Plantar Fasciitis Vs Achilles

Tendonitis

Bryan Lilisa & Santiago Romero

What is Plantar Fasciitis (Policeman’s Heel)
● Plantar Fasciitis is an irritation and Inflammation of the
plantar fascia.
● Plantar fascia is a strap of connective tissue that connects
the calcaneus to the toes.
● It is thick and strong center with the thinner, weaker wings
along the medial and lateral foot.
● Two heads of the gastroc and soleus blended into calcaneal
tendon (tricep surae)
What is Plantar Fasciitis (Policeman's Heel) Cont.
● Some other muscles affected by Plantar Fasciitis on the anterior side Tibialis
anterior, Peroneus longus, peroneus brevis, extensor digitorum longus
● The posterior muscle are Gastrocnemius, Soleus Muscle, extensor hallucis longus,
Achilles tendon and calcaneus bone.
● Affected nerve is lateral plantar nerve
Signs and symptoms of Plantar Fasciitis
● Most common symptoms are a stabbing pain near the heel.
● Pain is mostly in the morning
● Swelling
● Tenderness
● Also may cause limping
● More common to overweight
● Affect people who don’t wear supportive shoes and run
● Very common to people of ages 40-60 yrs
 What is Achilles Tendonitis?
● Cause by an overuse of the achilles tendon and muscles
● Inflammation of the achilles tendon, the tendon that
connects to the calf muscle to the heel bone resulting into
heel pain, tenderness and swelling .
● The Gastrocnemius and the Soleus are the muscles affected
in Achilles Tendonitis.
● Caused by repetitive or intense strain on the Achilles tendon
typically runners are affected due to sudden increased in
activity
● Symptoms include tenderness or stiffness, specially in the
Sign and Symptoms of Achilles Tendonitis
Pain and stiffness around the achilles tendon during the morning

Pain in the back of the leg or above the heel increasing pain during activity

Increased pain after more strenuous activities

Swelling that worsens throughout the day with activity

 Contraindications to Plantar Fasciitis
● Endangerment sites like the dorsalis pedis artery try not
to get to much pressure in that area it can injure the
patient.
● Treatment Duration and pressure for some elderly
patients with a degenerative, you must be careful when
using friction because it can tear off the tissue where it
attaches to the calcaneus, so it is best to go around and
work with the patient's tolerance
● Injections if the client has had a steroid shot or analgesic
injection within the last two weeks then that area must be
avoided.
Plantar Fasciitis massage protocol
● First it always happens early in the morning.
1. We start of by stretching the foot with either a belt or a strap making sure the foot is on top of a
rolled up towel just until you get a nice stretch. 3 x 30 sec
2. We do some friction around the foot to start the blood to flow. 5 min
3. Then massage the fascia with some stripping and strumming depending where the trigger point is
whether its at the heel or the middle. 4 min
4. Then some pulling of the fascia from side to side. 4 min
5. Specific kneading with the thumbs fanning like a little window wiper going up and down the sole
of the foot.. 5 min
6. Make sure to do an ice massage on the base of the foot where the pain is found. 8min
7. These techniques are for an acute case of plantar fasciitis which are almost all of them
Reasons for massage types and whether to use ice or
heat
● The reason for using a strumming massage for this type of irritation is because since
its the fascia it doesn’t have much movement at all So for this reason you try to
seperate the fascia.
● The best way to help this is also getting a frozen water bottle and roll it from the heel
to the toes relaxing the fascia and lowering the pain.
 Achilles Tendonitis Protocol
1. 3x 30 sec. Stretch the Gastrocnemius and Soleus by dorsiflexing foot
2. 2 min. Effleurage to increase circulation, warm up calf muscle
3. 3 min. Specific compression on any trigger points if there are any
4. 3 min. Work specifically on achilles by stripping for bottom of the heel up
to the end near the calf muscles
5. 3 mins. Work specifically on achilles by strumming working from the
bottom to the top of heel
6. 5 min. Specific Kneading to the Soleus
7. 2 min. Circular friction to release knots or trigger points to alleviate any
discomfort and increase ROM
8. 5 mins. Ice massage tendon and the muscles around the area
9. 7 mins. Broadbase Kneading to the Gastrocnemius & Soleus
10. 3 min. Finish up with Effleurage general areas (Gastroc.,Soleus)
 Plantar Fascia & Achilles Tendonitis
Differences Similarities
Plantar Fasciitis usually develops gradually but can appear
Contraindicated with steroid injection
suddenly and can be acute

Achilles Tendonitis usually occurs during sudden increase
of activity
Where the pain is located and whether or not the pain gets
worse throughout the day
Achilles Tendonitis mainly cause pain at the back of heel
Plantar fasciitis causes pain in the bottom of the heel in the
morning which tends to get better throughout with activity
Affects ambulation due to pain
Home remedies treatment are the same
ex: supportive shoes, stretching, icing
area, over-the-counter medications,
decrease activity that cause pain
Both tendons are connected to the
calcaneus