Treating Plantar Fasciitis in Runners: Load Bearing Treatment Accelerates Recovery

For dedicated runners, heel pain that will not go away is frustrating and takes the joy out of running. Ignoring the pain may work for a while, but eventually, you will need to enjoy running again.

In the past, treatment for plantar fasciitis involved mostly stretching of the calf muscles and Achilles tendon, along with orthotic inserts. However, new research has revealed that a load bearing approach that strengthens all of the structures surrounding the plantar fascia may accelerate healing and prevent recurring episodes of plantar fasciopathy.

 

Treating Plantar Fascitis in Runners

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In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)

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Complete tear of rectus femoris
with large hematoma (blood)

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Separation of muscle ends due to tear elicited
on dynamic sonography examination

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