Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, stabbing pain in the left plantar heel, most pronounced during the first steps upon awakening or after prolonged periods of inactivity. Pain improves with initial ambulation but exacerbates toward the end of the day. No history of acute trauma, numbness, or paresthesia.
Clinical Examination Findings
Physical examination of the left foot reveals localized tenderness at the medial calcaneal tubercle. Passive dorsiflexion of the toes reproduces the pain (Windlass test positive). No signs of erythema, edema, or ecchymosis. Neurovascular status intact with palpable dorsalis pedis and posterior tibial pulses.
Treatment Protocol
Initiate conservative management including: 1. Stretching exercises for the plantar fascia and Achilles tendon. 2. Use of supportive footwear with orthotic inserts/heel cups. 3. NSAIDs as needed for pain control. 4. Night splinting if symptoms persist. 5. Consider physical therapy referral for myofascial release.