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Plantar fasciitis

44 citationsUpdated Sep 2026

Overview

Plantar fasciitis is a common condition that may serve as a prodrome for systemic disease, which was present in 16.4% of one clinical series [2]. The long-term prognosis is significantly worse for women and patients with bilateral pain, with a 45.6% risk of having plantar fasciitis at a mean 10 years after symptom onset [14]. Initial evaluation should consider associated foot disorders while treating the condition [16].

Conservative management remains the first-line approach, though the placebo effect is statistically and clinically significant, increases over time, and depends on the treatment type [6]. Home stretching protocols and physical therapy yield similar clinical outcomes [8], while multimodal rehabilitation programs effectively improve outcomes and reduce plantar fascia thickness [17]. At three months, both shock-wave therapy and corticosteroids are effective for pain relief and function [13]. For chronic cases, platelet-rich plasma (PRP) may offer greater improvement in pain and function compared to corticosteroid injections [18]. Extracorporeal shockwave therapy (ESWT) is effective, safe, and provides good long-term results [30]; it is a reasonable earlier line of treatment before endoscopic plantar fascia release (EPF) is considered [10], particularly for patients refractory to nonoperative treatment who prefer to avoid surgery due to its low complication rate and potential cost-effectiveness [24].

Operative intervention is reserved for refractory cases. A randomized controlled trial demonstrated significant and clinically relevant superior results for operative treatment compared to supervised rehabilitation, measured by Foot Function Index at 1 year and VAS activity at 2 years [3]. Although plantar fasciotomy remains controversial due to biomechanical arguments against surgery, long follow-up reports indicate good success [4]. Endoscopic plantar fascia release is a standardised, reproducible procedure with good midterm results [9]. Local percutaneous radiofrequency is a safe, reproducible option with good pain outcomes for patients unresponsive to conservative treatment [1]. Following ESWT failure, EPFR yielded good to excellent outcomes in 85% of 17 patients after two years of follow-up [15].

Anatomy & Pathophysiology

Anatomy

The plantar fascia is a fibrous aponeurosis originating from the plantar medial aspect of the calcaneal tuberosity [26]. It divides into five slips that insert distally on each of the proximal phalanges [26]. These fibers merge with the surrounding dermis, transverse metatarsal ligaments, and flexor tendon sheaths [26]. The structure lacks elasticity, exhibiting a maximal elongation of only 4% of its length in cadaver specimens [26]. Dorsiflexion at the first metatarsophalangeal joint activates the windlass mechanism, which increases plantar fascial tension and elevates the medial longitudinal arch [26].

The heel fat pad consists of dense strands of fibroblastic septa arranged in a honeycomb pattern that encloses adipose tissue [12]. This pad contains a significant neurovascular supply separate from that to the surrounding musculature and skin [12]. The first branch of the lateral plantar nerve lies close to the plantar fascial origin and may be affected by localized tissue changes, swelling, or tethering [82]. The medial calcaneal nerve may exit through the abductor hallucis fascia or plantar fascia at the level of a plantar fascia release [43]. Plantar heel spurs originate in the flexor digitorum brevis [60].

Pathophysiology

Plantar fasciitis is characterized by pain localized to the insertion of the plantar fascia that is exacerbated by weightbearing, especially after periods of rest [23]. Morning pain is a signature symptom of the condition [21]. The pathology is believed to result primarily from repetitive microtrauma and excessive strain [26]. Recent studies suggest plantar fasciitis is a noninflammatory, degenerative process that may be more appropriately termed plantar fasciosis [26]. Histologically, the condition involves myxoid degeneration with disorientation of collagen fibers, angiofibroblastic hyperplasia, and calcification [26]. This presents as collagen degeneration and disorganization rather than significant inflammation [21]. The degeneration in the plantar fascia is similar to the chronic necrosis of tendinosis [21].

Heel spurs are a modest calcification of the plantar fascia and are present in 10-20% of the population, many of whom are painless [21]. Mechanical overload of the heel adipose tissue can result in atrophy, most often due to axial load trauma [12]. Chronic steroid use, either systemic or local injections, can result in adipose cell necrosis in the heel fat pad [12]. An inflammatory process, such as inflammatory arthropathy, can also contribute to heel fat pad atrophy [12]. The energy-dissipating properties of the plantar fat pad are associated with the sonographic appearance of the calcaneal enthesis in symptomatic limbs [39]. Digital loading is observed in patients with plantar fasciitis, suggesting that digital function plays a protective role [23].

Reduced ankle dorsiflexion due to tightness of the Achilles tendon or gastrocnemius muscle may be associated with the development of plantar fasciitis [26]. Obesity and weight-bearing professions are independent risk factors for plantar fasciitis [26]. Obesity and pronated foot posture are associated with chronic plantar heel pain and may be risk factors for its development [80]. Plantar fasciitis can be a prodrome of systemic disease, which was present in 16.4% of a 1975 series [2]. Bilateral involvement of plantar fasciitis occurs in approximately one third of patients and should prompt consideration of inflammatory disease [26].

Classification

Plantar fasciitis is the most common cause of plantar heel pain [11]. The condition commonly reflects a repetitive strain injury of the foot's plantar fascia structure caused by overuse standing or weight-bearing activities [21]. Anatomically, the plantar fascia is a sheet of connective tissue that spans the arch of the foot and stretches from the heel to the toes [21].

Other Considerations: Histological evidence shows collagen degeneration and disorganization with little inflammation, suggesting the condition is better classified as a degenerative process (fasciosis) rather than an inflammatory one [21]. Plantar heel pain is a common, disabling symptom among adults aged 50 years and over [19]. Prognosis for plantar fasciitis is significantly worse for women and patients with bilateral pain [14].

Clinical Presentation

Plantar fasciitis is the most common cause of heel pain in adults, affecting 2 million persons annually in the United States [26]. The peak incidence occurs between ages 40 and 60 years [26]. In a general practice clinic with 10,000 patients, between 24 and 65 patients will present with plantar fasciopathy each year [31]. Bilateral involvement occurs in approximately one third of patients [26]; however, bilateral presentation should prompt consideration of inflammatory disease [26].

The condition is defined as a painful heel syndrome with localized pain at the heel of the foot, which is worst in the morning or after resting for a long time [33]. Pain typically hits when getting up after a period of sitting or rest [21].

On palpation, tenderness in heel fat pad atrophy is located in the center of the heel, more lateral and proximal than that of plantar fasciitis [12]. Heel pain in the elderly and patients with atypical presentations should be investigated to rule out insufficiency fractures and tumors [12].

Investigations

Clinical Assessment: A comprehensive history and physical examination guides accurate diagnosis of plantar fasciitis [11]. Bilateral involvement occurs in approximately one third of patients and should prompt consideration of inflammatory disease [26]. If there is no history of trauma, testing for systemic disease such as inflammatory arthropathy should be considered [12].

Plain radiography: Plain radiographs are the initial study of choice in the imaging workup for foot and ankle pathology [63]. A standard series of weight-bearing radiographs of the foot includes AP, lateral, and oblique views [63]. Standing lateral and axial views of the hindfoot should be obtained to assess for arthritis, structural abnormalities, or bony pathology in heel pain evaluation [12]. An axial or Harris view of the calcaneus can be obtained to better visualize the bony anatomy of the calcaneus [63]. Weight-bearing radiographs are useful for excluding a stress fracture of the metatarsal neck in the evaluation of interdigital neuroma [62].

MRI: MRI is a fundamental tool in the workup of a patient with a soft-tissue or bone tumor in the foot [69]. It is also a valuable imaging modality in the evaluation of patients with suspected bone or soft-tissue infection [69].

Ultrasound: Ultrasound examination has been used to assess plantar fasciitis prognosis over a 5- to 15-year follow-up period [14]. Ultrasonography has been reported to be 85% accurate in diagnosing interdigital neuroma [62].

Other Considerations: The diagnosis of interdigital neuroma is usually made by conducting a careful history and physical examination, although various diagnostic studies may be helpful in selected cases [62]. Injection of the involved web space with local anesthetic that results in relief of the neuritic symptoms is diagnostic of interdigital neuroma [62].

Treatment

Non-Operative

Conservative management of plantar fasciitis is influenced by a statistically and clinically significant placebo effect that increases over time and varies depending on the specific conservative treatment applied [6]. Multimodal rehabilitation programs effectively improve clinical outcomes and reduce plantar fascia thickness [17]. Clinical reasoning advocates combining taping and plantar fascia stretching with education and footwear advice as the core self-management approach [76]. Taping demonstrates good agreement for first step pain in the short term with a standardized mean difference of 0.47 (95% CI 0.05 to 0.88) [76], while plantar fascia stretching shows a standardized mean difference of 1.21 (95% CI 0.78 to 1.63) for the same outcome [76].

Stepped care management with focused shockwave is recommended for first step pain in the short-term with an odds ratio of 1.89 (95% CI 1.18 to 3.04) [76], the medium-term with a standardized mean difference of 1.31 (95% CI 0.61 to 2.01) [76], and the long-term with a standardized mean difference of 1.67 (95% CI 0.88 to 2.45) [76]. Radial shockwave is recommended for first step pain in the short term with an odds ratio of 1.66 (95% CI 1.00 to 2.76) [76] and in the long term with an odds ratio of 1.78 [76]. Both corticosteroid and PRP injections are effective and successful in treating plantar fasciitis [73].

Extracorporeal shock wave therapy (ESWT) offers a role for patients with chronic plantar fasciitis refractory to nonoperative treatment who prefer to avoid surgery, given its low complication rate, potentially quicker recovery time, and potential cost-effectiveness [24]. Electrohydraulic high-energy shock waves applied to the heel are a safe and effective noninvasive method for chronic plantar fasciitis, with effects lasting up to and beyond one year [20]. Radial extracorporeal shock wave therapy significantly improves pain, function, and quality of life compared with placebo in patients with recalcitrant plantar fasciitis [36]. Three treatments with 1000 impulses of low-energy shock waves appear effective and may help patients avoid surgery for recalcitrant heel pain [47]. Both SWT and UT are effective in relieving pain and improving self-reported function, though SWT appears to be a better alternative due to higher improvement in VAS scores [35].

Intracorporeal pneumatic shock therapy yields a 92% rate of successful outcomes (excellent + good results) at 6 months in the treatment group, compared to 24% in the control group [77]. Heel pain measured 6 months after using intracorporeal pneumatic shock therapy was 2.04 ± 1.67 in the treatment group versus 7.16 ± 1.57 in the control group [77]. The VAS score was significantly lower in the treatment group compared to the control group at 6 month follow up for intracorporeal pneumatic shock therapy [77]. Further studies are needed to better assess the utility of mDHACM within current treatment guidelines for the management of plantar fasciitis [7]. The prognosis for plantar fasciitis is significantly worse for women and patients with bilateral pain [14].

Operative

Indications: Inclusion criteria for endoscopic debridement, ostectomy, release, and radiofrequency include patients with at least 6 months of recalcitrant heel pain refractory to conservative measures [75]. Conservative measures for inclusion include activity alteration, footwear modifications, plantar fascia-specific stretching exercises, and analgesics [75]. Patients with concomitant deformities of the foot and ankle or inflammatory conditions may be selected on a case-by-case basis [75]. Patients who have undergone previous surgery to treat PF pain may also be selected on a case-by-case basis [75].

Surgical Approach / Technique: Endoscopic fasciotomy provides superior results when compared to a controlled non-operative treatment protocol [3]. A randomized controlled trial found significant and clinically relevant superior results for the operative treatment of plantar fasciitis as measured by Foot Function Index at 1 year [3] and as measured by VAS activity at 2-year follow-up [3]. Plantar fasciotomy surgery remains controversial, with biomechanical arguments against surgery [4], although an article reports good success following plantar fasciotomy surgery over a long follow-up period [4]. Symptoms of pain and limb function were significantly improved in patients of the partial plantar fascia release treated group [40] and in patients of the percutaneous radiofrequency ablation treated group [40].

Complications

Adipose cell necrosis: Chronic steroid use, whether administered systemically or via local injections, can result in adipose cell necrosis [12].

Recovery

Prognosis and Natural History: Prognosis is significantly worse for women and patients with bilateral pain [14].

Non-Operative Treatment Outcomes: Customized orthoses or prefabricated orthoses improved function in the short term in patients with plantar fasciitis [22]. In patients with chronic plantar fasciitis, the current clinical evidence suggests that platelet-rich plasma may lead to a greater improvement in pain and functional outcome over corticosteroid injections [18].

Operative Treatment Outcomes: Endoscopic plantar fascia release yielded good to excellent outcomes in 85% of 17 patients with plantar fasciitis resistant to treatment by extracorporeal shock wave therapy after 2 years' follow-up [15]. Patients who experienced temporary improvement after local corticosteroid injection had better clinical outcomes following endoscopic plantar fascia release [32].

Key Evidence

  • [Paper] It is a safe and reproducible treatment option with good results in terms of pain for patients with plantar fasciitis and no response after conservative treatment. [1] (10.1016/j.eats.2021.01.031)
  • [L4] Plantar fasciitis can be a prodrome of systemic disease, which was present in 16.4% of the series. [2] (10.2106/00004623-197557050-00016)
  • [L1] This randomized controlled trial found significant and clinically relevant superior results for the operative treatment of plantar fasciitis as measured by Foot Function Index at 1 year and by VAS activity at 2-year follow-up when compared to the results of a supervised rehabilitation program. [3] (10.1007/s00167-020-05855-3)
  • [L4] Plantar fasciotomy surgery for plantar fasciitis remains controversial, with biomechanical arguments against surgery; however, this article reports good success following surgery over a long follow-up period. [4] (10.1177/2325967114527901)
  • [L1] This effect is statistically and clinically significant, increases over time, and depends on the type of conservative treatment applied to address plantar fasciitis. [6] (10.1530/eor-23-0082)
  • [L1] Further studies are needed to better assess the utility of mDHACM within current treatment guidelines for the management of plantar fasciitis. [7] (10.1177/1071100713502179)
  • [L1] The clinical outcomes of a home stretching protocol and physical therapy did not markedly differ for the treatment of plantar fasciitis. [8] (10.5435/jaaos-d-21-00009)
  • [L4] The endoscopic plantar fascia release technique can be performed as a standardised and reproducible procedure with good midterm results. [9] (10.1007/s00167-004-0496-6)
  • [L3] ESWT is a reasonable earlier line of treatment of chronic plantar fasciitis before EPF is tried. [10] (10.1007/s00402-009-1034-2)
  • [L5] Plantar fasciitis is the most common cause of plantar heel pain, and a comprehensive history and physical examination guide accurate diagnosis. [11] (10.5435/00124635-200806000-00006)
  • [L1] Both shock-wave therapy and corticosteroids were effective and successful in relieving pain and improving self-reported function in the treatment of plantar fasciitis at 3 months. [13] (10.1007/s00402-018-3071-1)
  • [L3] The risk of having plantar fasciitis was 45.6% at a mean 10 years after the onset of symptoms, with a significantly worse prognosis for women and patients with bilateral pain. [14] (10.1177/2325967118757983)
  • [L4] EPFR yielded good to excellent outcomes in 85% of 17 patients with plantar fasciitis resistant to treatment by ESWT after 2 years' follow-up. [15] (10.1016/j.arthro.2010.01.026)
  • [L1] Foot disorders should be initially evaluated and considered while treating. [16] (10.1186/s12891-025-09103-y)
  • [L2] Both programs effectively improved clinical outcomes and reduced plantar fascia thickness in patients with PF. [17] (10.1186/s12891-026-09562-x)
  • [L1] In patients with chronic plantar fasciitis, the current clinical evidence suggests that PRP may lead to a greater improvement in pain and functional outcome over CS injections. [18] (10.1177/2325967120915704)
  • [L3] Plantar heel pain is a common, disabling symptom among adults aged 50 years and over. [19] (10.1186/s12891-019-2718-6)
  • [L1] The application of electrohydraulic high-energy shock waves to the heel is a safe and effective noninvasive method to treat chronic plantar fasciitis, lasting up to and beyond one year. [20] (10.2106/00004623-200410000-00013)
  • [L5] [21] (10.1177/2325967124s00374)
  • [L1] In patients with plantar fasciitis, customized orthoses or prefabricated orthoses improved function in the short term. [22] (10.2106/jbjs.8902.ebo2)
  • [L3] [23] (10.1097/01.blo.0000057989.41099.d8)
  • [L1] Given the low complication rate, potentially quicker recovery time, and potential cost-effectiveness, there is likely a role for extracorporeal shock wave therapy in patients with chronic plantar fasciitis refractory to nonoperative treatment who would prefer to avoid surgery. [24] (10.2106/jbjs.o.00192)
  • [L5] [26] (10.5435/jaaos-22-06-372)
  • [L1] Extracorporeal shockwave treatment is effective and safe for patients with plantar fasciitis, with good long-term results. [30] (10.1177/0363546505281811)
  • [L1] [31] (10.1136/bjsports-2023-106948)
  • [L3] Patients who experienced temporary improvement after local corticosteroid injection had better clinical outcomes following endoscopic plantar fascia release. [32] (10.1186/s12891-025-08816-4)
  • [L4] [33] (10.1186/s13018-023-04202-9)
  • [L1] Both SWT and UT are effective in relieving pain and improving self-reported function in the treatment of plantar fasciitis, but SWT appears to be a better alternative due to higher improvement in VAS scores. [35] (10.1007/s00402-019-03262-z)
  • [L1] Radial extracorporeal shock wave therapy significantly improves pain, function, and quality of life compared with placebo in patients with recalcitrant plantar fasciitis. [36] (10.1177/0363546508324176)
  • [L3] The energy-dissipating properties of the plantar fat pad are associated with the sonographic appearance of the calcaneal enthesis in symptomatic limbs, providing a previously unidentified link between the mechanical behavior of the plantar fat pad and enthesopathy. [39] (10.1177/0363546510377405)
  • [L4] The symptoms of pain and limb function were significantly improved in patients both of the partial plantar fascia release treated group and the percutaneous radiofrequency ablation treated group. [40] (10.1186/s13018-020-1582-2)
  • [L1] Three treatments with 1000 impulses of low-energy shock waves appear to be an effective therapy for plantar fasciitis and may help the patient to avoid surgery for recalcitrant heel pain. [47] (10.2106/00004623-200203000-00001)
  • [L1] Both corticosteroid and PRP injections were effective and successful in treating plantar fasciitis. [73] (10.1007/s00402-012-1488-5)
  • [Paper] [75] (10.1016/j.eats.2024.103150)
  • [L1] [76] (10.1136/bjsports-2019-101970)
  • [L1] [77] (10.1007/s00402-009-0947-0)
  • [L3] Obesity and pronated foot posture are associated with chronic plantar heel pain and may be risk factors for the development of the condition. [80] (10.1186/1471-2474-8-41)
  • [L5] [82] (10.5435/00124635-199703000-00006)

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[2] Plantar fasciitis. The painful heel syndrome. The Journal of Bone & Joint Surgery. 1975. DOI: 10.2106/00004623-197557050-00016

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[4] Surgery for Patients With Recalcitrant Plantar Fasciitis. Orthopaedic Journal of Sports Medicine. 2014. DOI: 10.1177/2325967114527901

[6] The ‘placebo effect’ in the conservative treatment of plantar fasciitis: a systematic review and meta-analysis. EFORT Open Reviews. 2023. DOI: 10.1530/eor-23-0082

[7] Prospective, Randomized, Blinded, Comparative Study of Injectable Micronized Dehydrated Amniotic/Chorionic Membrane Allograft for Plantar Fasciitis—A Feasibility Study. Foot & Ankle International. 2013. DOI: 10.1177/1071100713502179

[8] A Prospective Randomized Controlled Trial Comparing Physical Therapy With Independent Home Stretching for Plantar Fasciitis. Journal of the American Academy of Orthopaedic Surgeons. 2022. DOI: 10.5435/jaaos-d-21-00009

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[15] Endoscopic Plantar Fascia Release by Hooked Soft‐Tissue Electrode After Failed Shock Wave Therapy. Arthroscopy. 2010. DOI: 10.1016/j.arthro.2010.01.026

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[17] The effect of multimodal rehabilitation program on pain, functional outcomes, and plantar fascia thickness in patients with plantar fasciitis: a randomized controlled trial. BMC Musculoskeletal Disorders. 2026. DOI: 10.1186/s12891-026-09562-x

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[21] Controversies of the Plantar Fasciitis. Orthopaedic Journal of Sports Medicine. 2024. DOI: 10.1177/2325967124s00374

[22] Customized or Prefabricated Foot Orthoses Improved Function Only in the Short Term in Patients with Plantar Fasciitis. The Journal of Bone & Joint Surgery. 2007. DOI: 10.2106/jbjs.8902.ebo2

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Section 1 -- Definitions.

a. Adapted Material means material subject to Copyright and Similar Rights that is derived from or based upon the Licensed Material and in which the Licensed Material is translated, altered, arranged, transformed, or otherwise modified in a manner requiring permission under the Copyright and Similar Rights held by the Licensor. For purposes of this Public License, where the Licensed Material is a musical work, performance, or sound recording, Adapted Material is always produced where the Licensed Material is synched in timed relation with a moving image.

b. Adapter's License means the license You apply to Your Copyright and Similar Rights in Your contributions to Adapted Material in accordance with the terms and conditions of this Public License.

c. Copyright and Similar Rights means copyright and/or similar rights closely related to copyright including, without limitation, performance, broadcast, sound recording, and Sui Generis Database Rights, without regard to how the rights are labeled or categorized. For purposes of this Public License, the rights specified in Section 2(b)(1)-(2) are not Copyright and Similar Rights.

d. Effective Technological Measures means those measures that, in the absence of proper authority, may not be circumvented under laws fulfilling obligations under Article 11 of the WIPO Copyright Treaty adopted on December 20, 1996, and/or similar international agreements.

e. Exceptions and Limitations means fair use, fair dealing, and/or any other exception or limitation to Copyright and Similar Rights that applies to Your use of the Licensed Material.

f. Licensed Material means the artistic or literary work, database, or other material to which the Licensor applied this Public License.

g. Licensed Rights means the rights granted to You subject to the terms and conditions of this Public License, which are limited to all Copyright and Similar Rights that apply to Your use of the Licensed Material and that the Licensor has authority to license.

h. Licensor means the individual(s) or entity(ies) granting rights under this Public License.

i. NonCommercial means not primarily intended for or directed towards commercial advantage or monetary compensation. For purposes of this Public License, the exchange of the Licensed Material for other material subject to Copyright and Similar Rights by digital file-sharing or similar means is NonCommercial provided there is no payment of monetary compensation in connection with the exchange.

j. Share means to provide material to the public by any means or process that requires permission under the Licensed Rights, such as reproduction, public display, public performance, distribution, dissemination, communication, or importation, and to make material available to the public including in ways that members of the public may access the material from a place and at a time individually chosen by them.

k. Sui Generis Database Rights means rights other than copyright resulting from Directive 96/9/EC of the European Parliament and of the Council of 11 March 1996 on the legal protection of databases, as amended and/or succeeded, as well as other essentially equivalent rights anywhere in the world.

l. You means the individual or entity exercising the Licensed Rights under this Public License. Your has a corresponding meaning.

Section 2 -- Scope.

a. License grant.

1. Subject to the terms and conditions of this Public License, the Licensor hereby grants You a worldwide, royalty-free, non-sublicensable, non-exclusive, irrevocable license to exercise the Licensed Rights in the Licensed Material to:

a. reproduce and Share the Licensed Material, in whole or in part, for NonCommercial purposes only; and

b. produce, reproduce, and Share Adapted Material for NonCommercial purposes only.

2. Exceptions and Limitations. For the avoidance of doubt, where Exceptions and Limitations apply to Your use, this Public License does not apply, and You do not need to comply with its terms and conditions.

3. Term. The term of this Public License is specified in Section 6(a).

4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a) (4) never produces Adapted Material.

5. Downstream recipients.

a. Offer from the Licensor -- Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.

b. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.

6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

b. Other rights.

1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.