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‘Plantar heel pain’ or ‘plantar fasciitis’?

Discussion in 'Biomechanics, Sports and Foot orthoses' started by NewsBot, Feb 20, 2017.

  1. NewsBot

    NewsBot The Admin that posts the news.

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    Editorial in BJSM:
    Is ‘plantar heel pain’ a more appropriate term than ‘plantar fasciitis’? Time to move on
    Henrik Riel, Matthew Cotchett, Eamonn Delahunt, Michael Skovdal Rathleff, Bill Vicenzino, Adam Weir, Karl B Landorf
    BJSM
     
  2. Craig Payne

    Craig Payne Moderator

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    Bad idea. 'plantar heel pain' = "sore heel" ... a meaningless term that could mean a whole lot of different pathologies.
    What is wrong with plantar fasciopathy? <-- explains what it is. 'Plantar heel pain' explains nothing.
     
  3. William Fowler

    William Fowler Active Member

    Agreed. That is a bad way to go. Plantar heel pain could mean any number of different problems.
     
  4. Trevor Prior

    Trevor Prior Active Member

    Actually I tend to agree with the concept of a broader term. Planter fasciopathy refers to just one structure, and is not specific with regards to the other structures often involved in symptoms in this area. The nature of the involvement of the plantar fascia (i.e. Simple thickening, intrasubstance oedema and partial tear / rupture) but also fat pad oedema, intrinsic muscle and calcaneal oedema are common findings and more rarely muscle atrophy due to nerve involvement. Classifying the condition clinically with only one catchall diagnosis is one of the issues that we have had with studies in this area - many do not know the extent of pathology present in their subjects. Plantar heel pain does not resolve this but plantar heel pain syndrome for instance might be more reflective of the extent of pathology that can occur. I have reviewed many with MRI over the last 10-15 years and the extent of pathology varies greatly. Even the shape of spurs varies and some can be seen to be potential contributors to symptoms.
     
  5. I think the term "plantar heel pain" is just as good (i.e. bad) as "metatarsalgia". Proximal plantar fasciitis is the term I use, which may be caused by multiple specific pathologies. Simon Bartold proposed the term "plantar heel pain syndrome" to me about 10 years ago, which to me, is better than "plantar heel pain" but also, to me, about the same in usefulness and specificity as "proximal plantar fasciitis".
     
  6. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    That's the point I like. "plantar heel pain' is a catch all for a zillion things like the term 'metatarsalgia'
     
  7. Admin2

    Admin2 Administrator Staff Member

  8. Trevor Prior

    Trevor Prior Active Member

    I cannot say I disagree with any of those comments, the point being there are a range of conditions and no one term can be sufficiently prescriptive. I think my point is that whatever is used needs to be defined sufficiently that it indicates to those less familiar that there are a range of conditions. So, perhaps one option, rather than using a different term, is to alter the definition of plantar fasciitis to be broader (that would remove the need for the discussion around fasciitis and fasciopathy).
     
  9. I think Plantar Heel pain more than I like Heel spur , but yes about as useful as shin splints, metatarsalgia

    But if a patient did come in saying that had Plantar Heel pain it would be great, as the next thing you would say is now we need to find the specific cause of the pain to begin treatment, instead of first having to unlearn the info they have and then move on to specifics
     
  10. Dieter Fellner

    Dieter Fellner Well-Known Member

    I am a fan of Landorf's work, in general challenging contemporary and historical beliefs. I want to read the full article but cannot find access. The very first sentence 'Plantar heel pain, also known as plantar fasciitis ... ' is contentious. 'Plantar fasciitis as one possible cause of plantar heel pain' might be a more digestible proposition.
     
  11. NewsBot

    NewsBot The Admin that posts the news.

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