Rupture of the Plantar Fascia
Plantar fascia rupture is not a very common injury, and it
has the characteristic of acute pain in the arch of the foot. It occurs due to
a tear in the plantar fascia, and that tear is painful. Rupture is often
associated with long standing flat feet deformity or can occur from steroid
injections. Another predisposing factor for plantar fascia rupture is plantar
fasciitis.
Anatomy
The plantar fascia is formed by three bands: the medial, the
central, and the lateral. The plantar aponeurosis is the central part of the
plantar fascia. The plantar fascia is inserted into the medial tuberosity of
the
The rupture of the plantar fascia may be misdiagnosed as
plantar fasciitis. When the plantar fascia tears, the patient will describe a
tearing pain that usually occurs during athletic activity. The tear may be
complete or incomplete. Complete tear of the plantar fascia occurs from sudden
trauma or injury. The patient feels “popping” or “snapping” suddenly. Walking will
be very difficult with tenderness, swelling and significant bruising on the
sole of the foot (the condition is painful). Some patients may have a noticeable
tightness of the calf muscle (equinus contracture) in association with rupture
of the plantar fascia. Partial rupture is less common and occurs from overuse,
as in running. MRI will identify the rupture, and it can also identify if the
rupture is partial or incomplete. Rupture is often in the arch of the foot
opposed to where the plantar fascia inserts into the heel (calcaneus). Ultrasound
has the same accuracy as MRI for imaging the plantar fascia. Interpretation of
the plantar fascia rupture may be difficult. You may need dynamic maneuvers
with dorsal flexion of the forefoot to stretch the plantar fascia. Usually the
proximal part of the plantar aponeurosis is clearly visualized on ultrasound.
MRI is probably better in diagnosis plantar fascia rupture.
Treatment of Plantar Fascia Rupture
-Non-Weight Bearing for 2-3 Weeks
-Walking Boot
-Crutches
-Physical Therapy
-Surgical Treatment is the last resort.
-Could be used in some athletes who
continue to have pain despite a well conducted conservative treatment
-Surgery is done to release the
fascia and the excise the scar
Patients with rupture of the plantar fascia typically
achieve a favorable outcome with return to full activity.
