Applied Aspect Regarding The Sole of Foot

Plantar Fasciitis

Plantar Fasciitis

Plantar Fasciitis is the inflammation of the Plantar Fascia

It is often caused by an overuse mechanismPlantar Fasciitis is the most common hind foot

problem in runnersIt causes pain on the plantar surface of the foot

and heelThe pain is often more severe when after sitting

and when beginning to walk in the morningThe pain dissipates after 5-10 mins of activity

and recurs after inactivity

Point tenderness is located at the proximal attachment of aponeurosis to the medial tubercle of calcaneum and on the medial surface of the bone

Exacerbated by dorsiflexion of the ankle and weight bearing.

Calcaneal Spur

An abnormal bony process that protrudes from the medial tubercle, if present along with pain on the medial side of the foot when walking may indicate plantar fasciitis.

Palpating the Dorsalis Pedis Artery

Palpation of the Dorsalis Pedis Pulse

Evaluated during a physical exam of the peripheral vascular system.

Palpated with the feet slightly dorsiflexed.It is easily palpated as it lies subcutaneously

along a line from extensor retinaculum to a point just lateral to the EHL tendons.

A diminshed or absent dorsalis pedis pulse suggests vascular insufficiency resulting from arterial disease.

The Five P signs of acute arterial occlusion are pain, pallor, paresthesia, paralysis and pulselessness.

Some times the dorsalis pedis artery is completely replaced by an enlarged perforating fibular artery.

Therefore some healthy adults and children have congenitally non-palpable dorsalis pedis pulses.

This condition is usually bilateral.

Plantar Reflex

Plantar Reflex

Nerve roots involved are L4, L5, S1 and S2It is a myotic reflex routinely tested during

nerological examinationsLateral aspect of the sole of the foot is

stroked beginning at heel and crossing to the base of big toe

Motion should be firm and continuous but neither painful nor ticklish.

Flexion of the toe is normal responseFanning of the lateral four toes and

dorsiflexion of the great toe is an abnormal response (The Babinski Sign)

A positive babinski’s sign is indicative of brain injury or cerebral disease except in infants.

As the corticospinal tracts are not fully developed in newborns, a Babinski sign is usually elicited and may be present until children are 4 years of age.

Except for Children with brain injury or cerebral disease

Neuromas

Morton’s Neuroma

A Neuroma is a growth of nerve tissue.A Neroma May be formed on the branch of

medial plantar nerve between 3rd and 4th metatarsal bones

This Neuroma is termed as Morton’s Neuroma

This causes pain between 3rd and 4th metatarsals

Usually results from wearing tight shoes and repeated irritation of the Nerve.