Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with bilateral heel pain, characteristically worse with the first few steps in the morning and after prolonged periods of inactivity. Pain is localized to the medial calcaneal tubercle. Symptoms are exacerbated by weight-bearing activities and prolonged standing. No history of trauma, numbness, or paresthesia reported.
Clinical Examination Findings
Physical examination reveals point tenderness at the medial calcaneal tubercle bilaterally. Pain is reproduced with passive dorsiflexion of the toes (Windlass test). Gait analysis shows an antalgic component. No signs of erythema, edema, or ecchymosis. Neurovascular status is intact bilaterally with palpable pedal pulses and normal sensation.
Treatment Protocol
Conservative management initiated: activity modification, avoidance of barefoot walking, and use of supportive footwear with orthotic arch support. Prescribed a regimen of plantar fascia stretching exercises and calf muscle stretching. Recommended icing the affected areas 15 minutes twice daily. Consider NSAIDs as needed for pain management.