Updated: Sep 29, 2019
Cause: Overuse, flatfoot, poor gait technique, hereditary, use of creatine.
Appearance: Pain, soreness, cramping in the leg after exertion, possible numbness in toes, drop foot.
How to Diagnose: Clinical exam, Wick’s catheter after exertion (treadmill test). MRI and bone scan have been unreliable for definitive diagnosis but can help rule out other pathology.
- Rest, ice, elevation, compression
- Anti-inflammatories (if ok to take)
- Orthotics if caused by excessive pronation
- Maximalist shoes
- Rest from athletics for 6 weeks
- Surgery (for athletes who have failed conservative care for at least 6 months)
o Return to sports at 6 weeks except for deep posterior compartment
§ Potential 6 month recovery
Long-term prognosis: Conservative care works in the vast majority of cases- icing before and after athletics, compression. Orthotics work well to prevent strain if the athlete has excessive pronation. Endoscopic surgery has the shortest down times.
Who to call: Podiatrist, orthopedic surgeon (skilled in arthroscopy/endoscopy)