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Walker boot immobilization with full weightbearing for 4 weeks
9%
228/2459
Corticosteroid injection to the plantar fascia
7%
163/2459
Surgical release of 50% of the plantar fascia
1%
29/2459
Heel spur resection
3%
80/2459
Achilles stretching exercises
79%
1949/2459
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This is the classic history of plantar fasciitis. The typical patient is 40-70 years of age and can point almost directly to the plantar medial heel as the source from where the pain emanates. It is a degenerative process associated with micro-tears of the plantar fascia. Figure A shows a calcaneal spur. It is widely accepted that heel spurs can occur concomitantly with plantar fasciitis, but they are not the etiology of the disorder. Treatment is predominantly aimed at intrinsic toe stretching (Illustration B) combined with Achilles stretching (Illustration A) as gastrocnemius contractures are often found concomitantly. Night splints have also been found to help. If surgery is required because conservative management fails after 6-12 months, only the medial third of the plantar fascia is released so that the medial longitudinal arch is not compromised.
3.6
(47)
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