Plantar Fasciitis

Degenerative fasciosis (not true 'itis') of the plantar fascia origin at the medial calcaneal tubercle due to repetitive micro‑trauma. Classic history: sharp 'first‑step' pain on arising or after rest; eases with a few minutes of walking, recurs after prolonged standing. Risk factors: tight gastrocnemius–soleus, cavus or planus foot, prolonged standing, obesity, running/sudden training change. Exam: point tenderness at medial calcaneal tubercle; positive Windlass test (pain with 1st MTP dorsiflexion standing). Imaging: X‑ray may show heel spur but is non‑diagnostic; ultrasound shows thickened fascia (>4 mm) with hypoechogenicity; MRI only if atypical or recalcitrant. Treatment ladder: activity modification, calf/plantar fascia stretching, heel cups/orthoses, NSAIDs, night splints → ESWT/PRP or limited corticosteroid injection → surgery (partial plantar fasciotomy ± gastrocnemius recession) after ≥6–12 months failed conservative care.