Foot and Ankle International
Tracking Pixel
presents
Wheeless' Textbook of Orthopaedics

Plantar Fascia



- See:
      - Plantar Fasciitis
      - Windlass Mechanism

- Anatomy:
    - plantar fascia is a strong layer of white fibrous tissue whose thick central part is bounded by thinner lateral portions;
    - central portion is attached to the medial calcaneal tubercle;
    - as it progresses distally it divides into 5 sections, each extending into a toe and straddling the flexor tendons;
            - superficial layer of each section attaches to deep skin fold between toes and the sole;
            - deep layer blends with the fibrous flexor sheath on each proximal phalanx and sends speta to the deep transverse ligament of the sole;
    - heel spurs: (see: heel pain)
            - are not in the plantar fascia as is commonly thought but are found in the origin of the short flexors;
            - they are present in 16% of normal population;

- Action and Function:
    - stabilizes the arch;
    - plantar aponeurosis provides stability of the 1st MP joint & medial arch thru its Windlass Mechanism;
            - this plantarflexes the first metatarsal therby enabling the 1st metatarsal to carry the majority of body wt during last half of stance phase;
            - if this mechanism is disrupted distally, plantar flexion does not occur and wt is transferred to the second
                    metatarsal, often resulting in a painful callus beneath 2nd metatarsal head;
    - during normal walking, the plantar aponeurosis functions mainly during heel rise to toe off and prevents the calcaneous from everting;
    - this mechanism brings about plantar flexion of metatarsals, which elevates and stabilizes the longitudinal arch,
            inverts the calcaneus and externally rotates the tibia;







Rupture of the plantar fascia in athletes.

Plantar fasciitis. The painful heel syndrome.

Dynamic Loading of the Plantar Aponeurosis in Walking.












Original Text by Clifford R. Wheeless, III, MD.