The plantar surface of the foot should likewise be specifically palpated. In the hindfoot, a painful heel pad should be differentiated from plantar fasciitis. The latter typically has tenderness at the anteromedial border of the calcaneus, whereas the former is more painful in the center of the fat pad. Warts may be distinguished from calluses by their punctuate bleeding when shaved, greater tenderness with side-to-side (versus direct) compression, and the absence of skin wrinkles passing through their substance. On the plantar surface of the first MTP the sesamoids should be examined for point tenderness as may occur with sesamoiditis or fracture. The plantar surface of the first MTP will similarly be tender after turf toe in which the plantar capsule has been injured or disrupted.
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