Plantar Fasciitis (Medial heel pain)

Updated: Sep 29, 2019



Cause: Overuse, trauma, tight Achilles tendon


Appearance: Heel pain that is worse when first standing up and throbs at the end of the day. Typically pain is on the inside (medial side) of the heel.



How to Diagnose: Clinical exam, MRI, Ultrasound


Treatment:

- Stretching the Achilles is first line treatment ( must be passive, never active)

o Eccentric training (see image)

o Night-splint stretching device (see image)

- Steroid injection(if ok to receive)

- 2-4 weeks rest from tennis, followed by return to clay court first, followed by hard court

- Ice and anti-inflammatories (if ok to take)

- Maximalist tennis shoes and orthotics help prevent recurrence

- Surgery is an option only in cases where conservative care has failed.

o We do NOT recommend Achilles tendon lengthening procedures as an adjunct given its effects on the tennis serving motion and first step push off

o We prefer the single incision endoscopic approach for faster recovery

§ Typically 3 weeks to return to sport


Long-term prognosis: If treated early, conservative care typically relieves pain reliably by 6 weeks. Surgery recovery typically lasts 3-6 weeks. Orthotics should be used to prevent recurrence. Stretching should be performed before and after activity.


Who to call: Podiatrist, orthopedic surgeon

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