Review Question - QID 406

Patients with distal entrapment of the lateral plantar nerve or its branches usually present with chronic heel pain that has been present for 9-12 months. Many of their symptoms are similar to plantar fasciitis, especially the location of their pain and their startup pain. In addition to the mechanical symptoms of plantar fasciitis, they present with neuritic pain that is unrelated to weight bearing or loading of the foot. Baxter and Thigpen described a biomechanical basis for the entrapment of the first branch of the lateral plantar nerve in the athlete. They proposed that entrapment results from the stretching and tethering of the plantar nerves, which are encased in the abductor hallucis deep fascial leashes, and from the hypertrophy of the small foot muscles, as well as from the increased forces in the hindfoot in the running athlete that create additional microtrauma to the runner's medial heel structures. They also noted that most of their patients with sports-related injuries had a normally arched or cavus-type foot.