A female high school volleyball player is sitting at the doctors office to get a look at her injury. Her physical therapist is working on her knee.
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.
