{"id":8266,"date":"2017-09-04T08:53:31","date_gmt":"2017-09-04T08:53:31","guid":{"rendered":"http:\/\/old.institutcataladelpeu.com\/?p=8266\/"},"modified":"2017-09-04T08:53:31","modified_gmt":"2017-09-04T08:53:31","slug":"fascitis-plantar-simptomes-i-tractament","status":"publish","type":"post","link":"https:\/\/old.institutcataladelpeu.com\/ca\/fascitis-plantar-simptomes-i-tractament\/","title":{"rendered":"Fascitis plantar: s\u00edmptomes i tractament."},"content":{"rendered":"

La fascitis plantar \u00e9s una inflamaci\u00f3 d’una membrana o banda de teixit connectiu anomenada f\u00e0scia, que es localitza a la planta del peu i que abasta des del calcani fins a les falanges proximals.<\/p>\n

La f\u00e0scia est\u00e0 formada per c\u00e8l\u00b7lules productores d’elements estructurals del teixit conjuntiu, una subst\u00e0ncia l\u00edquida fonamental que dona forma a les estructures i fibres de teixit conjuntiu tals com el col\u00b7lagen, les fibres reticulars o el\u00e0stiques.<\/p>\n

Les funcions de la f\u00e0scia s\u00f3n:<\/p>\n

1) Donar forma als teixits mitjan\u00e7ant sustentaci\u00f3, suspensi\u00f3 i estabilitat.<\/p>\n

2) Transmissora de forces. A nivell muscular, cada fibra genera moviment exercint tensi\u00f3 sobre aquestes fibres musculars.<\/p>\n

3) Afavoreix el moviment per la seva capacitat de deformaci\u00f3 i estirament.<\/p>\n

4) Ajuda a reparar teixits fibrosats.<\/p>\n

5) \u00c9s important en la comunicaci\u00f3 de les diferents estructures \u00f2ssies i musculars.<\/p>\n

El s\u00edmptoma m\u00e9s caracter\u00edstic d’aquesta lesi\u00f3 \u00e9s la pres\u00e8ncia de cremor o dolor agut en la inserci\u00f3 de la f\u00e0scia (zona interna del tal\u00f3) sobretot en llevar-se al mat\u00ed, despr\u00e9s d’una llarga estona assegut o en pujar escales. En comen\u00e7ar a caminar se sol reduir l’\u00edndex de dolor.<\/p>\n

En els esportistes, el dolor apareix despr\u00e9s de l’activitat f\u00edsica, i en cas de no tractar la f\u00e0scia en estadis incipients, pot arribar a limitar la vida esportiva. De fet, si el dolor persisteix, augmenta d\u2019intensitat cada vegada m\u00e9s, arriba a abastar tot el recorregut de l’arc plantar i triga m\u00e9s a desapar\u00e8ixer.<\/p>\n

Les causes que afavoreixen l’aparici\u00f3 d’una fascitis plantar s\u00f3n:<\/p>\n

a) La morfologia del peu (peus plans, peus buits, valgs, etc).<\/p>\n

b) Una deambulaci\u00f3 patol\u00f2gica o una trepitjada incorrecta.<\/p>\n

c) L’escur\u00e7ament de la musculatura posterior de la cama.<\/p>\n

d) Cal\u00e7ats inadequats (talons alts, cal\u00e7ats no estabilitzadors del rerepeu, etc).<\/p>\n

i) Sobrep\u00e8s.<\/p>\n

f) Canvis bruscs d’activitats di\u00e0ries.<\/p>\n

S’ha de diferenciar entre l\u2019esper\u00f3 calcani i la fascitis plantar. L\u2019esper\u00f3 calcani \u00e9s una calcificaci\u00f3 de la inserci\u00f3 en el tal\u00f3, mentre que la fascitis \u00e9s causada per una inflamaci\u00f3 sense necessitat d’acompanyar-se d’un esper\u00f3 de calcani.<\/p>\n

A l’inrev\u00e9s, tamb\u00e9 es troben de forma aleat\u00f2ria esperons de calcani en imatges radiol\u00f2giques i no sempre el pacient ha sofert amb anterioritat cap tipus de dolor.<\/p>\n

El diagn\u00f2stic es basa en l’examen f\u00edsic, l’estudi de la trepitjada i una valoraci\u00f3 radiol\u00f2gica si escau.<\/p>\n

El tractament de la fascitis plantar en les primeres fases consisteix en f\u00e0rmacs antiinflamatoris i analg\u00e8sics, aix\u00ed com exercicis d’estiraments del tend\u00f3 d’Aquil\u00b7les, bessons i de la f\u00e0scia.<\/p>\n

L’estirament de la f\u00e0scia influeix en el joc de les articulacions, aix\u00ed com en els diferents plans de moviment.<\/p>\n

Les adher\u00e8ncies de les capes que formen la f\u00e0scia provocaran dolor i disminuci\u00f3 de la mobilitat. Aquestes s\u00f3n t\u00edpiques per traumatismes, lesions o iatrog\u00e8nies postquir\u00fargiques o b\u00e9 per sobrec\u00e0rregues i hiperactivitat.<\/p>\n

Per obtenir el major estirament possible, \u00e9s ideal estirar en diferents plans, ja que la f\u00e0scia travessa diferents plans. Cal pensar que la f\u00e0scia cont\u00e9 gran quantitat de col\u00b7lagen i aigua, cosa que provoca una capacitat viscoel\u00e0stica m\u00e9s s\u00f2lida o m\u00e9s l\u00edquida en determinats moments.<\/p>\n

Aix\u00f2 variar\u00e0 en funci\u00f3 de la temperatura. Per exemple, en llevar-nos al mat\u00ed, la f\u00e0scia es comporta com un s\u00f2lid perqu\u00e8 la nostra temperatura \u00e9s m\u00e9s baixa. Despr\u00e9s de preescalfar o passejar una estona, la temperatura corporal augmenta amb la qual cosa la f\u00e0scia es transforma m\u00e9s en un l\u00edquid i \u00e9s m\u00e9s el\u00e0stica.<\/p>\n

Els estiraments b\u00e0sics s\u00f3n els seg\u00fcents:<\/p>\n

1) Estirament amb una tovallola:<\/p>\n

Ens col\u00b7loquem asseguts a terra, amb el tronc al\u00e7at, les cames estirades i els peus rectes. Es col\u00b7loca la tovallola a nivell del coixinet plantar (metatars) i el pacient tiba de tots dos extrems de la tovallola cap a si mateix. S’ha de mantenir la tracci\u00f3 entre 15 i 30 segons. S\u2019ha de realitzar aquest exercici deu vegades.<\/p>\n

2) \u00das d’ampolla o llauna com a corr\u00f3:<\/p>\n

Es fa rodolar l’ampolla o la llauna sota el peu nu cap a endavant i cap a endarrere. Utilitzeu una ampolla o una llauna acabades de treure del congelador per aplicar fred simult\u00e0niament.<\/p>\n

3) C\u00e0rrega sobre una cama:<\/p>\n

Ens recolzem de forma unipodal sobre el peu afecte de fascitis i ajudant-se a mantenir l\u2019equilibri, ens posem de puntetes.<\/p>\n

Una vegada estem de puntetes, descendim el tal\u00f3 lentament fins que torni a tocar a terra. Se sol realitzar unes deu vegades aproximadament.<\/p>\n

4) Estirament del panxell:<\/p>\n

Recolzant les mans en una barra o una paret, col\u00b7loquem la cama a tractar en posici\u00f3 estirada de manera que la superf\u00edcie plantar del peu toqui totalment a terra (no ha de perdre contacte amb el terra durant l’exercici).<\/p>\n

L’altra cama es col\u00b7loca lleugerament flexionada i tot seguit, desplacem el cos cap a endavant per aconseguir una tracci\u00f3 del panxell. Mantinguem la posici\u00f3 de m\u00e0xima tibantor del genoll durant deu segons. Repetim l’exercici deu vegades.<\/p>\n

5) Estirament en gra\u00f3 o taula inclinada:<\/p>\n

Recolzant un dels peus en una taula inclinada, flexionem el genoll de l’extremitat contr\u00e0ria a la que volem estirar. Pressionem el tal\u00f3 cap avall amb l’extremitat a estirar durant un minut. Repetim aquest exercici unes cinc vegades.<\/p>\n

En el cas de no millorar o recidivar freq\u00fcentment, \u00e9s recomanable un estudi de la marxa per part del pod\u00f2leg per tal de valorar l’\u00fas de plantilles personalitzades que disminueixin la pressi\u00f3 a la zona afectada i amortir els impactes.<\/p>\n

L’assessorament d’un tipus de sabatilla esportiva que no vagi acompanyada d’un estudi de la trepitjada per part del pod\u00f2leg, no t\u00e9 una garantia cl\u00ednica d’\u00e8xit.<\/p>\n

En fases m\u00e9s avan\u00e7ades en les quals el dolor augmenta de freq\u00fc\u00e8ncia i d\u2019intensitat, podem rec\u00f3rrer a les infiltracions o b\u00e9 a la cirurgia com a \u00faltima opci\u00f3 en cas de fascitis plantar cr\u00f2nica o greu.<\/p>\n

En definitiva, realitzar escalfaments i estiraments espec\u00edfics per a la planta del peu aix\u00ed com un estudi de la trepitjada, \u00e9s una bona prevenci\u00f3 enfront de la fascitis plantar.<\/p>\n

 <\/p>\n

\"Fascitis

Un peu pronat pot ser causant de fascitis plantar.<\/p><\/div>\n

 <\/p>\n

\"Fascitis

Un peu buit pot ser causant de fascitis plantar.<\/p><\/div>\n

 <\/p>\n

\"Fascitis

Un peu valg pot ser causant de fascitis plantar.<\/p><\/div>\n

 <\/p>\n

\"Fascitis

Un peu pla essencial pot ser causant de fascitis plantar.<\/p><\/div>\n

 <\/p>\n

\"Fascitis

Observeu la inflamaci\u00f3 en la vora interna del tal\u00f3.<\/p><\/div>\n

 <\/p>\n

\"Fascitis

\u00c9s molt important l’estudi de la trepitjada, tant en prevenci\u00f3 com en tractament.<\/p><\/div>\n

 <\/p>\n

\"Fascitis

Ecografia. Severa fascitis plantar amb trencament intrasubst\u00e0ncia de la f\u00e0scia.<\/p><\/div>\n

 <\/p>\n

\"Fascitis

Radiografia. Observeu la pres\u00e8ncia d\u2019esper\u00f3 calcani.<\/p><\/div>\n

 <\/p>\n

\"Fascitis

Estirament mitjan\u00e7ant tovallola.<\/p><\/div>\n

 <\/p>\n

\"Fascitis

Rodament mitjan\u00e7ant una llauna.<\/p><\/div>\n

 <\/p>\n

\"Fascitis

Aplicaci\u00f3 d’embenat neuromuscular per fascitis plantar i esper\u00f3 calcani.<\/p><\/div>\n

 <\/p>\n

\"Fascitis

F\u00e8rula domicili\u00e0ria per estirar f\u00e0scia. Observeu la dorsiflexi\u00f3 dels dits.<\/p><\/div>\n","protected":false},"excerpt":{"rendered":"

La fascitis plantar \u00e9s una inflamaci\u00f3 d’una membrana o banda de teixit connectiu anomenada f\u00e0scia, que es localitza a la planta del peu i que abasta des del calcani fins a les falanges proximals. La f\u00e0scia est\u00e0 formada per c\u00e8l\u00b7lules productores d’elements estructurals del teixit conjuntiu, una subst\u00e0ncia l\u00edquida fonamental que dona forma a les […]<\/p>\n","protected":false},"author":3,"featured_media":8255,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[282,346,306],"tags":[],"class_list":["post-8266","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles","category-icp-ca","category-patologia-ca"],"yoast_head":"\nFascitis plantar: s\u00edmptomes i tractament. - Institut Catal\u00e0 del Peu<\/title>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"ca_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Fascitis plantar: s\u00edmptomes i tractament. - Institut Catal\u00e0 del Peu\" \/>\n<meta property=\"og:description\" content=\"La fascitis plantar \u00e9s una inflamaci\u00f3 d’una membrana o banda de teixit connectiu anomenada f\u00e0scia, que es localitza a la planta del peu i que abasta des del calcani fins a les falanges proximals. 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Posseeix els t\u00edtols de M\u00e0ster i Postgrau en Cirurgia Podol\u00f2gica (UB), Postgrau en Biomec\u00e0nica (UB) i Llicenciatura en Antropologia. 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