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(max-width:900px){.sr-author-grid{grid-template-columns:1fr;gap:0}.sr-pf-dev__grid{grid-template-columns:1fr}.sr-pf-dev__col+.sr-pf-dev__col{border-left:0;border-top:1px solid var(--rule)}.sr-pf-rels{grid-template-columns:1fr 1fr}.sr-final-cta{grid-template-columns:1fr;gap:24px}.sr-pf-refs{grid-template-columns:1fr}.sr-pf-ref{border-left:0;padding:16px 0;border-top:1px solid rgba(255,255,255,.1)}.sr-pf-ref:first-child{border-top:0;padding-top:16px}.sr-pf-alt{grid-template-columns:1fr;gap:5px;padding:14px 0}.sr-pf-alt__s{text-align:left}}\n@media (max-width:760px){.sr-pf-scale{padding:0}.sr-pf-railwrap{padding:16px 0 0}.sr-pf-2026 .sr-pf-mark{position:static;display:block;width:auto;height:auto;padding:0 0 0 12px}.sr-pf-2026 .sr-pf-mark--thr{margin:0 0 16px}.sr-pf-2026 .sr-pf-mark--meas{margin:16px 0 0}.sr-pf-rail{height:14px}.sr-pf-ticks{margin:16px 0 0}.sr-pf-mark em{max-width:46ch}}\n@media (max-width:640px){.sr-pf-2026{font-size:18px;padding:0 0 60px}.sr-pf-badge__x{display:none}.sr-pf-band{padding:28px 20px 24px}.sr-pf-rels{grid-template-columns:1fr}.sr-pf-txbody{padding:20px 18px 4px}.sr-pf-dev__col{padding:22px 20px}.sr-pf-dev__links{padding:16px 20px}.sr-pf-dev__links a{flex:1 1 auto;text-align:center}#quick-answer{padding:22px 20px 8px}#quick-answer p{font-size:18.5px}.sr-final-cta{padding:28px 20px 26px}.sr-pf-spec li{grid-template-columns:1fr;gap:2px}.sr-pf-rt__seg em{display:none}.sr-pf-play svg{width:62px;height:62px}}\n@media (prefers-reduced-motion:reduce){.sr-pf-2026 *,.sr-light-toc *{animation-duration:.001ms!important;animation-iteration-count:1!important;transition-duration:.001ms!important}}<\/style>\n<div class=\"sr-mast\">\n<p class=\"sr-deck\">One structure, one landmark, one number. The plantar fascia measured where it leaves the medial calcaneal tubercle &mdash; with every moment timestamped, the preset, depth and frequency read off the device screen, and the whole recording transcribed.<\/p>\n<div class=\"sr-author-panel\" data-suresult-author-panel aria-label=\"Article authors\">\n<p class=\"sr-byline__label\">Written and clinically reviewed by<\/p>\n<div class=\"sr-author-grid\">\n<article class=\"sr-author-card\" data-sr-author=\"fernando-mariz-md\">\n<div class=\"sr-author-card__head\"><img src=\"https:\/\/suresultmed.com\/wp-content\/uploads\/fernando-mariz-md-author-avatar.png\" alt=\"Fernando Mariz, MD\" width=\"42\" height=\"42\" loading=\"lazy\" decoding=\"async\"><span class=\"sr-author-card__id\"><b>Fernando Mariz, MD<\/b><span class=\"sr-author-card__role\">Gynecology, pelvic surgery, sonography<\/span><\/span><\/div>\n<details data-sr-author-bio>\n<summary>About Dr. Mariz<\/summary>\n<p>I am Dr. Fernando Mariz, a gynecology and pelvic surgery physician practicing in New York City. Before my medical career, I served in the U.S. Marine Corps, where I developed the discipline, focus, and steadiness that continue to shape the way I care for patients today. At Maiden Lane Medical, my work covers women&rsquo;s health, preventive care, sonography, pelvic pain, abnormal uterine bleeding, and minimally invasive gynecologic procedures.<\/p>\n<p class=\"sr-author-card__links\"><a href=\"https:\/\/maidenlanemedical.com\/profile\/fernando-mariz-md\/\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">Maiden Lane Medical profile<\/a> &middot; <a href=\"https:\/\/weillcornell.org\/fernando-marizmd-9639\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">Weill Cornell Medicine<\/a><\/p>\n<\/details>\n<\/article>\n<article class=\"sr-author-card\" data-sr-author=\"jailyn-avila-md\">\n<div class=\"sr-author-card__head\"><img src=\"https:\/\/suresultmed.com\/wp-content\/uploads\/jailyn-avila-md-author-avatar.png\" alt=\"Jailyn Avila, MD\" width=\"42\" height=\"42\" loading=\"lazy\" decoding=\"async\"><span class=\"sr-author-card__id\"><b>Jailyn Avila, MD<\/b><span class=\"sr-author-card__role\">Emergency medicine, POCUS education<\/span><\/span><\/div>\n<details data-sr-author-bio>\n<summary>About Dr. Avila<\/summary>\n<p>I am Dr. Jailyn Avila, an emergency medicine physician, educator, and digital health innovator based in Southern California. My clinical work is rooted in emergency care, while my teaching focuses on point-of-care ultrasound, residency education, and practical training for physicians. Through my roles with Emergent Medical Associates, UHS SoCal MEC Emergency Medicine Residency, Core Ultrasound, and FemInEM, I work at the intersection of patient care, medical education, and accessible digital learning.<\/p>\n<p class=\"sr-author-card__links\"><a href=\"https:\/\/jailynavila.com\/\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">Personal site<\/a> &middot; <a href=\"https:\/\/feminem.org\/about\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">FemInEM<\/a><\/p>\n<\/details>\n<\/article>\n<\/div>\n<p class=\"sr-author-meta\"><span class=\"sr-verified-badge\">Verified authors<\/span><span>Updated <b>September 10, 2026<\/b><\/span><\/p>\n<\/div>\n<\/div>\n<figure class=\"sr-pf-stage\">\n<button class=\"sr-pf-player\" id=\"sr-pf-player\" type=\"button\" aria-label=\"Play the plantar fascia walkthrough from 0:31\"><br \/>\n<img src=\"https:\/\/suresultmed.com\/wp-content\/uploads\/plantar-fascia-probe-on-medial-heel-poster.jpg\" alt=\"Plantar fascia scan on a Suresult D3Ultra: the probe held against the medial heel with the live long-axis image of the fascia on the tablet, MSK preset at 40 mm depth and 7.5 MHz\" width=\"1600\" height=\"900\" fetchpriority=\"high\" decoding=\"async\"><br \/>\n<span class=\"sr-pf-play\"><svg viewBox=\"0 0 84 84\" aria-hidden=\"true\" focusable=\"false\"><circle cx=\"42\" cy=\"42\" r=\"40\" fill=\"rgba(10,14,18,.62)\" stroke=\"rgba(255,255,255,.9)\" stroke-width=\"1.6\"\/><path d=\"M34.5 28.2 L58 42 L34.5 55.8 Z\" fill=\"#fff\"\/><\/svg><\/span><br \/>\n<span class=\"sr-pf-badge\"><span>3:33<\/span><span class=\"sr-pf-badge__k\">8 key moments<\/span><span class=\"sr-pf-badge__x\">Transcript below<\/span><\/span><br \/>\n<\/button><figcaption class=\"sr-pf-cap\"><b>Scanned by Brandon Ramakko, DC, on a D3Ultra; the clip went up on the Suresult channel 13 October 2025.<\/b> Playback starts at 0:31, where the clinical content does, and every jump link here lands at 0:31 or later. The poster above and the frozen frame further down are two different moments of one scan, and every timestamp on this page is on the YouTube clock.<\/figcaption><\/figure>\n<section id=\"quick-answer\">\n<h2>Quick answer<\/h2>\n<p><strong>A normal plantar fascia measures roughly 3.5 to 4.0 mm where it leaves the medial calcaneal tubercle; thicker than 4.0 mm, with the bright striped pattern replaced by a dark heterogeneous band, is plantar fasciitis.<\/strong> Put a linear probe in long axis on the spot the patient points to, find the bright calcaneal cortex, pick the fascia up off it, freeze, and drop two calipers &mdash; superficial border to deep border. That is the entire exam, and it takes about a minute. The evidence behind the cut-off is strong in both directions: pooled across 23 imaging studies, a fascia over 4.0 mm carried an odds ratio of 105 for chronic plantar heel pain, and a hypoechoic proximal fascia carried an odds ratio of 204. I read those two findings together rather than trusting the millimetres alone, because thickness drifts with body size and hypoechogenicity does not. Start at 0:31 for the rule and the settings, at 2:08 for the scan itself.<\/p>\n<p class=\"sr-answer-note\">Looking for a device rather than the exam? The <a href=\"https:\/\/suresultmed.com\/specialty\/handheld-ultrasound-for-sports-medicine\/\">sports medicine hub<\/a> covers the models used for foot, ankle and tendon work, and the <a href=\"https:\/\/suresultmed.com\/shop\/handheld-ultrasounds\/d3ultra-multipurpose-handheld-ultrasound\/\">D3Ultra product page<\/a> carries the full specification and current price.<\/p>\n<\/section>\n<section id=\"the-number\">\n<div class=\"sr-pf-band\">\n<p class=\"sr-pf-band__eye\">One number<\/p>\n<h2>Four millimetres, and why the answer is rarely close to it<\/h2>\n<p class=\"sr-pf-band__sub\">This exam produces a single measurement and compares it to a single line. What makes it easy in practice is that real feet do not cluster around the line &mdash; they sit well below it or well above it. Click the amber marker to jump the video to the moment the caliper reads.<\/p>\n<div class=\"sr-pf-scale\">\n<p class=\"sr-pf-scale__h\">Plantar fascia thickness at the medial calcaneal tubercle, in millimetres<\/p>\n<div class=\"sr-pf-railwrap\"><span class=\"sr-pf-mark sr-pf-mark--thr\" style=\"left:50.0%\"><b>4.0 mm<\/b><em>The published threshold. Above it, with the fibrillar pattern lost, is plantar fasciitis.<\/em><\/span><\/p>\n<div class=\"sr-pf-rail\"><span class=\"sr-pf-zone sr-pf-zone--ok\" style=\"width:50.0%\"><\/span><span class=\"sr-pf-zone sr-pf-zone--hi\" style=\"width:50.0%\"><\/span><\/div>\n<p><a class=\"sr-pf-mark sr-pf-mark--meas\" style=\"left:35.0%\" href=\"#t=159\" data-sr-seek=\"159\"><b>2.80 mm<\/b><em>What the caliper reads on camera at 2:39. A normal fascia, on the hardest foot he could find.<\/em><\/a><\/p>\n<div class=\"sr-pf-ticks\"><span>0<\/span><span>1<\/span><span>2<\/span><span>3<\/span><span>4<\/span><span>5<\/span><span>6<\/span><span>7<\/span><span>8<\/span><\/div>\n<\/div>\n<p class=\"sr-pf-scale__key\"><span><i style=\"background:#3f9d96\"><\/i>0 to 4.0 mm: normal<\/span><span><i style=\"background:#d9a54b\"><\/i>above 4.0 mm: thickened<\/span><\/p>\n<p class=\"sr-pf-scale__cap\">The presenter\u2019s own rule of thumb, stated at 0:31: a normal fascia measures two or three millimetres and an abnormal one five or six, so a result sitting on the threshold itself is rare. That is the useful part \u2014 this measurement usually lands nowhere near the line you are comparing it to.<\/p>\n<\/div>\n<div class=\"sr-pf-refs\"><span class=\"sr-pf-ref\"><b>3.5\u20134.0<i>mm<\/i><\/b><em>Normal fascia at the calcaneal insertion, long axis<\/em><span class=\"sr-pf-ref__s\">Manske 2025<\/span><\/span><span class=\"sr-pf-ref\"><b>4.0<i>mm<\/i><\/b><em>Mean maximal thickness of the central bundle in healthy feet<\/em><span class=\"sr-pf-ref__s\">Draghi 2017<\/span><\/span><span class=\"sr-pf-ref\"><b>+2.16<i>mm<\/i><\/b><em>How much thicker the fascia is in chronic plantar heel pain, pooled<\/em><span class=\"sr-pf-ref__s\">McMillan 2009<\/span><\/span><\/div>\n<div class=\"sr-pf-alts\"><span class=\"sr-pf-alt\"><b>Plantar fibromatosis<\/b><em>Well-demarcated nodular thickenings inside the fascia, iso- to hypoechoic. A thick reading that sits in a lump rather than along the band.<\/em><span class=\"sr-pf-alt__s\">Draghi 2017<\/span><\/span><span class=\"sr-pf-alt\"><b>A fascial tear<\/b><em>Partial or complete interruption of the fibres, often with fluid around them. Thickening plus a discontinuity is a different diagnosis.<\/em><span class=\"sr-pf-alt__s\">Draghi 2017<\/span><\/span><span class=\"sr-pf-alt\"><b>Tibialis posterior tendinopathy<\/b><em>The tendon runs behind the medial malleolus, a probe-width away from where you are already standing. Check it before you call the fascia normal.<\/em><span class=\"sr-pf-alt__s\">Named in the recording at 1:32<\/span><\/span><span class=\"sr-pf-alt\"><b>Plantar myofascial trigger points<\/b><em>A focal hypoechoic nodule inside the plantar muscle rather than in the fascia. Echogenicity was long disputed and is now measured.<\/em><span class=\"sr-pf-alt__s\">Named at 1:32; Chen 2024<\/span><\/span><\/div>\n<div class=\"sr-pf-rt\"><span class=\"sr-pf-rt__seg sr-pf-rt__seg--teach\" style=\"width:60.1%\"><b>0:00<\/b><em>The rule, the settings and the differential<\/em><\/span><span class=\"sr-pf-rt__seg sr-pf-rt__seg--live\" style=\"width:31.9%\"><b>2:08<\/b><em>The fascia scanned and measured on camera<\/em><\/span><span class=\"sr-pf-rt__seg sr-pf-rt__seg--close\" style=\"width:8.0%\"><b>3:16<\/b><em>Close<\/em><\/span><\/div>\n<p class=\"sr-pf-band__key\"><span><i style=\"background:#c98a2b\"><\/i>the rule, the settings and the differential<\/span><span><i style=\"background:#3f9d96\"><\/i>the fascia scanned and measured<\/span><span><i style=\"background:rgba(255,255,255,.28)\"><\/i>close<\/span><\/p>\n<p class=\"sr-pf-band__note\">The foot scanned here is normal, and that was the point of choosing it: Brandon Ramakko says at 1:48 that this model has the thinnest, most awkwardly placed fascia he has had to scan, so if the measurement works on her it works on anyone. The consequence is that this recording contains no thickened fascia acquired on camera. Two heels above the threshold do appear on screen at 0:22 as labelled reference pictures with no stated provenance; they are not acquisitions from this session, and their numbers are not repeated here.<\/p>\n<\/div>\n<\/section>\n<section id=\"key-moments\">\n<p class=\"sr-pf-krow\">Timestamped<\/p>\n<h2>Key moments, with the settings<\/h2>\n<p>The third column is the part normally missing from a scan video: the preset, depth, transmit frequency and gain showing on the device at that moment. The interesting entry is the frequency. This linear array offers 7.5 and 10 MHz, and the fascia is shallow enough that 10 would resolve it better &mdash; but the heel pad is thick skin that eats signal, so the scan runs at 7.5.<\/p>\n<div class=\"sr-table-wrap\">\n<table class=\"sr-pf-km\">\n<colgroup>\n<col style=\"width:82px\">\n<col>\n<col style=\"width:272px\"><\/colgroup>\n<thead>\n<tr>\n<th>Time<\/th>\n<th>What is on screen<\/th>\n<th>Preset, depth, frequency, gain<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td class=\"sr-pf-t\"><a href=\"#t=31\" data-sr-seek=\"31\">0:31<\/a><\/td>\n<td><b>The threshold, and getting through the heel pad<\/b><span class=\"sr-pf-flag\">before the probe goes down<\/span><span class=\"sr-pf-screen\">Presenter to camera, foot in the frame<\/span><\/td>\n<td class=\"sr-pf-set\">Stated, not yet on screen: 7.5 MHz for this scan, with 5 MHz on the curvilinear side as the fallback<\/td>\n<\/tr>\n<tr>\n<td class=\"sr-pf-t\"><a href=\"#t=73\" data-sr-seek=\"73\">1:13<\/a><\/td>\n<td><b>Positioning: anything that gives you access to the foot<\/b><span class=\"sr-pf-flag\">before the probe goes down<\/span><span class=\"sr-pf-screen\">Presenter to camera, demonstrating a dangling foot<\/span><\/td>\n<td class=\"sr-pf-set\">No device panel on screen<\/td>\n<\/tr>\n<tr>\n<td class=\"sr-pf-t\"><a href=\"#t=92\" data-sr-seek=\"92\">1:32<\/a><\/td>\n<td><b>What else produces the same heel pain<\/b><span class=\"sr-pf-flag\">before the probe goes down<\/span><span class=\"sr-pf-screen\">Presenter to camera<\/span><\/td>\n<td class=\"sr-pf-set\">No device panel on screen<\/td>\n<\/tr>\n<tr>\n<td class=\"sr-pf-t\"><a href=\"#t=108\" data-sr-seek=\"108\">1:48<\/a><\/td>\n<td><b>A deliberately difficult fascia, and an atypical tubercle<\/b><span class=\"sr-pf-flag\">before the probe goes down<\/span><span class=\"sr-pf-screen\">Presenter to camera, palpating the medial heel<\/span><\/td>\n<td class=\"sr-pf-set\">No device panel on screen<\/td>\n<\/tr>\n<tr>\n<td class=\"sr-pf-t\"><a href=\"#t=128\" data-sr-seek=\"128\">2:08<\/a><\/td>\n<td><b>Gel on, probe down, first look<\/b><span class=\"sr-pf-screen\">Probe placed on the medial heel, live image appears<\/span><\/td>\n<td class=\"sr-pf-set\">MSK preset \u00b7 D 40 mm \u00b7 F 7.5 MHz \u00b7 GN 105 dB \u00b7 Compound ON<\/td>\n<\/tr>\n<tr>\n<td class=\"sr-pf-t\"><a href=\"#t=142\" data-sr-seek=\"142\">2:22<\/a><\/td>\n<td><b>Calcaneal cortex first, then the fascia above it<\/b><span class=\"sr-pf-screen\">Live long-axis image: the bright cortex, then the fascial band<\/span><\/td>\n<td class=\"sr-pf-set\">MSK preset \u00b7 D 40 mm \u00b7 F 7.5 MHz \u00b7 DR 80 \u00b7 ENH 0 \u00b7 MI 0.7 \u00b7 TIS 0.1<\/td>\n<\/tr>\n<tr>\n<td class=\"sr-pf-t\"><a href=\"#t=159\" data-sr-seek=\"159\">2:39<\/a><\/td>\n<td><b>The measurement: 2.8 mm<\/b><span class=\"sr-pf-screen\">Frozen frame, LENGTH tool, calipers on the superficial and deep borders<\/span><\/td>\n<td class=\"sr-pf-set\">FREEZE \u00b7 Meas \u2192 LENGTH \u00b7 reads 2.80 mm \u00b7 cine 99\/100<\/td>\n<\/tr>\n<tr>\n<td class=\"sr-pf-t\"><a href=\"#t=170\" data-sr-seek=\"170\">2:50<\/a><\/td>\n<td><b>What else to check while you are there<\/b><span class=\"sr-pf-screen\">Presenter to camera<\/span><\/td>\n<td class=\"sr-pf-set\">No device panel on screen<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<p class=\"sr-table-note\">Settings transcribed from the device interface visible in the recording. The preset name and software version are legible in the title bar throughout: MSK, V 3.6.78, probe header SX-6CT. The first four rows are argued to camera with the software window covered by the presenter&rsquo;s own title card, so no panel is readable for them; the frequency shown against row one is what he says aloud at 1:05, not what is on screen.<\/p>\n<\/section>\n<section id=\"what-it-shows\">\n<p class=\"sr-pf-krow\">Reading the images<\/p>\n<h2>What this scan shows<\/h2>\n<p>Three layers, in order, from the skin down. Heel pad first &mdash; thick fibro-fatty tissue, mottled and grey, and the reason this window is harder than it looks. Then the plantar fascia: a tight band of parallel collagen that draws as a bright striped ribbon with crisp upper and lower edges. Then the calcaneus, which stops the sound dead and draws as a brilliant white line with pure black shadow under it. Find the bone first. It is unmissable, it tells you the fascia is the ribbon sitting directly on top of it, and it anchors the measurement.<\/p>\n<figure class=\"sr-pf-fig\">\n<img src=\"https:\/\/suresultmed.com\/wp-content\/uploads\/plantar-fascia-thickness-2-8-mm-frozen.jpg\" alt=\"Frozen plantar fascia measurement on a Suresult D3Ultra: calipers on the superficial and deep borders of the fascia reading LENGTH 2.80 mm, MSK preset, 40 mm depth, 7.5 MHz, GN 105 dB, DR 80\" width=\"1300\" height=\"713\" loading=\"lazy\" decoding=\"async\"><figcaption class=\"sr-pf-figcap\"><b>The frozen measurement at 2:53, reading 2.80 mm.<\/b> Calipers on the superficial and deep borders of the fascia, taken just distal to the tubercle where the band is thickest. MSK preset &middot; D 40 mm &middot; F 7.5 MHz &middot; GN 105 dB &middot; DR 80 &middot; ENH 0 &middot; Compound ON &middot; MI 0.7 &middot; TIS 0.1 &middot; cine 99\/100 on freeze.<\/figcaption><\/figure>\n<p>The measurement goes in one place: long axis, immediately distal to the origin on the medial calcaneal tubercle, where the fascia is at its thickest before it tapers forward. Angle the probe slightly medially so the beam strikes the fibres square, because a fascia sampled off-axis reads darker and thicker than it is. Then look at the band itself and not only at the number. A diseased fascia loses its stripes, turns hypoechoic and heterogeneous, and gives up the sharp deep edge that normally sits against the bone.<\/p>\n<p>What I want you to take from a normal study like this one is calibration. You cannot recognise a swollen, dark, edgeless fascia until you have watched a thin bright one glide over the calcaneal cortex a dozen times, and this recording is that reference at the difficult end &mdash; a thin fascia, an atypically placed tubercle, and a heel pad that fights the beam.<\/p>\n<\/section>\n<section id=\"transcript\">\n<p class=\"sr-pf-krow\">Verbatim<\/p>\n<h2>Full transcript<\/h2>\n<details class=\"sr-pf-tx\" id=\"sr-pf-transcript\" data-sr-transcript=\"1\" open>\n<summary>Transcript &mdash; 3:33, 9 passages<\/summary>\n<div class=\"sr-pf-txbody\">\n<p class=\"sr-pf-txnote\"><span>Transcribed from the recording and edited for readability; square brackets mark an editorial clarification. Every timestamp jumps the video, and any timestamp before 0:31 opens it at 0:31, where the clinical content starts.<\/span><\/p>\n<section class=\"sr-pf-txsec\">\n<h3 class=\"sr-pf-txwin\">The whole test, in two sentences<\/h3>\n<div class=\"sr-pf-txcol\">\n<p class=\"sr-pf-txp\"><a class=\"sr-pf-txt\" href=\"#t=0\" data-sr-seek=\"0\">0:00<\/a>Today we\u2019re going to use a Suresult D3Ultra to evaluate the plantar fascia for plantar fasciitis or fasciosis. Now, the evaluation itself is very, very, very simple. You look at the medial tubercle, which is typically where the patient says their pain is, and if the plantar fascia is larger than 4 millimetres, they have plantar fasciitis or fasciosis. If it\u2019s less than 4 millimetres, then they\u2019re probably fine. And normal is around like two or three, and abnormal is like five or six, so it\u2019s very rare that you\u2019ll find someone around that 4 millimetre mark.<\/p>\n<\/div>\n<\/section>\n<section class=\"sr-pf-txsec\">\n<h3 class=\"sr-pf-txwin\">Getting penetration through the heel<\/h3>\n<div class=\"sr-pf-txcol\">\n<p class=\"sr-pf-txp\"><a class=\"sr-pf-txt\" href=\"#t=39\" data-sr-seek=\"39\">0:39<\/a>Now, the plantar surface itself can be a little tricky to scan through, because it\u2019s hard to get penetration sometimes through that thick skin. So you may have to increase power or decrease frequency in order to see anything. In fact, I\u2019ve even had to go down to like 5 megahertz with the curvilinear side just to get the penetration to measure the plantar fascia. But in theory the structure is quite shallow, so higher frequency should be better for higher resolution. I think I\u2019m going to use 7.5 megahertz for this today.<\/p>\n<\/div>\n<\/section>\n<section class=\"sr-pf-txsec\">\n<h3 class=\"sr-pf-txwin\">Patient positioning<\/h3>\n<div class=\"sr-pf-txcol\">\n<p class=\"sr-pf-txp\"><a class=\"sr-pf-txt\" href=\"#t=73\" data-sr-seek=\"73\">1:13<\/a>Now, our sample patient here \u2014 this is a possible patient positioning, but you can pretty much have almost any patient position that gives you access to the foot. If you have a taller table where they\u2019re sitting and their foot is dangling \u2014 just a dangling foot, and just place it underneath and check.<\/p>\n<\/div>\n<\/section>\n<section class=\"sr-pf-txsec\">\n<h3 class=\"sr-pf-txwin\">What else could be causing the heel pain<\/h3>\n<div class=\"sr-pf-txcol\">\n<p class=\"sr-pf-txp\"><a class=\"sr-pf-txt\" href=\"#t=92\" data-sr-seek=\"92\">1:32<\/a>Some other structures you should keep in mind: sometimes it\u2019s actually a problem, for example, with the tibialis posterior tendon instead of the plantar fascia, or it could be myofascial trigger points at the bottom of the foot instead of the plantar fascia. So those are other things to consider.<\/p>\n<\/div>\n<\/section>\n<section class=\"sr-pf-txsec\">\n<h3 class=\"sr-pf-txwin\">A deliberately hard case<\/h3>\n<div class=\"sr-pf-txcol\">\n<p class=\"sr-pf-txp\"><a class=\"sr-pf-txt\" href=\"#t=108\" data-sr-seek=\"108\">1:48<\/a>I\u2019ve already scanned her before, and in particular she has probably the most difficult plantar fascia I\u2019ve ever had to scan. It\u2019s very thin, and the medial tubercle \u2014 you expect it sort of around here, but it\u2019s actually a little bit further on her. So if I can use this to evaluate her plantar fascia, then I can probably evaluate anyone\u2019s plantar fascia.<\/p>\n<\/div>\n<\/section>\n<section class=\"sr-pf-txsec\">\n<h3 class=\"sr-pf-txwin\">Acquisition<\/h3>\n<div class=\"sr-pf-txcol\">\n<p class=\"sr-pf-txp\"><a class=\"sr-pf-txt\" href=\"#t=128\" data-sr-seek=\"128\">2:08<\/a>We\u2019ll get some gel on here. We\u2019ll turn it on, and let\u2019s go like this.<\/p>\n<\/div>\n<\/section>\n<section class=\"sr-pf-txsec\">\n<h3 class=\"sr-pf-txwin\">Reading the image<\/h3>\n<div class=\"sr-pf-txcol\">\n<p class=\"sr-pf-txp\"><a class=\"sr-pf-txt\" href=\"#t=142\" data-sr-seek=\"142\">2:22<\/a>So we\u2019re seeing the calcaneus as the cortex there. And there\u2019s the plantar fascia. That wasn\u2019t so bad \u2014 that was pretty easy. So here\u2019s that surface, and here\u2019s the bottom of it, and that\u2019s the thickness we need to measure.<\/p>\n<\/div>\n<\/section>\n<section class=\"sr-pf-txsec\">\n<h3 class=\"sr-pf-txwin\">The measurement<\/h3>\n<div class=\"sr-pf-txcol\">\n<p class=\"sr-pf-txp\"><a class=\"sr-pf-txt\" href=\"#t=159\" data-sr-seek=\"159\">2:39<\/a>So I can grab the measurement tool \u2014 we need a length \u2014 and grab that. And it\u2019s 2.8 millimetres. Pretty easy.<\/p>\n<\/div>\n<\/section>\n<section class=\"sr-pf-txsec\">\n<h3 class=\"sr-pf-txwin\">What else to look for while you are there<\/h3>\n<div class=\"sr-pf-txcol\">\n<p class=\"sr-pf-txp\"><a class=\"sr-pf-txt\" href=\"#t=170\" data-sr-seek=\"170\">2:50<\/a>Now, you can of course scan over the entire plantar fascia looking for other pathologies. And as I mentioned, you could look for myofascial trigger points, either through palpation or with the ultrasound unit. Remember, muscle that looks unusually hypoechoic \u2014 darker than usual \u2014 could indicate a myofascial trigger point. And again, I do recommend checking the tibialis posterior tendon for tendinopathy there. Anyways, I hope you found this useful. Cheers.<\/p>\n<p class=\"sr-pf-txp sr-pf-txp--omit\">[Sponsor segment omitted, 3:16\u20133:33]<\/p>\n<\/div>\n<\/section>\n<\/div>\n<\/details>\n<\/section>\n<section id=\"device\" class=\"sr-choice\">\n<p class=\"sr-pf-krow\">Hardware<\/p>\n<h2>Device and settings<\/h2>\n<p>The left column is the published specification; the right column is what the device interface actually showed while this exam was running, and the right column is the one I would copy. Note what is not maximised. Gain is at the ceiling and frequency is one step below it &mdash; the deliberate trade for a window where the obstacle is attenuation in the heel pad rather than the depth of the target. If almost all of your week is superficial tendon and nerve work at 12 MHz and above, a three-geometry head like this is not a good fit: its linear side stops at 10 MHz and a dedicated high-frequency linear probe will out-resolve it every time.<\/p>\n<div class=\"sr-pf-dev\">\n<div class=\"sr-pf-dev__grid\">\n<div class=\"sr-pf-dev__col\" data-sr-spec-table=\"1\">\n<p class=\"sr-pf-dev__h\">Published specification<\/p>\n<p class=\"sr-pf-dev__name\">Suresult D3Ultra<\/p>\n<p class=\"sr-pf-dev__price\">Three geometries, one head &mdash; {{SRX_PRICE:28571}}<\/p>\n<ul class=\"sr-pf-spec\">\n<li><b>Linear<\/b><span>7.5 \/ 10 MHz &middot; 20 \/ 40 \/ 60 \/ 100 mm &middot; 40 mm<\/span><\/li>\n<li><b>Convex<\/b><span>3.2 \/ 5.0 MHz &middot; 90&ndash;300 mm &middot; 45&deg;<\/span><\/li>\n<li><b>Phased<\/b><span>3.2 \/ 5.0 MHz &middot; 90&ndash;300 mm &middot; 60&deg;<\/span><\/li>\n<li><b>Signal path<\/b><span>192 elements &middot; 64 channels &middot; 256 grey levels<\/span><\/li>\n<li><b>Gain range<\/b><span>30&ndash;105 dB &middot; dynamic range 40&ndash;110<\/span><\/li>\n<li><b>Doppler<\/b><span>Colour, Power and PW, alongside B and M<\/span><\/li>\n<li><b>Handpiece<\/b><span>156 &times; 65 &times; 20 mm &middot; 263 g &middot; 2 h scanning<\/span><\/li>\n<li><b>Connects to<\/b><span>iOS, Android, Windows &middot; dual-band Wi-Fi<\/span><\/li>\n<\/ul>\n<\/div>\n<div class=\"sr-pf-dev__col\">\n<p class=\"sr-pf-dev__h\">Read off the screen in this recording<\/p>\n<ul class=\"sr-pf-spec\">\n<li><b>Preset<\/b><span>MSK &middot; software V 3.6.78 &middot; probe header SX-6CT<\/span><\/li>\n<li><b>Array<\/b><span>Linear &middot; unchanged for the whole scan<\/span><\/li>\n<li><b>Depth<\/b><span>D 40 mm &middot; generous for a structure a centimetre down<\/span><\/li>\n<li><b>Frequency<\/b><span>F 7.5 MHz &middot; one step below this array&rsquo;s 10 MHz ceiling<\/span><\/li>\n<li><b>Gain<\/b><span>GN 105 dB &middot; the top of the published range<\/span><\/li>\n<li><b>Dynamic range<\/b><span>DR 80 &middot; ENH 0 &middot; Compound ON<\/span><\/li>\n<li><b>Output<\/b><span>MI 0.7 &middot; TIS 0.1<\/span><\/li>\n<li><b>Measurement<\/b><span>B mode, freeze, Meas &rarr; LENGTH &middot; reads 2.80 mm<\/span><\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div class=\"sr-pf-dev__links\"><a href=\"https:\/\/suresultmed.com\/shop\/handheld-ultrasounds\/d3ultra-multipurpose-handheld-ultrasound\/\">D3Ultra specification and price &rarr;<\/a><a href=\"https:\/\/suresultmed.com\/specialty\/handheld-ultrasound-for-sports-medicine\/\">Sports medicine hub &rarr;<\/a><a href=\"https:\/\/suresultmed.com\/suresult-video-library\/\">Scan Library &rarr;<\/a><\/div>\n<\/div>\n<\/section>\n<section id=\"related\">\n<p class=\"sr-pf-krow\">Same probe, other windows<\/p>\n<h2>Related scans<\/h2>\n<div class=\"sr-pf-rels\"><a class=\"sr-pf-rel\" href=\"https:\/\/suresultmed.com\/suresult-video-library\/\"><span class=\"sr-pf-rel__img\"><img decoding=\"async\" src=\"https:\/\/suresultmed.com\/wp-content\/uploads\/suresult-asset-0984-quick-tibialis-posterior-tendon-scan-clean-thumbnail.png\" alt=\"Tibialis posterior tendon scanned behind the medial malleolus on a Suresult D3Ultra, live B-mode image on the tablet\" width=\"640\" height=\"360\" loading=\"lazy\"><span class=\"sr-pf-rel__len\">3:57<\/span><\/span><span class=\"sr-pf-rel__b\"><span class=\"sr-pf-rel__t\">Tibialis posterior tendon, behind the medial malleolus<\/span><span class=\"sr-pf-rel__d\">The differential named in this recording at 1:32, scanned properly. It is the tendon that explains the heel that hurts with a normal fascia.<\/span><span class=\"sr-pf-rel__cta\">Watch in the Library &rarr;<\/span><\/span><\/a><a class=\"sr-pf-rel\" href=\"https:\/\/suresultmed.com\/suresult-video-library\/\"><span class=\"sr-pf-rel__img\"><img decoding=\"async\" src=\"https:\/\/suresultmed.com\/wp-content\/uploads\/suresult-asset-0957-quick-achilles-scan-clean-thumbnail.png\" alt=\"Achilles tendon scanned in long axis on a Suresult D3Ultra, live B-mode image of the tendon fibres on the tablet\" width=\"640\" height=\"360\" loading=\"lazy\"><span class=\"sr-pf-rel__len\">5:32<\/span><\/span><span class=\"sr-pf-rel__b\"><span class=\"sr-pf-rel__t\">Achilles tendon in long and short axis<\/span><span class=\"sr-pf-rel__d\">The other end of the same calcaneus. Posterior heel pain and plantar heel pain arrive at the same clinic appointment and are two different scans.<\/span><span class=\"sr-pf-rel__cta\">Watch in the Library &rarr;<\/span><\/span><\/a><a class=\"sr-pf-rel\" href=\"https:\/\/suresultmed.com\/carpal-tunnel-ultrasound-median-nerve\/\"><span class=\"sr-pf-rel__img\"><img decoding=\"async\" src=\"https:\/\/suresultmed.com\/wp-content\/uploads\/carpal-tunnel-median-nerve-anisotropy-poster.jpg\" alt=\"Median nerve at the carpal tunnel on a Suresult D3Ultra, transverse view of the nerve inside the tunnel\" width=\"640\" height=\"360\" loading=\"lazy\"><span class=\"sr-pf-rel__len\">5:27<\/span><\/span><span class=\"sr-pf-rel__b\"><span class=\"sr-pf-rel__t\">Median nerve at the carpal tunnel<\/span><span class=\"sr-pf-rel__d\">The same discipline on a different structure: find the thickest point, freeze, take one number, and read it against a published cut-off.<\/span><span class=\"sr-pf-rel__cta\">Read the walkthrough &rarr;<\/span><\/span><\/a><\/div>\n<p class=\"sr-pf-hublink\">All the clinical clips, filterable by anatomy and probe, are in the <a href=\"https:\/\/suresultmed.com\/suresult-video-library\/\">Scan Library<\/a>.<\/p>\n<\/section>\n<section id=\"faq\">\n<p class=\"sr-pf-krow\">Asked on this search<\/p>\n<h2>Heel pain questions<\/h2>\n<div class=\"sr-faq sr-pf-faq\">\n<details class=\"sr-pf-q\" open>\n<summary>Can plantar fasciitis be seen on ultrasound?<\/summary>\n<p>Yes, and it is the first-line imaging test for it. The plantar fascia is a superficial band a few millimetres thick, so a linear probe resolves it easily where it leaves the medial calcaneal tubercle. Two findings carry the diagnosis: the band is thicker than 4.0 mm, and its normally bright fibrillar pattern turns dark and heterogeneous. In a pooled analysis of 23 imaging studies, people with chronic plantar heel pain were far more likely than controls to show both \u2014 an odds ratio of 105.11 for thickness above 4.0 mm and 204.12 for hypoechogenicity of the proximal fascia. I read the two together and never the thickness alone.<\/p>\n<p><span class=\"sr-pf-cite\">Source: <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC2784446\/\" rel=\"nofollow noopener\" target=\"_blank\">McMillan AM, Landorf KB, Barrett JT, Menz HB, Bird AR. Diagnostic imaging for chronic plantar heel pain: a systematic review and meta-analysis. Journal of Foot and Ankle Research 2009;2:32<\/a>. Accessed September 10, 2026.<\/span><\/details>\n<details class=\"sr-pf-q\">\n<summary>How thick is a normal plantar fascia on ultrasound?<\/summary>\n<p>About 3.5 to 4.0 mm at the calcaneal insertion, tapering as it runs forward; the mean maximal thickness of the central bundle in healthy feet is reported at 4.0 mm, against 2.3 mm for the lateral bundle and 0.6 mm for the medial one. A measurement above 4.0 mm at the insertion is treated as pathological. The fascia scanned in this recording measures 2.80 mm, which is a normal result on a foot the presenter picked because it is unusually thin and unusually hard to scan.<\/p>\n<p><span class=\"sr-pf-cite\">Source: <a href=\"https:\/\/ijspt.scholasticahq.com\/article\/141177-diagnostic-musculoskeletal-ultrasound-in-the-evaluation-of-the-plantar-fascia\" rel=\"nofollow noopener\" target=\"_blank\">Manske RC, Wolfe C, Page P, Voight M. Diagnostic Musculoskeletal Ultrasound in the Evaluation of the Plantar Fascia. International Journal of Sports Physical Therapy 2025;20(7):1091\u20131096<\/a>. Accessed September 10, 2026.<\/span><\/details>\n<details class=\"sr-pf-q\">\n<summary>Where exactly do you measure the plantar fascia?<\/summary>\n<p>In long axis, at the thickest part of the fascia next to the calcaneus, just distal to its origin on the medial calcaneal tubercle, with the probe angled slightly medially so the beam meets the fibres square. Put one caliper on the superficial border and one on the deep border and read the distance between them. The textbook position is prone with the ankle over a bolster; in this recording the model sits with the knee bent and the sole presented, which is the position I would use in a clinic room where the patient is already sitting.<\/p>\n<p><span class=\"sr-pf-cite\">Source: <a href=\"https:\/\/ijspt.scholasticahq.com\/article\/141177-diagnostic-musculoskeletal-ultrasound-in-the-evaluation-of-the-plantar-fascia\" rel=\"nofollow noopener\" target=\"_blank\">Manske RC, Wolfe C, Page P, Voight M. Diagnostic Musculoskeletal Ultrasound in the Evaluation of the Plantar Fascia. International Journal of Sports Physical Therapy 2025;20(7):1091\u20131096<\/a>. Accessed September 10, 2026.<\/span><\/details>\n<details class=\"sr-pf-q\">\n<summary>What does plantar fasciitis look like on ultrasound?<\/summary>\n<p>A healthy fascia is a tight, bright, striped band with sharp borders sitting directly on the bright line of the calcaneal cortex. In plantar fasciitis that band swells past 4.0 mm, the stripes blur into a dark heterogeneous block, and the deep border next to the bone loses its edge. Fluid around the fascia, calcification inside it and increased flow on Doppler can all appear alongside. The recording on this page shows a normal fascia, so it teaches the baseline rather than the abnormality.<\/p>\n<p><span class=\"sr-pf-cite\">Source: <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC5265197\/\" rel=\"nofollow noopener\" target=\"_blank\">Draghi F, Gitto S, Bortolotto C, Draghi AG, Ori Belometti G. Imaging of plantar fascia disorders: findings on plain radiography, ultrasound and magnetic resonance imaging. Insights into Imaging 2017;8(1):69\u201378<\/a>. Accessed September 10, 2026.<\/span><\/details>\n<details class=\"sr-pf-q\">\n<summary>What frequency should you use to scan the plantar fascia?<\/summary>\n<p>High enough to resolve a 3 mm band, low enough to get through the heel pad. The fascia sits roughly a centimetre down, so resolution matters more than penetration and the top of a linear array is the usual answer. The skin over the plantar surface is thick, though, and it eats signal: the presenter runs this scan at 7.5 MHz rather than the 10 MHz his linear array also offers, and says he has dropped to 5 MHz on the curvilinear side on other feet to see anything at all. Start high, and trade frequency for power only when the image gives you nothing.<\/p>\n<p><span class=\"sr-pf-cite\">Source: <a href=\"https:\/\/www.youtube.com\/watch?v=FlOCR7xp11Q\" rel=\"nofollow noopener\" target=\"_blank\">POCUS for Plantar Fasciitis \u2014 Suresult channel, 13 October 2025<\/a>. Accessed September 10, 2026.<\/span><\/details>\n<\/div>\n<\/section>\n<section id=\"sources\">\n<p class=\"sr-pf-krow\">Provenance<\/p>\n<h2>Sources<\/h2>\n<ul class=\"sr-pf-src\">\n<li><a href=\"https:\/\/ijspt.scholasticahq.com\/article\/141177-diagnostic-musculoskeletal-ultrasound-in-the-evaluation-of-the-plantar-fascia\" rel=\"nofollow noopener\" target=\"_blank\">Manske RC, Wolfe C, Page P, Voight M. Diagnostic Musculoskeletal Ultrasound in the Evaluation of the Plantar Fascia. International Journal of Sports Physical Therapy 2025;20(7):1091\u20131096<\/a><span>Technique reference for this exam: long axis with slight medial obliquity along the thickest part of the fascia near the calcaneus, patient prone with the ankle on a bolster; a normal fascia is a thick hyperechoic fibrillar band of approximately 3.5 to 4.0 mm that tapers anteriorly, with a thickness exceeding 4.0 mm suggestive of pathology, and the fibrillar pattern turning hypoechoic and heterogeneous in disease. Accessed September 10, 2026.<\/span><\/li>\n<li><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC2784446\/\" rel=\"nofollow noopener\" target=\"_blank\">McMillan AM, Landorf KB, Barrett JT, Menz HB, Bird AR. Diagnostic imaging for chronic plantar heel pain: a systematic review and meta-analysis. Journal of Foot and Ankle Research 2009;2:32<\/a><span>Twenty-three studies pooled. The plantar fascia of participants with chronic plantar heel pain was 2.16 mm thicker than controls (95% CI 1.60 to 2.71, P below 0.001); they were more likely to measure above 4.0 mm (OR 105.11, 95% CI 3.09 to 3577.28) and more than 200 times more likely to show hypoechogenicity of the proximal fascia (OR 204.12, 95% CI 52.00 to 801.28, four studies, 209 cases and 146 controls, heterogeneity 0%). The wide interval on the thickness estimate is the study\u2019s own. Accessed September 10, 2026.<\/span><\/li>\n<li><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC5265197\/\" rel=\"nofollow noopener\" target=\"_blank\">Draghi F, Gitto S, Bortolotto C, Draghi AG, Ori Belometti G. Imaging of plantar fascia disorders: findings on plain radiography, ultrasound and magnetic resonance imaging. Insights into Imaging 2017;8(1):69\u201378<\/a><span>Anatomy and the differential. The fascia arises from the medial tubercle of the calcaneus; mean maximal thickness is 4.0 mm in the central bundle, 2.3 mm laterally and 0.6 mm medially. Sonographic features of plantar fasciitis are loss of fibrillar structure, thickness over 4 mm, perifascial collections, calcification and hyperaemia on Doppler. Plantar fibromatosis appears as well-demarcated iso- to hypoechoic nodular thickenings, and tears as partial or complete fibre interruption. Accessed September 10, 2026.<\/span><\/li>\n<li><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC10857038\/\" rel=\"nofollow noopener\" target=\"_blank\">Chen H-Y, Hsu C-H, Chen K-H, et al. Assessment of the Performance of Ultrasonography for Detecting Myofascial Trigger Points. Sensors 2024;24(3):718<\/a><span>Whether trigger points read as hyperechoic or hypoechoic had been disputed. Using spontaneous endplate noise on needle EMG as the reference standard in an animal model, trigger points were hypoechoic on B-mode with 100% sensitivity, and detection accuracy and precision were 89.9% and 89.2%. The authors state that human studies are the next step. Accessed September 10, 2026.<\/span><\/li>\n<li><a href=\"https:\/\/www.acep.org\/sonoguide\/basic\/msk\" rel=\"nofollow noopener\" target=\"_blank\">ACEP Sonoguide \u2014 Musculoskeletal Ultrasound<\/a><span>Baseline sonoanatomy for this window: fascia draws as thin hyperechoic lines, muscle as striated hypoechoic slabs between them, and a bone cortex as a bright surface with no echoes deep to it \u2014 which is why the calcaneus is the landmark you find first. Accessed September 10, 2026.<\/span><\/li>\n<li><a href=\"https:\/\/suresultmed.com\/shop\/handheld-ultrasounds\/d3ultra-multipurpose-handheld-ultrasound\/\" rel=\"nofollow noopener\" target=\"_blank\">Suresult D3Ultra product page<\/a><span>Manufacturer figures for the three-geometry head this scan was run on: array geometries, frequency steps, depth range, gain and dynamic range. The price shown in the card above is rendered live from this page. Accessed September 10, 2026.<\/span><\/li>\n<li><a href=\"https:\/\/www.youtube.com\/watch?v=FlOCR7xp11Q\" rel=\"nofollow noopener\" target=\"_blank\">POCUS for Plantar Fasciitis \u2014 Suresult channel, 13 October 2025<\/a><span>The recording transcribed on this page. Presented by Brandon Ramakko, DC. Accessed September 10, 2026.<\/span><\/li>\n<\/ul>\n<\/section>\n<div class=\"sr-final-cta\">\n<div>\n<h2>Which probe does your foot and ankle work actually need?<\/h2>\n<p>A fascia measurement wants resolution and almost no depth; a heel pad that will not let signal through wants the opposite. A three-geometry head covers both from one device, and a dedicated high-frequency linear probe covers the first one better. Tell us the setting and the case mix and you will get a direct recommendation in one conversation &mdash; one probe, two, or neither.<\/p>\n<\/div>\n<div class=\"sr-chat-link\">\n<button class=\"sr-crisp-consult-btn\" type=\"button\" data-sr-crisp-open onclick=\"window.$crisp=window.$crisp||[];window.$crisp.push(['do','chat:open']);\">ONLINE EXPERT CONSULT<\/button>\n<\/div>\n<\/div>\n<nav id=\"sr-pf-toc\" class=\"sr-light-toc sr-sticky-toc sr-article-toc\" data-suresult-toc data-sr-hide-on-wide-table aria-label=\"Plantar fascia walkthrough navigation\">\n<div class=\"sr-light-toc__head\">\n<div class=\"sr-light-toc__title\">On this page<\/div>\n<p><span class=\"sr-light-toc__progress\" id=\"sr-pf-progress\">0%<\/span><\/div>\n<div class=\"sr-light-toc__links\"><a href=\"#quick-answer\">Quick answer<\/a><a href=\"#the-number\">The number<\/a><a href=\"#key-moments\">Key moments<\/a><a href=\"#what-it-shows\">What this scan shows<\/a><a href=\"#transcript\">Full transcript<\/a><a href=\"#device\">Device and settings<\/a><a href=\"#related\">Related scans<\/a><a href=\"#faq\">Heel pain questions<\/a><a href=\"#sources\">Sources<\/a><\/div>\n<p class=\"sr-light-toc__note\">Not sure which probe your foot and ankle work needs?<\/p>\n<p><button class=\"sr-crisp-consult-btn\" type=\"button\" data-sr-crisp-open onclick=\"window.$crisp=window.$crisp||[];window.$crisp.push(['do','chat:open']);\">ONLINE EXPERT CONSULT<\/button><br \/>\n<\/nav>\n<\/div>\n<p><script>(function(){\nvar AMP=String.fromCharCode(38);\nvar VID='FlOCR7xp11Q';\nvar OPEN=31;\nfunction embed(start){\nvar s=Number(start);\nif(!s){s=OPEN;}\nif(s<OPEN){s=OPEN;}\nvar u='https:\/\/www.youtube-nocookie.com\/embed\/'+VID+'?rel=0'+AMP+'autoplay=1';\nu=u+AMP+'start='+s;\nreturn u;\n}\nfunction mount(start){\nvar pl=document.getElementById('sr-pf-player');\nif(!pl){return null;}\nif(pl.classList.contains('is-live')){\nvar fr=pl.querySelector('iframe');\nif(fr){fr.src=embed(start);}\nreturn pl;\n}\nvar 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afterwards.\",\"thumbnailUrl\":[\"https:\/\/suresultmed.com\/wp-content\/uploads\/plantar-fascia-probe-on-medial-heel-poster.jpg\"],\"uploadDate\":\"2025-10-13\",\"duration\":\"PT3M33S\",\"embedUrl\":\"https:\/\/www.youtube-nocookie.com\/embed\/FlOCR7xp11Q\",\"isFamilyFriendly\":true,\"inLanguage\":\"en\",\"publisher\":{\"@type\":\"Organization\",\"@id\":\"https:\/\/suresultmed.com\/#organization\",\"name\":\"Suresult\",\"url\":\"https:\/\/suresultmed.com\/\"},\"actor\":{\"@id\":\"https:\/\/suresultmed.com\/plantar-fasciitis-ultrasound-scan\/#presenter\"},\"mainEntityOfPage\":{\"@id\":\"https:\/\/suresultmed.com\/plantar-fasciitis-ultrasound-scan\/\"},\"transcript\":\"Today we\u2019re going to use a Suresult D3Ultra to evaluate the plantar fascia for plantar fasciitis or fasciosis. Now, the evaluation itself is very, very, very simple. You look at the medial tubercle, which is typically where the patient says their pain is, and if the plantar fascia is larger than 4 millimetres, they have plantar fasciitis or fasciosis. If it\u2019s less than 4 millimetres, then they\u2019re probably fine. And normal is around like two or three, and abnormal is like five or six, so it\u2019s very rare that you\u2019ll find someone around that 4 millimetre mark. Now, the plantar surface itself can be a little tricky to scan through, because it\u2019s hard to get penetration sometimes through that thick skin. So you may have to increase power or decrease frequency in order to see anything. In fact, I\u2019ve even had to go down to like 5 megahertz with the curvilinear side just to get the penetration to measure the plantar fascia. But in theory the structure is quite shallow, so higher frequency should be better for higher resolution. I think I\u2019m going to use 7.5 megahertz for this today. Now, our sample patient here \u2014 this is a possible patient positioning, but you can pretty much have almost any patient position that gives you access to the foot. If you have a taller table where they\u2019re sitting and their foot is dangling \u2014 just a dangling foot, and just place it underneath and check. Some other structures you should keep in mind: sometimes it\u2019s actually a problem, for example, with the tibialis posterior tendon instead of the plantar fascia, or it could be myofascial trigger points at the bottom of the foot instead of the plantar fascia. So those are other things to consider. I\u2019ve already scanned her before, and in particular she has probably the most difficult plantar fascia I\u2019ve ever had to scan. It\u2019s very thin, and the medial tubercle \u2014 you expect it sort of around here, but it\u2019s actually a little bit further on her. So if I can use this to evaluate her plantar fascia, then I can probably evaluate anyone\u2019s plantar fascia. We\u2019ll get some gel on here. We\u2019ll turn it on, and let\u2019s go like this. So we\u2019re seeing the calcaneus as the cortex there. And there\u2019s the plantar fascia. That wasn\u2019t so bad \u2014 that was pretty easy. So here\u2019s that surface, and here\u2019s the bottom of it, and that\u2019s the thickness we need to measure. So I can grab the measurement tool \u2014 we need a length \u2014 and grab that. And it\u2019s 2.8 millimetres. Pretty easy. Now, you can of course scan over the entire plantar fascia looking for other pathologies. And as I mentioned, you could look for myofascial trigger points, either through palpation or with the ultrasound unit. Remember, muscle that looks unusually hypoechoic \u2014 darker than usual \u2014 could indicate a myofascial trigger point. And again, I do recommend checking the tibialis posterior tendon for tendinopathy there. Anyways, I hope you found this useful. Cheers. 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The plantar fascia is a superficial band a few millimetres thick, so a linear probe resolves it easily where it leaves the medial calcaneal tubercle. Two findings carry the diagnosis: the band is thicker than 4.0 mm, and its normally bright fibrillar pattern turns dark and heterogeneous. In a pooled analysis of 23 imaging studies, people with chronic plantar heel pain were far more likely than controls to show both \u2014 an odds ratio of 105.11 for thickness above 4.0 mm and 204.12 for hypoechogenicity of the proximal fascia. I read the two together and never the thickness alone.\"}},{\"@type\":\"Question\",\"name\":\"How thick is a normal plantar fascia on ultrasound?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"About 3.5 to 4.0 mm at the calcaneal insertion, tapering as it runs forward; the mean maximal thickness of the central bundle in healthy feet is reported at 4.0 mm, against 2.3 mm for the lateral bundle and 0.6 mm for the medial one. A measurement above 4.0 mm at the insertion is treated as pathological. The fascia scanned in this recording measures 2.80 mm, which is a normal result on a foot the presenter picked because it is unusually thin and unusually hard to scan.\"}},{\"@type\":\"Question\",\"name\":\"Where exactly do you measure the plantar fascia?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"In long axis, at the thickest part of the fascia next to the calcaneus, just distal to its origin on the medial calcaneal tubercle, with the probe angled slightly medially so the beam meets the fibres square. Put one caliper on the superficial border and one on the deep border and read the distance between them. The textbook position is prone with the ankle over a bolster; in this recording the model sits with the knee bent and the sole presented, which is the position I would use in a clinic room where the patient is already sitting.\"}},{\"@type\":\"Question\",\"name\":\"What does plantar fasciitis look like on ultrasound?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"A healthy fascia is a tight, bright, striped band with sharp borders sitting directly on the bright line of the calcaneal cortex. In plantar fasciitis that band swells past 4.0 mm, the stripes blur into a dark heterogeneous block, and the deep border next to the bone loses its edge. Fluid around the fascia, calcification inside it and increased flow on Doppler can all appear alongside. The recording on this page shows a normal fascia, so it teaches the baseline rather than the abnormality.\"}},{\"@type\":\"Question\",\"name\":\"What frequency should you use to scan the plantar fascia?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"High enough to resolve a 3 mm band, low enough to get through the heel pad. The fascia sits roughly a centimetre down, so resolution matters more than penetration and the top of a linear array is the usual answer. The skin over the plantar surface is thick, though, and it eats signal: the presenter runs this scan at 7.5 MHz rather than the 10 MHz his linear array also offers, and says he has dropped to 5 MHz on the curvilinear side on other feet to see anything at all. Start high, and trade frequency for power only when the image gives you nothing.\"}}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/suresultmed.com\/plantar-fasciitis-ultrasound-scan\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/suresultmed.com\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Scan Library\",\"item\":\"https:\/\/suresultmed.com\/suresult-video-library\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Plantar fasciitis ultrasound: measuring the fascia at the heel\",\"item\":\"https:\/\/suresultmed.com\/plantar-fasciitis-ultrasound-scan\/\"}]}]}<\/script><\/p>\n","protected":false},"excerpt":{"rendered":"<p>One structure, one landmark, one number. 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