The full content of Annals is available to subscribers

Subscribe/Learn More  >
In the Clinic |

Plantar Fasciitis

Craig Young, MD
Ann Intern Med. 2012;156(1_Part_1):ITC1-1. doi:10.7326/0003-4819-156-1-201201030-01001
Text Size: A A A

In the United States, up to 10% of adults will have heel pain in their lifetime (1) and plantar fasciitis is one of the more common causes of heel pain in adults. It is among the top 5 diagnoses of foot and ankle pain in runners (2, 3) as well as in professional football, baseball, and basketball players (4). Per year, plantar fasciitis affects 2 million people in the United States and results in approximately 1 000 000 visits to physicians, 62% of which are to primary care physicians (5). The annual cost of treatments for this disorder is between $192 and $376 million (6).

First Page Preview

View Large
First page PDF preview


Grahic Jump Location

Figure 1. Palpation of the medial tubercle of the calcaneus. The borders of the plantar fascia are drawn on the bottom of the foot.

Grahic Jump Location
Grahic Jump Location

Figure 2. Calf and arch stretch using a towel.

Grahic Jump Location
Grahic Jump Location

Figure 4a. Wall stretches. With the knee in extension.

Grahic Jump Location
Grahic Jump Location

Figure 5a. Stretching healing tissue. Using a can for a dynamic rolling stretch of the arch.

Grahic Jump Location
Grahic Jump Location

Figure 5b. Manually stretching the plantar fascia.

Grahic Jump Location




CME Activities are only available to ACP members and Individual Annals subscribers. If you are a member or a subscriber please sign in. Otherwise please become a member or subscribe to Annals.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Bare Feet on Hard Surfaces is the Problem
Posted on February 16, 2012
Timothy, Hunter, MD
Conflict of Interest: None Declared

Plantar Fasciitis is a common problem evaluated in the primary care setting. Your recent January 3rd article concerning that condition is informative and your recommendations for prevention and therapy are realistic. You should add, however, one more very important bit of advice: Stop walking around in bare feet on hard surfaces. Fifteen years ago I used to send several patients a year to the podiatrist for plantar that did not respond to conservative therapy, but since I started to advise patients to stay off the hard surfaces in bare feet I cannot remember the last time I sent someone to the podiatrist. This country has experienced a significant change in its interior flooring over the pst twenty or so years transitioning from thick shag or plush carpeting to tile or hardwood floors. This transition in flooring led to, in my opinion, a significant increase in plantar fascial complaints. It is my experience that just about every patients this problem admits to walking around their tile and wood floors in bare feet. We need to support our arches. Thick grass, soft sand, and 1960's style shag carpeting are all fine for bare feet, but not our hard floors. It is simple common sense advice and it works for just about every patient with this difficulty. Timothy Hunter, MD. Myrtle Beach, SC. 29572

Conflict of Interest:

None declared

Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $32.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Journal Club
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.