Tiger Woods had to withdraw from the Hero World Challenge golf tournament last week because of a foot condition called plantar fasciitis. He stated that he will opt for a stretch and relax approach versus surgical intervention. Stretching is definitely a big part of the treatment plan for plantar fasciitis, but I hope he is going to do more than stretching alone, otherwise he may be in for a long layoff. Plantar fasciitis is the most common orthopedic complaint that I see in my practice. I have many patients that try self treatment with rest and stretching for a long time before they come in to see me. I hope that Tiger sought advice from a foot and ankle specialist. Quite often patients require additional treatments to get them out of pain and back to activities faster. After confirming the diagnosis with x-rays and musculoskeletal ultrasound, the initial treatment I most often employ is a cortisone injection into the inflamed area of the plantar fascia using the ultrasound image for placement. Although this may sound painful to you, it is usually quite tolerable for most patients. I use a thin gauge needle and a side of the foot approach to lessen the discomfort. The injection is very effective at reducing pain quickly, allowing progression to the rehabilitation phase of treatment faster. The rehabilitation phase is where we emphasize stretching and strengthening exercises. The final phase in treatment that many miss is the prevention phase. The key component in allowing the plantar fascia to fully heal and prevent recurrent injury is support of the arch. The most effective and convenient way to accomplish this is with foot orthotics, which are specialized insoles that are placed in the shoes. Obviously, the best kind of foot orthotic is one that is custom made to the shape of the person’s foot. Consistent use of custom foot orthoses along with a continued stretching regimen will keep the vast majority of cases of plantar fasciitis from coming back. I see hundreds of cases of plantar fasciitis yearly and only need to do surgery on 5 or 6 cases. If you think you or a loved one has plantar fasciitis, don’t wait it out. Come in for evaluation and treatment. You will get back to activity fast!
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