Challenge of the Week / Sports / 05.20.2022

A 30-year-old male patient presents with heel pain. He states that he had been running and felt a pop in the plantar medial aspect of his foot. He reports a long history of plantar fasciitis, for which he has been receiving corticosteroid injections. On examination, he has pain at the plantar medial aspect of his foot. A Thompson test demonstrates good plantar flexion. Which of the following is the most appropriate next step in treatment?
    • Immobilization and protected weight-bearing in a boot for 2 to 3 weeks, followed by physical therapy
    • This patient has sustained a plantar fascia rupture, and the appropriate treatment includes immobilization and a period of non-weight-bearing, followed by physical therapy.

 

    • Operative repair of the plantar fascia
    • Initial treatment of a plantar fascia rupture is not operative repair but immobilization and protected weightbearing.

 

    • Custom orthotics with a heel relief
    • Orthotics are insufficient for the initial treatment of a plantar fascia rupture as they do not limit motion and cannot adequately unload the heel.

 

    • Operative repair of the Achilles tendon
    • The Thompson test is not indicative of an Achilles tendon rupture; therefore, this is not the appropriate treatment choice.

 

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