Clinical Presentation & Protocol
Patient Usually Complains Of
Classic presentation of 'start-up' pain. Severe, sharp heel/tendon pain taking the first steps out of bed in the morning or after prolonged sitting. Pain lessens with initial ambulation but returns with prolonged weight-bearing. No acute trauma.
Clinical Examination Findings
Healthy, often active or obese individuals.
Treatment Protocol
1. Rigorous daily eccentric stretching program (Alfredson protocol / Plantar fascia specific). 2. Prescribed silicone heel cups/orthotics to cushion heel strike. 3. Night splint prescription to maintain ankle dorsiflexion. 4. NSAIDs and ice-bottle rolling regimen. 5. Extracorporeal Shockwave Therapy (ESWT) discussed.