Hello and welcome to the zero to finals podcast. My name is Tom and in this episode I'm going to be

talking to you about common foot problems. And you can find written notes on this topic at

zero to finals.com slash foot problems or in the orthopedic section of the zero definals surgery book. So let's get

straight into it. Let's start by talking about plantar fasciitis. Plantar fasciitis is inflammation of the

plantar fascia. The plantar fascia is made up of thick connective tissue. It attaches to the

calcaneus at the heel, travels along the sole of the foot and branches out to connect to the flexor

tendons of the toes. The presentation of plantar fasciitis is with a gradual onset of pain in the plantar aspect

of the foot, on the bottom of the foot.

This is worse with pressure, particularly when walking or standing for prolonged periods.

There is tenderness to palpation of this area, particularly where the plantar fascia attaches

to the calcaneus just below

the heel of the foot. Management involves rest, ice, analgesia, for example, non-steroidal

anti-inflammatory drugs or ensades, physiotherapy, and steroid injections. Steroid injections can be

very painful and rarely they can cause

rupture of the plantar fascia or a condition called fat pad atrophy, which we'll talk about

in more detail shortly. Rarely, specialist management of plantal fasciitis may be required

with extra corporeal shockwave therapy or surgery.

Next let's talk about fat pad atrophy.

Fat pad atrophy affects the fat pad over the heel of the foot, which is under the calcaneous bone.

The fat pad normally protects the heel from impact.

Atrophy, which means wasting away of the fat pad can occur with age or inflammation

from repetitive impacts such as jumping activities, running, walking and obesity.

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