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Ruptured Plantar Fascia – Causes, Symptoms & Treatment of a Tear

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Dealing with a ruptured plantar fascia can be painful. This article provides a detailed examination of this condition. You will learn the causes, symptoms, diagnosis methods, and treatment for plantar fascia injuries. 

The importance of specialized footwear and orthotics will be addressed, as well as potential consequences of neglecting such an injury. 

What Is the Plantar Fascia?

The plantar fascia is the connective tissue that runs along the bottom of the foot. It is separated into a medial (inner) band, a central band, and a lateral (outer) band. 

When the plantar fascia becomes overloaded or overstretched, it will tear due to plantar injury. Plantar fascia injuries should be addressed quickly to optimize recovery. 

jumping

What Causes Plantar Fascia Ruptures?

Plantar fascia ruptures occur due to sudden injuries or impacts, such as falls or heavy objects striking the foot. 

Microtears in the plantar fascia can develop gradually due to the repetitive stress associated with plantar fasciitis. In rare instances, a plantar aponeurosis tear may be triggered by a corticosteroid injection.

Ruptures can also result from repetitive stress or foot trauma. Activities that cause stress on the plantar fascia include running, jumping, or dancing. 

What Does a Ruptured Plantar Fascia Ligament Feel Like?

In the case of an acute tear or a plantar fascial rupture, you may experience a sudden and intense pain in the heel or arch of the foot. This can make it difficult to put weight on the affected foot. 

For plantar fascia tears resulting from chronic microtrauma to the ligament, you may feel a persistent, dull, and achy pain in the heel or arch of the foot.

What Are Common Symptoms of a Rupture in the Plantar Fascia?

An acute plantar rupture of the fascia will result in a variety of noticeable symptoms. These symptoms are listed below.

  • Bruising in the plantar aspect (bottom) of the foot
  • Foot swelling
  • Inability to bear weight on the foot
  • A bulge or “hole” on the bottom of the foot in the area of the plantar fascia rupture
  • A noticeable discontinuity along the area of the plantar fascia
  • A distinct “popping” sensation in the arch or heel
ultrasound

How Are Injuries to the Plantar Fascia Diagnosed?

If you suspect a tear in your plantar fascia, you should be evaluated by a Podiatrist. During the examination, your doctor will review your medical history and conduct a physical exam. 

To rule out other potential causes of heel or arch pain, such as stress fractures or bone tumors, an x-ray of the foot will be ordered. While the plantar fascia itself cannot be directly visualized on an x-ray, an ultrasound can be utilized to detect and locate the tear. 

In some cases, your doctor may also recommend an MRI scan, which provides detailed images of the soft tissue, tendons, bones, and ligament injuries in the foot. 

This imaging modality helps identify the presence, severity, and any associated foot problems, including stress fractures.

How Do You Treat a Ruptured Plantar Ligament?

Treatment for plantar fascia ruptures will depend on the severity of the injury and how much pain you’re in. 

In most cases, plantar fascia injuries can be treated conservatively with RICE therapy and immobilization.

You will need to remain non-weight bearing in a cast boot for 4-8 weeks, followed by a gradual transition to weight-bearing in a cast boot for another 2-4 weeks before returning to athletic shoes.

Physical therapy will need to be completed for 4 weeks to reduce pain and improve gait. 

Full recovery from plantar fascia ruptures can take up to 3 months as stated by A. Saxena in the American Journal of sports medicine

person holding orthotics

Arch Support

During the recovery phase, your doctor may recommend the use of an arch support  to elevate the arch and relieve strain on the plantar fascia. 

Custom orthotics, tailored to fit your feet, are the ideal choice and can be obtained from your foot doctor’s office. It’s worth checking with your insurance provider to determine if this is a covered benefit. If not, over-the-counter orthotics, such as Powerstep orthotics, can still provide significant support. 

Here are some recommendations based on foot conditions:

Wearing shoes like rocker bottom shoes can help alleviate strain on the plantar fascia. These shoes have a curved sole that facilitates a rocking motion while walking. This reduces pressure on the heel and ball of the foot. 

Rocker bottom shoes provide support, cushioning, and help decrease inflammation and pain associated with a plantar fascia tear. They also contribute to improved balance, stability, and fall prevention.

surgery

What Happens if Your Plantar Fascia Tear Does Not Heal?

If the plantar fascia tear does not heal, surgery may be needed. This procedure involves the release of the plantar fascia and removal of scar tissue. 

The surgery can be performed either endoscopically or through open surgery. Following the procedure, a non-weight bearing period of 4 to 6 weeks in a cast boot is typically required, followed by a gradual transition to weight bearing. 

Additionally, physical therapy will be essential for rehabilitation purposes.

Can You Walk With a Plantar Fascia Tear?

While it is technically possible to walk with a torn plantar fascia, it is strongly advised against doing so due to the significant pain it can cause. 

Walking with a torn plantar fascia can exacerbate the pain by placing excessive pressure on the damaged tissue. It is important to prioritize rest if you suspect a torn plantar fascia. 

Continuing to walk with this ligament injury can impede the healing process and potentially lead to additional tissue damage.

Can You Run With a Torn Plantar Fascia?

Running with a torn plantar fascia is not recommended. Due to the nature of the injury, running can intensify foot pain and further aggravate the damaged tissue. Running while the plantar fascia is torn can delay the recovery process and potentially worsen the condition.

Is a Plantar Fascial Ligament Injury Serious?

Yes, a plantar fascial ligament tear should be taken seriously because it can result in substantial pain and limitations in weight-bearing activities. 

Continuing to walk or run with a torn plantar fascia can exacerbate the pain and impede the healing process. 

If you suspect a plantar fascia tear, it is important to be evaluated by a Podiatrist to ensure proper diagnosis and treatment. Ignoring the condition can lead to prolonged discomfort and potential complications.

How Is Plantar Fasciitis in the Foot Different From a Plantar Fascia Ligament Tear?

Plantar fasciitis in the foot is characterized by inflammation of the plantar fascia, while a plantar fascia ligament tear involves a partial or complete rupture of the plantar fascia. While both conditions affect the plantar fascia, a tear indicates a more severe injury compared to the inflammation associated with plantar fasciitis.

Conclusion

In conclusion, a ruptured plantar fascia is a condition that should not be ignored due to the significant pain and limitations it can cause in weight-bearing activities. Prompt diagnosis and appropriate treatment are essential for optimal recovery. 

From understanding the causes and symptoms to receiving a proper diagnosis, this article has provided valuable insights into the management of plantar fascia injuries. Whether through conservative measures like immobilization and physical therapy, the use of specialized footwear and orthotics, or, in rare cases, surgical intervention, addressing a torn plantar fascia is crucial to facilitate healing and prevent further damage.

By prioritizing rest, seeking medical attention, and following recommended treatment protocols, individuals can maximize their chances of a successful recovery and return to a pain-free, active lifestyle.

Related articles: Cortisone Shots for Plantar Fasciitis:  Pros & Cons of a Foot Steroid Injection

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References

  1. Cocco G, Ricci V, Boccatonda A, Abate M, Guagnano MT, Schiavone C. Ultrasound follow-up of spontaneous tears of the plantar fascia treated with conservative therapies: Two case reports. Medicine (Baltimore). 2019 Dec;98(52):e18428.
  2. Pascoe SC, Mazzola TJ. Acute Medial Plantar Fascia Tear. J Orthop Sports Phys Ther. 2016 Jun;46(6):495. 
  3. Reais, N. (2019, November 27). Plantar Fascia Acute Rupture: A Rare Entity – Case Report.
  4. Kline, A. (2009, May 1). Plantar Fascial Rupture of the Foot: A case report.
  5. Rolf C, Guntner P, Ericsäter J, Turan I. Plantar fascia rupture: diagnosis and treatment. J Foot Ankle Surg. 1997 Mar-Apr;36(2):112-4

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Vaishnavi Bawa
Dr. Vaishnavi Bawa is a Podiatrist who specializes in treating foot and ankle pathology. LifesLittleSteps mission is to educate the public about foot health in an easy-to-understand manner using evidence-based medicine.
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