Talk:Plantar fasciitis/Archive 1

Comment
Article needs a picture or diagram to help. DyslexicEditor 09:41, 12 May 2006 (UTC)

, The article on the foot already carries this picture, but this does not show the plantar facia itself (immediately under the skin and sub-dermal layer), nor where the pain is usually experienced along it (namely at its attachment over the front edge of the heal bone). So I'm not sure if this would help further this article or not - what do others think ? David Ruben Talk 12:22, 12 May 2006 (UTC)


 * Hmmm... I think it needs a diagram then.  The foot article has many pictures of feet, but their best diagram Image:Foot.png is lacking.  This picture of a skeleton Image:Foot-bones.jpg, if it was photoeditted to be labbelled might be good--I don't know if it is okay to edit a GFDL with labels and upload it, though.  DyslexicEditor 12:40, 12 May 2006 (UTC)

ultrasound
The article currently says:
 * Therapeutic ultrasound, with or without iontophoresis, and more recently, extracorporeal shockwave therapy (ESWT) have been used with some success in patients with symptoms lasting more than 6 months.

However, the title of the article referenced seems to indicate that it's only about ESWT. I've added a reference to a controlled study that showed that ordinary therapeutic ultrasound was not effective, and changed the text appropriately.--75.83.140.254 21:05, 1 January 2007 (UTC)

I have found that certain heel seats and gel heel cushions really help with the pain. I also found out about night splints, what this does is keep the ligaments stretched while your sleeping. I have found heelthatpain.com splints, heel seats, the dorcel night splint work extremely well, especially with early morning heel pain. —Preceding unsigned comment added by 99.132.218.230 (talk) 18:53, 25 September 2008 (UTC)

Reebok DMX Shoes
While Reebok DMX shoes are not a cure, they provided me instant relief from the pain of plantar fasciitis.

I had plantar fasciitis a few years ago from too much standing on a ladder without using steel shanked boots while remodelling a home for 5 years. My podiatrist prescribed me anti-pronating inserts, stretches, Reebok DMX shoes and steel shanked boots for times when I would be on a ladder in the future. I went straight from her office to get the Reeboks and even without the inserts, the shoes allowed me to instantly walk normally again. I just found out a co-worker was suffering from this affliction and encouraged him to find some of these shoes. This also reminded me to share my experience here. What makes these shoes so soft is they contain two air bladders connected by a small straw. One bladder is at the front of the shoe and one is at the back. As you walk, air is forced through the resistance of the small straw, giving a very soft landing on each step. As far as I know, only the Reebok DMX shoes are constructed in this way.

See also The American Academy of Podiatric Sports Medicine http://www.aapsm.org/walkingshoes.html for a longer list of shoes approved by this organization.

Laughingskeptic 18:44, 14 January 2007 (UTC)


 * Here's my experience when I got it in 2004, posted on the uk.rec.walking newsgroup - . Occasional minor reoccurences (and new occurence on other foot) since, easily controlled with stretching. -- John (Daytona2 · talk) 18:20, 30 December 2007 (UTC)

Weight on the heel
"Weight on the heel does not cause plantar fasciitis."

This is an odd claim! It might be technically correct, but it is hard to believe that heel weight would not at least aggravate the condition, since that is where it is usually felt. If this claim remains in the article, it should have a reference supporting it.-69.87.200.231 13:08, 13 July 2007 (UTC)

"Running long distances or putting repetitive pounding on the heel of the foot during exercise often are huge factors that can add excessive stress to the heel of the foot, therefore contributing to development of plantar fasciitis." "Additional and unnecessary strain on the heel will aggravate the area even more, and cause the pain to become even more severe."  -69.87.200.231 13:17, 13 July 2007 (UTC)
 * The claim does not strike me as odd, as it is traction on the attachment of the plantar fascia to the end of the heel bone, and not pressure on the bone itself, that produces the pain. Many cases, in fact, result from walking or running barefoot on the beach, where the bone itself is well-cushioned by the sand but the fascia of the arch is stressed by having to "pull" the heel up out of the sand with each stride that causes the problem. Sfahey 03:57, 28 August 2007 (UTC)

Spelling of Plantar Fasciitis
My podiatrist calls it "Planar Fascitiis" on the internet it is also spelled "Planar Fascitiis" and other numerous spellings.

Perhaps someone knows how to link up additional spellings to this entry as I have almost started a new entry on the subject.

Thanks Astrocloud 19:07, 26 August 2007 (UTC)
 * You need a new podiatrist. It is quite clearly "plantar", referring to the underside of the foot, as in "plantar warts". re: the internet: googling "nucular" yields 173,000 hits, but doesn't make it right. Sfahey 03:53, 28 August 2007 (UTC)


 * Also, "Fascitiis" is wrong. "Itis" is the suffix.

Acupuncture
The article used to say: "It should be noted that acupuncture has not been scientifically proven to be an effective treatment for any condition, and that pain is highly subjective and subject to placebo effects."

This is not true. A very quick search releaved, just in the last few weeks, at least three peer-review article on the effects of acupuncture:

Acupuncture in Polycystic Ovary Syndrome: Current Experimental and Clinical Evidence. Stener-Victorin E, Jedel E, Mannerås L., Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy, Göteborg University, Sweden. (Journal of Neuroendocrinology, 2007 Nov 28)

Monitoring of neuromuscular blockade at the P6 acupuncture point reduces the incidence of postoperative nausea and vomiting.Arnberger M, Stadelmann K, Alischer P, Ponert R, Melber A, Greif R., Department of Anesthesiology, Inselspital, University Hospital Bern, Switzerland. (Anesthesiology. 2007 Dec;107(6):903-8)

Laser acupuncture in children with headache: A double-blind, randomized, bicenter, placebo-controlled trial.Gottschling S, Meyer S, Gribova I, Distler L, Berrang J, Gortner L, Graf N, Shamdeen MG., University Children’s Hospital, Department of Pediatric Hematology and Oncology, Saarland University. (Pain. 2007 Nov 15) —Preceding unsigned comment added by 216.16.236.150 (talk) 19:43, 4 December 2007 (UTC)

Stretch EZ
Another product recommended for treating plantar fasciitis is the Stretch EZ. It was developed for athletes to help stretch their legs, hips, and lower back. Also, it has been proven to increase flexibility and prevent injury. It is endorsed by Physical Therapists that have used Stretch EZ to treat sports related injuries and conditions such as plantar fasciitis with positive results. There are many product reviews such as the one on :http://www.killerlifestyle.com/wp02/2007/10/29/product-review-stretch-ez/ (MarkH45 (talk) 00:46, 31 May 2008 (UTC))

Explanation of Changes
I made several changes. Potentially controversial changes I'll justify here.

1) removed link to a web site selling products with only one minor sentence being used as justification for the link.

2) removed newspaper link that was redundant

3) changed the ESWT link to a more professional and faster website that isn't loaded with ads.

4) deleted odd comment not justified in the new ESWT link ("brain no longer receives signals")

5) removed link to the picture because the data for the statistics in it comes from a non-peer-reviewed web site selling products

6) removed newspaper link that referenced a small study on glucosamine. The bottom of the heel isn't a joint, so i don't know why someone was looking into that.  Also, the reference didn't mention glucosamine. I imagine a mess if every small study with an odd claim was listed.

7) provided reference for the needle fasciotomy and shortened the comments since the prior sentence says surgery is a last resort and therefore the needle fasciotomy should not be given more space than "first resort" treatments.

8) moved "lessen pressure under the balls of the feet" to an appropriate area to fix bad text flow. Also improved explanation.

9) removed reference to acupuncture. If acupuncture is listed, more alternative treatments should be listed like: prolotherapy, cryosurgery, glucosamine, rolfing, epsom salts, iontopheresis with acetic acid, magnets, and light therapy, none of which have any significant study and do not deserve more than a sentence for each. —Preceding unsigned comment added by 24.214.120.227 (talk • contribs) 22:20, 8 March 2008


 * Personally I liked the image. OK site supports itself commercially, but it is a detailed site and general seems sensibly written (with caveats to particular views). OK a self-reported survey, but primary focus on calcaneum attachment and less extend further along the sole matches my clinical impression (but I certainly in mind have no fixed % values for the distribution). I've restored the image, shortening the caption, but added as footnote that a self-reported survey. Whilst I've provided the link to the web site, you'll note I left it as an inline link rather than give specific promotional value to the site's name - is this acceptable ? David Ruben Talk 23:26, 8 March 2008 (UTC)

Other names
Someone has removed the line that says it used to be called Policemans heel in the UK (which is true) and it now says that it used to be called Dog's heel... I found only 2 other references to dog's heel through google, but a lot for policeman's heel (which is what my doctor even calls it). Think it would be ok to turn it back? 79.68.78.142 (talk) 23:15, 12 July 2008 (UTC)
 * I say "go for it". Sfahey (talk) 04:50, 14 July 2008 (UTC)

One of my doctors has also called it Policeman's Foot —Preceding unsigned comment added by 82.7.42.183 (talk) 19:10, 30 July 2008 (UTC)

What is the plantar fascia?
Oh, by going to another article, I see that the plantar fascia is the thick connective tissue which supports the arch of the foot. Do we think the opening paragraph needs to be in more layman's terms? --Knulclunk (talk) 02:16, 18 August 2008 (UTC)
 * Agree/done. Those goofy nicknames didn't belong in the 1st sentence anyway. Sfahey (talk) 13:30, 18 August 2008 (UTC)

Recent edit by User:Dr.Joshie
The recent edit to this article by User:Dr.Joshie replaced most of the material in the article, much of which was sourced, with a mass of material which sounds at least reasonable, but none of which is sourced. (I'm not qualified to judge the quality of either version of the article beyond being able to see that the previous version had quite a few references.) It would be helpful for someone else to assess the recent edit and decide whether it should remain.

To Dr.Joshie: If the material is to remain, it needs to be sourced. --Tkynerd (talk) 03:32, 19 September 2008 (UTC)

I know, I know.....
This is not a forum, but I have been wearing New Balance sneakers (any type, they pretty much all have a stiff heel cup), and the Doc Martens' Saxon model. I feel better than I have in quite a while. —Preceding unsigned comment added by 72.226.77.1 (talk) 04:11, 25 September 2008 (UTC)

Differential diagnoses - what type of pain is it?
It's mentioned that there is pain but if someone can add what type of pain- e.g. burning, an ache, etc that would be useful for laypeople like me who hobble across this page in trying to find out what is wrong with their hooves. —Preceding unsigned comment added by 92.29.55.18 (talk) 14:34, 14 August 2009 (UTC)

For me, when I try to step on the affected foot, it feels like there's a a blunt piece of glass embedded in my foot. If I brush the sore point very ligthly with my finger, it burns. At night it throbs agonisingly, so much so that I wake up gritting my teeth. Also, for me it doesn't just occur on the heel - over the years I've had it occur in places all over the soles of either foot. Usually it goes away by itself, after a few days. —Preceding unsigned comment added by 212.182.184.113 (talk) 19:09, 11 October 2009 (UTC)

Statement needs update
The following statement needs to be updated or have a qualifier added: Evidence is lacking to strongly support any type of treatment for plantar fasciitis.[5] See Journal of Bone and Joint Surgery, online: http://www.ejbjs.org/cgi/content/full/90/4/928#SEC10 The news of the effective stretching method is also presented in a short online CBS video segment at: http://www.cbsnews.com/stories/2007/04/19/earlyshow/health/main2703942.shtml

I also agree that showing the actual plantar fascia ligament would be helfpul to readers. It's okay to use my own image of the foot with plantar fascia (and Achilles tendon) shown, which is at http://plantarfasciitis-treatment.com/2009/08/18/stop-inflammation-and-trauma-in-plantar-fasciitis/

Sorry, I don't understand how to insert information properly here, or how to sign.(Ellen Graves) 03:29, 24 August 2009 (UTC)Jkg718 (talk)

too much jargon -- DISAGREE
As of Oct 2009, this page has been flagged for having too much jargon. I totally disagree. I read the article carefully looking for instances of excessive jargon. What is here belongs here. This is a medical article and using anatomical terms to describe anatomy is required. Using drug names to describe drugs is required. Everything else is pretty much straight forward. Perhaps some auto-bot does the flagging, but it's wrong, and this should be taken down. —Preceding unsigned comment added by Lapabc (talk • contribs) 16:57, 8 October 2009 (UTC)

>>I forgot to add, does anyone know who to contact to remove / take down the flagging? —Preceding unsigned comment added by Lapabc (talk • contribs) 17:00, 8 October 2009 (UTC)
 * Hello, any user can add or remove a jargon tag and you should feel free to remove tags you disagree with. The worst that can happen is that someone will put them back. I added this particular tag in August. The article has been cleaned up significantly since then so I would not object to its removal. To remove the tag, delete the text reading "Cleanup-jargon" at the top of the article. Gruntler (talk) 18:46, 8 October 2009 (UTC)


 * I removed it. Glad to have this one resolved!  —Preceding unsigned comment added by 24.152.174.76 (talk) 04:26, 10 October 2009 (UTC)

Percentages in image add up to more than 100%
The percentages in the image of the areas of pain add up to more than 100%. I don't understand what that means. Could someone explain it to me? —Preceding unsigned comment added by 67.98.222.16 (talk) 00:46, 24 September 2010 (UTC)


 * I interpret it to mean that some people have symptoms in more than one area at the same time. And since there are eight areas on the chart, any given case of PF could be counted up to eight times, creating an upper limit of 800%. Langrel (talk) 04:58, 1 October 2010 (UTC)

Extracorporeal shockwave therapy
ESWT now has an extensive track record in the treatment of so-called "intractable plantar fasciitis." The term "plantar fasciosis" is better description of a degenerative process of the fascia which is resistant to treatment with anti-inflammatory medications. The ESWT industry originated in Germany and it's website, http://www.ismst.com/ obtains an extensive listing of research in this area. ESWT is in a somewhat unique category of medicine as it is non-pharmaceutical and non-surgical. It is a "disruptive" technology that can lessen the need for surgical treatment. ESWT has been met with resistance in the surgical community and has had an uphill struggle in the realm of medical politics. Unfortunately, the Wikipedia site on "plantar fasciitis" reflects the political landscape in that information about ESWT has been repeatedly edited out. I am very dissapointed at this type of censorship. — Preceding unsigned comment added by 70.132.206.22 (talk) 17:36, 11 February 2012 (UTC)
 * Hi. Thank you for bringing this up. It looks important. You're not being censored. We're constrained in what we can add to medical articles by this policy: Identifying reliable sources (medicine). Essentially, medical claims need to be supported by authoritative systematic reviews or similar secondary sources. I went to the site and under Literature found a long list of papers on medical shockwave therapy. Rather than spend 20 minutes scanning those, I searched PubMed for reviews using "shockwave treatment plantar fasciitis" and turned up 5.
 * It's late here, so I'll start looking at them tomorrow. This may take a day or two. Would you consider creating an account for yourself? That way I'll be able to recognise you if we need to talk again.
 * It's late here, so I'll start looking at them tomorrow. This may take a day or two. Would you consider creating an account for yourself? That way I'll be able to recognise you if we need to talk again.
 * It's late here, so I'll start looking at them tomorrow. This may take a day or two. Would you consider creating an account for yourself? That way I'll be able to recognise you if we need to talk again.
 * It's late here, so I'll start looking at them tomorrow. This may take a day or two. Would you consider creating an account for yourself? That way I'll be able to recognise you if we need to talk again.
 * It's late here, so I'll start looking at them tomorrow. This may take a day or two. Would you consider creating an account for yourself? That way I'll be able to recognise you if we need to talk again.
 * It's late here, so I'll start looking at them tomorrow. This may take a day or two. Would you consider creating an account for yourself? That way I'll be able to recognise you if we need to talk again.


 * I notice you are continuing to insert your text. Please don't. Please be patient. I will attend to this but, until one specific reliable source has been cited (rather than that list of several hundred on the web site), we can't include those claims. --Anthonyhcole (talk) 18:26, 11 February 2012 (UTC)
 * ??? All of the references cited in the ISMST website are papers published in reputable journals. There are items in the article on plantar fasciitis such needling of the plantar fascia which is supported by one reference and is a far more obscure treatment than ESWT.  The paragraph on ESWT in the article shows bias against ESWT.  Why not simply look at the prior discussions on the subject that had some reasonable balance that were present early in 2011?  There is discussion of having issues with reversions but how about those that seem determined not to have a discussion about ESWT in the article? ESWT had been deleted for a number of months. EWST should not require a different burden of proof than any of the other treatments listed in the article, deserves to be mentioned in a balanced fashion. — Preceding unsigned comment added by 173.173.99.116 (talk • contribs) 23:27, 11 February 2012‎

Please remember 3RR. Xavexgoem (talk) 20:41, 11 February 2012 (UTC)
 * I added some studies, with the highest quality reviews I could find (either to high impact journals or reviews that did a good job with evidence assessment, or to medical society recommendations). I did not review the reviews cited above by Anthonyhcole, though some may be a bit old (multiple RCTs came out in the 2002-2003 years). Yobol (talk) 21:32, 11 February 2012 (UTC)

The ISMST is the largest organization in the ESWT industry. Its' members include respected scientists and clinicians. Its' website, http://www.ismst.com/ provides one of the largest lists of literature on ESWT. ESWT is somewhat outside the mainstream of allopathic medical practice in the US so it is not reasonable to expect numerous articles and endorsements in the "big name" medical journals. Plantar fasciitis is often treated by podiatrists so domestic literature may be found in the Journal of the American Podiatric Medical Association or the Journal of the American College of Foot and Ankle Surgeons: http://www.jfas.org/search/quick   The current paragraph in the Wkipedia article on plantar fasciitis cites the long discredited Buchbinder study in which faulty patient selection occurred and the patients in the study were provided a subtherapeutic dose of ESWT. The technique for application of ESWT is well established by the industry and physicians who utilize the modality. Buchbinder did not follow conventional technique. It would be like giving with a headache, one half of a Tylenol, not seeing results, then concluding that Tylenol has no effect on headaches. I have listed references in the conventional format in Wikipedia articles in prior years but I do not understand how references are to be listed as the instructions appear cryptic using some code which generates the listed reference. That is another reason I need refer to the ISMST website. A more complete explanation of how to use the system is lacking. — Preceding unsigned comment added by 173.173.99.116 (talk) 23:05, 11 February 2012 (UTC)


 * The sources we use for our articles is determined by the guideline on reliable sources for medical claims. If you have some you would like to add that meet that guideline, please suggest it, but Wikipedia presents the mainstream as mainstream and fringe as fringe.  We do not give additional WP:WEIGHT to views beyond what is mainstream as that would go against our policy on having a neutral point of view.  BTW, the Buchbinder article that is cited is a review, not a primary research article, so I'm not sure what you are referring to. Yobol (talk) 23:11, 11 February 2012 (UTC)

Yobol. You are now resorting to name calling and insults. Your statement that "mainstream is mainstream" and "fringe is fringe" is outrageous. Do you consider alternative medicine to be "fringe?" Many therapies possibly labelled as "alternative" in the US are mainstream in other advanced nations. Germany publishes the Commission E monographs which document the efficacy of herbal and natural therapies. ESWT is mainstream in many nations and is not even labeled as alternative medicine in the US. — Preceding unsigned comment added by 173.173.99.116 (talk • contribs) 23:27, 11 February 2012‎
 * Actually, yes, most alt med is WP:FRINGE by definition, but this is a digression. I am not here to label ESWT, but to neutrally describe it based on the best sources available.  If you have other sources that meet our guidelines for reliable sourcing for medical claims, please bring them forward.  ESWT, as far as I can tell from the best sources, has at best a mixed record for efficacy, which is what our current article says.  To say otherwise, you will need to find other high quality secondary sources that say differently. Yobol (talk) 23:42, 11 February 2012 (UTC)
 * The ISMST website contains scores of "high quality secondary sources." It is a compendium of references.  You obviously have an agenda if you refused to acknowledge the references on that site. You see no need to critique the reference to needling of the fascia, a technique with less than 5% of the level of proof and literature of ESWT.  Your utilization of the term "fringe" is by your own definition. You are biased, have an unstated agenda and have little business editing this article, let alone being on Wikipedia.  — Preceding unsigned comment added by 173.173.99.116 (talk) 00:57, 12 February 2012 (UTC)
 * Just "edit warring" information into an article doesn't work. It annoys and wastes the time of editors you need to collaborate with.
 * Editing is a collaboration.
 * You'll need to master WP:MEDRS. Claims of efficacy won't get into a medical article unless they're supported by the kind of source outlined in that guideline. One good source is enough for most medical claims.
 * Just saying "X is so," and pointing readers to a hundred or more references on a web site won't work. You'll need to find a source that conforms to WP:MEDRS that supports "X is so."
 * So read that guideline.
 * Some other points: sign your comments by following them with ~ (When you don't do that other editors have to search the history and sign for you, which takes a minute or so and annoys them.) Get a user name so we know when we're talking to you and will know what we've already discussed.
 * Yobol has included text that reflects the sources he/she has cited. If you wish to challenge that text, you must do that with a WP:MEDRS-compliant source that supports your objections. That's how it works here. --Anthonyhcole (talk) 08:53, 12 February 2012 (UTC)
 * This is an example of intellectual dishonesty. Any statement or comment in an article can be taken out of context and referenced presumably meeting your interpretation of WP:MEDRS. Consider what the authors, Rompe, et. al. were really stating in the referenced article in question, "Conclusions With current studies heterogenous in terms of the duration of the disorder; type, frequency and total dose of shock wave therapy (SWT); period of time between SWT; type of management and control group; timing of follow-up and outcomes assessed, a pooled meta-analysis of SWT for chronic plantar fasciopathy was considered inappropriate. Neverhteless, there was a preponderance of well-designed studies showing favourable results. It appears that one should only consider SWT for plantar fasciopathy after more common, accepted and proven non-invasive treatments have failed."  So Rompe acknowledges the fact that a number of early studies were not well designed which generated controversial results but that there are a sufficient number of well designed studies which support the efficacy of ESWT for recalcitrant plantar fasciitis. Most clinicians such as myself now realize that ESWT has its primary effect for patients who specifically have plantar fasciosis which is discussed here.173.173.99.116 (talk) 15:06, 12 February 2012 (UTC)  — Preceding unsigned comment added by 173.173.99.116 (talk) 15:01, 12 February 2012 (UTC)
 * Which is why our article says, "One review found that the preponderance of evidence supports the use of ESWT, but only after several months of treatment with more accepted and proven therapies have failed, as a possible alternative to surgical intervention." I fail to see the problem here. Yobol (talk) 18:36, 12 February 2012 (UTC)
 * I didn't realize this was the subject of discussion until now, but I added a citation from 2002, a metaanalysis. Results were favorable for SWT, and the authors suggested it be used as a treatment for cases refractory to other treatments.  If anybody objects to this addition, let me know. Rytyho usa (talk) 10:01, 9 December 2012 (UTC)

Metatarsalgia, a.k.a. capsulitis
There's a related diagnosis / condition that ought to be mentioned in this article, as it is NOT PF. There's another kind of foot pain, more like dull "sore feet," often in the balls of the feet, that is unconnected to the heel and with PF. It's metatarsalgia or capsulitis. I raise this because in most cases, "sore feet" is immediately assumed in health or athletic forums to be PF. I've had PF myself and can tell the difference -- no sharp pain in this case, not associated with the heel, etc. Please add a section that links to this other condition, and flesh out the article on metatarsalgia. Much obliged! A.k.a. (talk) 17:07, 4 February 2010 (UTC)

Metatarsalgia is completely unrelated to plantar fasciitis so its discussion in this article does not make sense. — Preceding unsigned comment added by 166.147.72.20 (talk) 04:22, 3 December 2013 (UTC)

Invitation to edit
It is proposed that Plantar fasciitis be part of the trial of a new template; see the green strip at the top of Pain where it has been in place for a couple of months. The purpose of this project is to encourage readers to edit, while equipping them with the basic tools. If you perceive a problem with this, or have any suggestions for improvement, please discuss at the project talk page --Anthonyhcole (talk) 09:47, 10 January 2011 (UTC).


 * Invitation to edit? Really?  I am a medical professional and would love to edit this weak article.  I tried to do so about a year ago, only to be frustrated by the self appointed guardians of site rectitude here who feel the need to prevent changes, not to mention the arcane structural changes in the means to provide references for statements.  Take a look at the MIT Technology Review article about this issue in the recent November/December issue which discussed the shrinking authorship here in Wikipedia.  Better look fast though as my comments will not be here very long!  — Preceding unsigned comment added by 166.147.72.20 (talk) 04:34, 3 December 2013 (UTC)
 * Actually, your comments on a talk page (other than outright vandalism, personal attacks or violations of our WP:BLP policy) aren't going anywhere.
 * As to what you encountered "about a year ago", I can only really speculate. Because you are editing under an IP address with no edits to this article, you must have been using a different IP address (or a registered account) at that time. I have no way to see what happened without a lot of guesses. If you can take a look at the article's history and tell us when this was, we cab certainly look at it. - Sum mer PhD  (talk) 14:32, 3 December 2013 (UTC)

Shoe Type Contradiction
In the therapies section, it says minimalist/no shoes and motion control shoes may be employed to fix the problem. This is a contradiction as these are the two extremes of types of a running shoe.

Since there is conflicting evidence for both arguments and the issue is laregly personal, I propose that the section be amended to "PF may be fixed by... a change in footwear" —Preceding unsigned comment added by 130.15.38.200 (talk) 19:50, 25 May 2010 (UTC)


 * This is the problem when there needs to be broad consensus among authors and changes are being approved "by committee."  The bottom line is that traditional shoe design has emphasized the importance of the shank for hundreds of years. The shank of the shoe protects the arch and prevents torsional strain on the plantar fascia. Minimalist shoes are a recent fad, have no shanks and are largely a marketing gimmick.  — Preceding unsigned comment added by 166.147.72.20 (talk) 04:26, 3 December 2013 (UTC)
 * Material in the article needs to reflect what reliable sources have to say about the subject. As this is a collaborative project, yes, consensus will determine the content in the long run. This is not a site for individuals to present their opinions of what is correct. There are sites for that kind of thing, ranging from medical journals to blogs. Wikipedia is not part of that continuum. - Sum mer PhD  (talk) 14:40, 3 December 2013 (UTC)

Who is the arbiter of which sources are deemed reliable or not? — Preceding unsigned comment added by 166.147.72.29 (talk) 02:59, 27 December 2013 (UTC)
 * Guidelines for this can be found at WP:MEDRS. In case of a dispute as to whether or not a source is reliable, discuss the issue on the article's talk page. If no consensus is found, discuss the source at the Reliable sources/Noticeboard. - Sum mer PhD  (talk) 03:20, 27 December 2013 (UTC)

Hi folks, please remember to sign your comments by clicking the button with the pencil or by typing four ~ marks in a row. I think the shoe debate is very important to this issue because it reflects two very different treatment approaches, both which have enough success to be worth further investigation. It is appropriate for articles to reflect controversy in treatment approaches. Ideally sources can be produced to support each of these. The minimalist approach is new enough that while there are some good studies for using it to treat various conditions, I'm not certain if there are any for the treatment of PF yet. The primier holistic podiatrist advocating minimal shoes for the treatment of various conditions is Dr. Ray McClanahan of Northwest Foot and Ankle, Portland, Oregon. --Karinpower (talk) 22:14, 12 May 2014 (UTC)

Pre-GA comments
I'm not going to do the full review but here are some quick comments: Wiki CRUK John (talk) 10:30, 20 May 2014 (UTC)
 * The lead in particular is much too dense with unexplained medical terminology, as so often. This will just put off the average reader.
 * I'm getting dubious about what seems to be a common practice of just having DMOZ in External links. It seems a semi-moribund, and typically US-centric, resource to me. In this case 2 of the 6 links on the DMOZ page (# 2 & 3 I think) perpetuate what other links say is the "misnomer" that "heel spur" (which WP redirects to Calcaneal spur) is the same as Plantar fasciitis. One thing all the 6 sites do is mention both terms, those making the distinction all pointing out the "misnomer", not mentioned by WP as such, though heel spurs are covered in para 2 of diagnosis. I must say I'd never heard the term in the UK, but it seems to be common in the US. Probably the lead should have a sentence explaining.
 * It's a pity there's no image of the foot labelling some of the medical terms for the parts that the article uses.
 * maybe more later
 * Thanks for pointing out the external link. I hadn't even noticed that and I agree that it was not a good choice of link. It's replaced. Regarding the lead, it's more helpful if you tell me with specific examples how the lead is too dense (because it doesn't appear too dense to me). I know it's a pity that there's no image consistent with what you described, but that's beyond the scope of what I can do. You're saying there should be a sentence in the lead explaining heel spurs? That part doesn't make sense to me since that's linked in the body of the article and has a main page. The article is about plantar fasciitis, not heel spurs. The only reason heel spurs are mentioned at all in the article is because they're sometimes seen on imaging even though they don't actually relate to the symptoms. TylerDurden8823 (talk) 13:48, 20 May 2014 (UTC)
 * Ok if you can't see that "Plantar fasciitis (also known as plantar fasciopathy or jogger's heel) is a common painful disorder of the muscular or tendinous site of insertion at the bone affecting the heel and plantar surface of the foot. The disorder is characterized by fibrosis, inflammation, or structural deterioration of the foot's plantar fascia." is not the best way to start an article in a general encyclopedia on a common complaint that apparently affects 10% of the population at some point in their lives, then I'm not sure where to start. Don't you have some non-medical friends or relations you could try that opening on, and see what they think? Try looking at the links at DMOZ for simple language, even if combined with incorrect terminology. Obviously we need to combine accessibility, accuracy and precision, which is not simple.


 * As I said above "heel spur" was a new term for me, but the fact that all 6 of DMOZ's chosen links either: a) said heel spur = Plantar fasciitis or b) said that it was a common misconception that heel spur = Plantar fasciitis, strongly suggests to me that an encyclopedic treatment ought to dispose of this matter by mentioning the common misconception (for which the Am Family Doctor DMOZ article is a good ref), which this article doesn't yet do.  This should probably be in the lead, or higher up than the present mention, on the 4th screen down with my machine. Wiki CRUK John (talk) 14:15, 20 May 2014 (UTC)

Additional comments: All-in-all I think it would pass after adding some more citations and fixing a couple areas for tone. Good work ITasteLikePaint (talk) 14:03, 20 May 2014 (UTC)
 * The lead contains a review of relevant anatomy that seems redundant with the wikilinks and doesn't seem to appear in other GA class articles about medical conditions.
 * I've added several tags for sources and tone
 * In the risk factors section, can odds ratios be reported?
 * The paragraph on Extracorporeal shockwave therapy in the treatment section... I've never heard of Extracorporeal shockwave therapy. Is it a commonly used medical treatment?


 * I'll address each point separately. I will see if I can find odds ratios, but that depends on the literature. As for extracorporeal shockwave therapy, yes, it is well-accepted as an effective medical treatment for PF and has undergone a good amount of research. It's commonly used for more refractory cases (e.g., if conservative treatments such as NSAIDs, etc. fail). Just to clarify, plantar fasciitis is not the same thing as a heel spur. They may coexist, but they are separate entities. Regarding the anatomy, I put that there because many people may not know what the plantar fascia is, but I suppose that receives decent enough coverage at Plantar fascia. So, perhaps that should be removed...I'll give that some thought and see if others agree. The literature does not discuss heel spurs and plantar fasciitis being commonly conflated, it simply says that heel spurs are often discovered on imaging when evaluating plantar fasciitis pain, but that the pain itself does not stem from the heel spur. As for the lead being dense, I think it's just a difference in opinion on our parts. I think it's actually pretty simplified as it stands though I worked on it a bit this morning to simplify enthesopathy to what it says now. You need to be more specific if you're going to just say the whole paragraph is more dense. Provide a suggestion here and there on how to simplify it. I don't have friends/family who work on Wikipedia or look at my work on Wikipedia. Frankly, that's what the Wikipedia community is for, to collaborate at the community level.
 * By dense I mean the vocabulary is too technical and not explained. I didn't mean "friends/family who work on Wikipedia" (why would I?) but ordinary people who might want to look at the article - readers, consumers. See if you can find anyone without medical training who finds it clear, and see WP:MEDMOS on the appropriate style. One, I think two, of the pub-med references that were in the article's only external link when you asked for it to be looked at do mention the misnomer, so don't tell me the literature doesn't. Wiki CRUK John (talk) 09:36, 21 May 2014 (UTC)
 * I take it you're referring to this link off of DMOZ: http://www.aafp.org/afp/1999/0415/p2200.html If so, it's from 1999 and this one (I'm guessing this is the other reference you were referring to) http://www.aafp.org/afp/2001/0201/p467.html is from 2001. None of the newer reviews I read discuss plantar fasciitis being labeled with the misnomer "heel spur syndrome". I have no control over normal people reading the lead. As I said earlier, I will attempt to bring it up at WP:MED and see if I can get other people to look at it and see if they think the lead is adequately comprehensible or if it is too "dense". As I mentioned before, saying it's dense doesn't tell me much. It's more helpful if you're specific and show examples of how that is true and offer examples of how to simplify it. TylerDurden8823 (talk) 13:20, 21 May 2014 (UTC)
 * "I have no control over normal people reading the lead" - you make it sound like a problem! Wikipedia is not a medical textbook and should not be written like one. See MEDMOS again. Wiki CRUK John (talk) 14:07, 21 May 2014 (UTC)
 * I agree with here. The lead should be written in laymen's terms. The technical medical jargon can be used later in the article. The lead should give the average reader a brief and digestible—not technical—overview of the subject. — Fr&epsilon;ckl&epsilon;fσσt | Talk 14:50, 21 May 2014 (UTC)
 * I'm not suggesting lay people reading the lead is a problem. Seriously, let's focus on the content and not on the editor. What I was suggesting (which was clearly misinterpreted) is I can't recruit lay people to say to them "hey, is this lead too complicated? If so, how is that true? Where did you get confused?" That's what I need to know in order to fix it. I'm not disagreeing that the lead should be written in laymen's terms Frecklefoot, but I have yet to see a single concrete suggestion of how it should be changed aside from removing the anatomy of the plantar fascia (I moved it instead of deleting it for a middle ground approach). Please do not refer me to WP:MEDMOS. I've read it before and I'm aware of it, so let's move past that. As I said before, we disagree about how complex the lead currently reads. I think it's simple enough for laymen, you two disagree and that's fine. So, if you have any specific suggestions about how to simplify the lead's language instead of just telling me it needs to be simplified, please let me know.  TylerDurden8823 (talk) 02:33, 22 May 2014 (UTC)
 * Should be better now. I don't think I can make it much simpler than it stands now. Also found an illustration depicting dorsiflexion/plantar flexion of the foot to give readers a visual. TylerDurden8823 (talk) 08:05, 22 May 2014 (UTC)
 * Better; here is my suggestion:


 * Plantar fasciitis (also known as plantar fasciopathy or jogger's heel) is a common painful disorder affecting the heel and underside of the foot. It is a disorder of the insertion site of muscle or tendon on the bone and is characterized by scarring, inflammation, or structural breakdown of the foot's plantar fascia.


 * How does that strike you? It removes all technical jargon from opening sentence, but still conveys all the information. As a non-medical layman, I find it digestible. — Fr&epsilon;ckl&epsilon;fσσt | Talk 15:55, 22 May 2014 (UTC)
 * Much better I think. The next sentence then pipes the difficult and unfamiliar "overuse injury of the plantar fascia" to the surely very familiar Repetitive strain injury.  Para 2 is now fine. I din't mind the anatomy in para 1 at all, so long as non-technical vocabulary was used or included. Wiki CRUK John (talk) 16:32, 22 May 2014 (UTC)
 * The anatomy move was actually the result of a conversation I had with Jmh. Regarding the proposed change above, I have no objections since it's only a slight rephrasing. TylerDurden8823 (talk) 01:30, 23 May 2014 (UTC)

Comment
Just commenting: it seems a very US oriented description for an article on a global Internet site. 87.115.43.103 (talk) 11:33, 22 July 2013 (UTC)
 * I agree that the current version of the article is US-centric. A significant reason for that is many of the secondary sources (at least the ones I have come across) have not really discussed international statistics. I am hoping that future review articles do just that so such statistics can be included in the article. If anyone does find such a review article, please feel free to link it here and I'll look at it or feel free to add the statistics on your own. TylerDurden8823 (talk) 05:31, 13 June 2014 (UTC)

Sources for claims about Tibialis anterior weakening
I think some discussion about this issue needs to occur here since there is disagreement about the sources being used and whether the claim is valid or not. So far, I have been unable to find peer-reviewed secondary sources to support the claims being made by Abductive. The sources used so far to substantiate the statement have been (as far as I can tell) out of compliance with WP:MEDRS and the existing citations discussing calf-strengthening exercises instead of tibialis anterior strengthening exercises are MEDRS compliant. Bleacher report is not a good source for medical claims and a primary pilot study (http://www.ncbi.nlm.nih.gov/pubmed/20067715) is not really a suitable choice for this claim. Thoughts? TylerDurden8823 (talk) 04:45, 24 June 2014 (UTC)
 * WP:MEDRS is a guideline, not a rule. Also, it says, "ideally". See my section below. Abductive  (reasoning) 17:57, 24 June 2014 (UTC)
 * It's a guideline for a reason. It ensures high quality sources are used for medical claims and this guideline should be followed for medical articles including this one. TylerDurden8823 (talk) 00:56, 25 June 2014 (UTC)

WP:MEDRS does not have to apply to this article
Given that podiatry is its own field, with weaker barriers to entry as a practitioner and weaker journals, articles on conditions of the foot cannot be held to the WP:MEDRS standard. Abductive (reasoning) 17:56, 24 June 2014 (UTC)
 * That being said, here are some sources. Take a look:
 * 
 * 
 * Abductive (reasoning) 23:00, 24 June 2014 (UTC)
 * Abductive wrote, "conditions of the foot cannot be held to the WP:MEDRS standard." So you're saying podiatry is not evidence-based medicine? Sources please. --Ronz (talk) 23:09, 24 June 2014 (UTC)
 * Check the sources I have just provided. They seem to be evidence-based secondary and tertiary sources. Abductive  (reasoning) 23:32, 24 June 2014 (UTC)
 * With all due respect Abductive, I must disagree with your reasoning. Many of the journal articles discussing plantar fasciitis do not come from podiatry journals. Many of the references used in this article come from journals from separate but related fields such as orthopedics, radiology, physical medicine and rehabilitation, and sports medicine. Also, just because a topic is predominately discussed in weaker journals (which does not seem to apply here) does not excuse it from being subjected to the higher standards of WP:MEDRS. Podiatry should absolutely be held to evidence-based medicine standards and an article about plantar fasciitis should have claims rooted in evidence-based medicine as well. TylerDurden8823 (talk) 01:01, 25 June 2014 (UTC)
 * Those are the type of sources I provided above. Read what they say about which muscles to stretch and which to strengthen. Abductive  (reasoning) 01:05, 25 June 2014 (UTC)
 * I have no objection to the sources listed above (I was going through them now). I didn't see anything about tibialis anterior weakness in reference #5 above, but #3 and #4 seemed like suitable references. Does anyone else have objections to these references? Abductive, please note that I am not disputing what you are saying, but the sources you tried to use earlier to support the claim were inadequate. These are better sources and lend credence to your claim. It's important that we follow WP:Verifiability and WP:Verifiability/reliable sources. TylerDurden8823 (talk) 01:11, 25 June 2014 (UTC)
 * Good, good. It seems to me that the sources I give, and others which I can't link to because of the Wikimedia spam blacklist, talk about a number of muscles which support the foot, the arch of the foot, dorsiflexion of the foot and so forth. Even one or two calf muscles promote dorsiflexion. Meanwhile, the muscles that connect to the Achilles tendon need stretching, massage, or even medical intervention to loosen them up. Abductive  (reasoning) 02:26, 25 June 2014 (UTC)
 * I suspect others won't have an issue with the sources you placed earlier in this section, but I cannot speak on their behalf. I didn't see anything immediately objectionable amount them with a cursory read. TylerDurden8823 (talk) 02:58, 25 June 2014 (UTC)
 * So...are you going to put this information in? Or would you rather someone else do it? Just let us know when you have the chance. TylerDurden8823 (talk) 01:14, 27 June 2014 (UTC)

File:PF-PainAreas.jpg
The commons description mentions as a source a webpage: Am I correct that this webpage describes unpublished data? If so, then this beautiful pic would be not based on a reputable source. Mme Mim (talk) 04:59, 28 February 2015 (UTC)

Calcaneal Spurs
The page currently says that the relationship between calcaneal spurs and PF is unknown. PF is known to cause heel spurs. The shortening of the plantar fascia pulls on the periosteum, which causes bone to grow underneath it. Changing to reflect this. Moreover, the article explains this in a later section. — Preceding unsigned comment added by 184.179.22.154 (talk) 18:41, 9 July 2015 (UTC)
 * Both the lead and the body state the relationship is unknown to be causal. Doc James  (talk · contribs · email) 19:25, 9 July 2015 (UTC)

Please add a pronunciation key
Please add a pronunciation key for this and many other medical issues. — Preceding unsigned comment added by Bksubhuti (talk • contribs) 05:53, 15 May 2016 (UTC)

Policeman's Heel misnomer
Plantar fasciitis is NOT Policeman's Heel. That is a different condition completely. Policemen's Heel is plantar calcaneal bursitis, and the management of it is very different. FootmanJ (talk) 11:01, 26 July 2013 (UTC)

Wrong IT IS "Policeman's heel," ask a qualified Chiropodist preferably not based in the US. I suffer from it and believe you me it is painful, my arches collapsed in both feet as a result of injury and I now have to wear orthotics specially built for me. — Preceding unsigned comment added by 90.244.55.57 (talk) 12:15, 3 August 2013 (UTC)
 * Bring sources that meet wp:MEDRS, please. LeadSongDog come howl!  02:29, 16 October 2013 (UTC)

I've recently been to a qualified chiropodist in the UK and he diagnosed plantar calcaneal bursitis and referred to it as policeman's heel - not plantar fasciitis. I was attempting to manage what I thought was plantar fasciitis for over 12 months with zero improvement - policeman's heel is a very separate injury with completely different treatments. Incredibly painful as I'm sure plantar fasciitis is too. — Preceding unsigned comment added by 2.24.37.221 (talk) 20:24, 15 November 2016 (UTC)

"Fevers or night sweats"?
Why is this even included in the lede (and nowhere else)? I didn't see this mentioned in the cite that followed it. Is this intended to distinguish from gout or something? Kortoso (talk) 20:19, 13 January 2017 (UTC)
 * I moved into the article body. It sounds like a distinguishing factor between plantar fasciitis and something else, but I didn't check the refs to figure it out. --Ronz (talk) 20:37, 13 January 2017 (UTC)
 * The presence or absence of B symptoms helps to differentiate from rheumatologic diagnoses (e.g., seronegative spondyloarthropathies). Was previously mentioned in the body but appears to have been removed at some point. TylerDurden8823 (talk) 04:00, 14 January 2017 (UTC)
 * It is a pertinent negative. Yes it separates it from rheumatology and infectious causes. Doc James  (talk · contribs · email) 15:39, 14 January 2017 (UTC)