Skip to Main Content

++

ICD-9-CM Code

++

  • 728.71 Plantar fascial fibromatosis

++

ICD-10-CM Code

++

  • M72.2 Plantar fascial fibromatosis

++

Preferred Practice Pattern

++
++

Key Features

++

Description

++

  • Inflammation of fascia on bottom of the foot or at the insertion of the medial calcaneal tubercle

  • Overstretching of the fascia can occur via two processes

    • Acute inflammatory process

      • Usually with pes cavus (high arch) foot type2

      • Rapid overstretch possible from missing a step or curb

      • May be caused by trauma, as in stepping on hard object or ledge

    • Chronic inflammatory process

      • Usually with a pes planus (flat foot, low arch) foot type2

      • Chronic overstretching of the fascia or ligamentous support

      • Degenerative tendinosis of the foot's intrinsic flexors and invertors

++

Essentials of Diagnosis

++

  • Diagnosis usually made by clinical examination3

  • Can be an independent diagnosis, not associated with a disease process

  • May not be fasciitis, but inflamed flexor digitorum brevis or tibialis posterior4

    • May feel better once warmed up

    • Fatigues gradually throughout the day

++

General Considerations

++

  • Most common orthopedic foot complaint

++

Demographics

++

  • Most common in middle age

  • Men and women equally affected

    • Distance running

    • Poor footwear

    • Weight gain, pregnancy

    • Prolonged standing on hard floors, including cement, tile, hardwood

++

Clinical Findings

++

Signs and Symptoms

++

  • Stabbing pain in heel with

    • First step of the day5

    • First step out of a chair

    • Barefoot walking on a hard surface

  • Burning sensation underneath mid arch indicates tibial nerve entrapment3,5

  • Heel pain with palpation at origin of the fascia where heel spur can occur5

  • Aching, fatigue, soreness as day progresses may indicate inflamed flexor digitorum brevis or tibialis posterior5,6

  • Mild swelling along bottom of feet5

++

Functional Implications

++

  • Pain with standing; limitation on standing in one spot

  • Pain along bottom of foot and heel with ambulation

  • Balance and instability due to altered gait and stance patterns

++

Possible Contributing Causes

++

  • Pes planus (flat feet) foot type can cause chronic elongation of the fascia

  • Pes cavus rigid foot type with acute strain

  • Rearfoot and forefoot varus

  • Occupation that demands

    • Prolonged standing

    • Steel-toed shoes

    • Shoes with no arch support

    • Standing on hard surfaces

  • Sudden weight gain that overloads muscular system

  • Pregnancy

    • Ligamentous laxity (hormone relaxin)

    • Excessive weight gain

    • Decreased arch height

    • Barefoot

  • Obesity

  • Limited dorsiflexion (tight heel cord)

  • Lack of talocrural joint mobility

  • Jogging or running on cement

++

Differential Diagnosis

++

  • Heel spur

  • Heel pain

  • Tibial nerve entrapment

  • Flexor digitorum brevis tendonitis

  • Tibialis posterior tendonitis

  • S1 radiculopathy

  • Reiter's syndrome

    ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.