J Manipulative Physiol Ther. 1994 Jun; 17(5): 329-34.

A comparative radiologic examination for unresponsive plantar fasciitis.

Kell PM.

OBJECTIVE: To report a method of radiographically assessing the presence of the posterior calcaneus subluxation involved in cases of unresponsive plantar fasciitis. Complete resolution of pain occurred following short lever manipulative procedures directed at the calcaneus. CLINICAL FEATURES: Two cases of plantar fasciitis which previously had received comprehensive podiatric treatment were referred for chiropractic assessment. Bilateral radiographs of the lateral feet were compared. The relative position of the calcaneus in relationship to the proximal head of the 5th metatarsal were compared with the less affected or asymptomatic foot. A comparative postview of the plantar fascial foot was then taken at the conclusion of treatment. Kell's line assists the clinician in measuring and comparing the calcaneus/5th metatarsal distances. INTERVENTION: Short lever (chiropractic) manipulative procedures were directed at the posteriorward calcaneus. CONCLUSION: Radiographic assessment for unresponsive plantar fasciitis assists in determining where the site of short lever manipulation be delivered in order to improve calcaneus position and release sagittal stress on the plantar fascia.