The relationship between static and dynamic structures implicated in the heel pain triad
Surabhi Das, Hong Joo Kim, Archana Jain, Winston Loh
Conclusion
The present dissection aims to investigate the role of the plantar aponeurosis as a mover of the medial ankle and tibialis posterior in the development of the Heel Pain Triad, compared to findings of current literature. The plantar aponeurosis, spanning from the calcaneal tuberosity to the metatarsophalangeal joints and fascia of the foot, acts as a secondary restraint and participates in the windlass mechanism. Tibialis posterior, which attaches distally to the navicular, cuneiform, cuboid and metatarsal bases, functions to supinate the subtalar joint and creates a rigid lever for the propulsive phase of gait. Together, the plantar aponeurosis and tibialis posterior provide support for the medial longitudinal arch. Dysfunction of arch maintenance and foot mechanics during gait can contribute to pathology of the posterior tibial nerve and its branches leading to heel pain.