, unsupportive slippers. While they felt comfortable at first, these choices provided no structural support for her arches and allowed excessive stretching of the Plantar Fascia — leading to ongoing micro-trauma and inflammation.
Assessment Findings
– Localized tenderness at the medial heel and Plantar Fascia insertion
– Limited ankle dorsiflexion due to tight Gastrocnemius and Soleus muscles
– Mild over-pronation observed during gait assessment
– Negative neurological findings, ruling out tarsal tunnel and nerve entrapment
Key Notes
– After the age of 40, there is decreased fascia elasticity & strength (hint: stretches and footwear can help with this!)
– Women experience more Ligament Laxity (ligaments becoming more loose over time) due to hormonal changes they experience (hint: Orthotics can help!), they also have less supportive footwear choices like high heel shoes
CASE ANSWERS
Diagnosis
Mechanical Plantar Fasciitis associated with reduced arch support due to constant barefoot walking and wearing unsupportive slippers on hard surfaces.
Management Plan
Footwear: Introduced stable, supportive footwear with a firm heel counter and rocker forefoot to reduce strain during toe-off.
Orthotics: Custom foot orthoses fabricated to support the medial longitudinal arch and reduce Plantar Fascia tension.
Exercise Program: Daily calf stretches and Plantar Fascia strengthening to improve flexibility and tissue resilience.
Night Splint: Recommended to maintain gentle elongation of the fascia and calf complex overnight.
Patient Education: Advised consistent use of supportive indoor footwear and avoidance of barefoot walking on hard floors.
Outcome
After six weeks of adherence to the treatment plan:
– Sarah reported an 80% reduction in morning pain.
– Improved ankle flexibility and gait symmetry were observed.
– She resumed full daily activity and continued using orthotic support indoors and outdoors.
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