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Thread: Plantar fasciitis or intrinsic foot muscle strain , how do you differentiate ?

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  1. #1
    Join Date
    Dec 2015
    Wilton Street Glasgow

    Plantar fasciitis or intrinsic foot muscle strain , how do you differentiate ?

    Pain from intrinsic muscle strain and from plantar fasciitis . How do you differentiate between the two and is there a difference in the treatment prescribed ?

    In some instances it might be quite easy to differentiate between muscle pain and pain from the fascia .

    My understanding is that foot pain is often at its worst for the first few steps after getting out of bed in the morning , so that may be the best time to have the test ( carried out by the patient themselves but only after diagnosis and instruction by a suitably qualified individual ) .

    The test ? Dead easy . You would need a simple board for the foot with a raised ,ramp section at one end for the toes and a non elastic leather strap to hold the foot in place . Before taking those first few steps the patient would place their foot on the board ,located on the floor , with the toes inclined on the ramp . The leather strap would go round the board and the foot , and be fastened to hold the foot to the board . The patient now presses the toes against the ramp section so that the ball of the foot tends to lift off the board but is held in place by the rigid leather strap . The fascia is being unloaded here , whilst the intrinsics are contracting . Pain means a muscular pain source .

    Once again you would carry this out only after expert instruction but in essence its pretty simple once you know how .

    Further to the above , it will be understood that if a patient has marked pain with the first few steps in the morning , but the technique outlined does not produce pain when the intrinsics are contracting ,then it is likely to be a fascia based problem .

    Toe curling type exercises are unlikely to be of any use in the test since they principally concern the extrinsics .

    How often is intrinsic muscle damage or insertional tendonitis mistaken for plantar fasciitis ? Given the number of muscles in the foot and the job they perform during the latter part of stance , I would imagine the misdiagnosis happens frequently .

    Asked in the first sentence of this post , " is there a difference in the treatment prescribed ? "

    Well , a muscle strain might initially be treated with rest and ice , but progressive strengthening exercises would normally also be involved , as soon as symptoms began to resolve . Physiotherapists would normally routinely recommend targeted, strengthening exercises for skeletal muscle strains but this might not happen with injuries attributed to plantar fascia problems .

    Therefore with the foot , I can see considerable value in being able to differentiate between muscle and "fascia related " problems .

    Any thoughts

    ( Much of the above is from material written by me on Podiatry Arena in the last few days )
    Last edited by Gerrard Farrell; 09-04-2019 at 02:06 PM.

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