The condition is generally self-limiting with conservative means; however, improvement is often gradual and commonly prolonged. Daily plantar fascia and Achilles tendon stretching are cornerstones of management25-27 (Fig. 70-16). Multifaceted con-
servative treatment yields success rates in excess of 90%.26 Adjunctive treatment such as orthotics devices, night splints, anti-inflammatory medications, and ultrasound therapy are other treatment modalities.
Activity modification with cessation of impact-loading activities and institution of cross-training activities are also helpful. A cortisone injection may be used with caution; its strong anti-inflammatory effect should be weighed against potential side effects (e.g., plantar fascia rupture or fat-pad atrophy).
Biomechanical assessment of lower extremity alignment is a vital component in treatment and to circumvent recurrence. Physical examination of the foot with the patient positioned in prone facilitates assessment of the hindfoot-forefoot alignment (Fig. 70-17). Semirigid shoe inserts may be prescribed to accom-
Figure 70-17 A clinical photograph of a biomechanical foot examination performed in a prone position. The "tripod" of the foot formed by the calcaneal tuberosity and head of the first and fifth metatarsals can be readily assessed.
modate abnormal foot structure. It remains an essential component of treatment, especially in running athletes.
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Everything you wanted to know about. How To Cure Tennis Elbow. Are you an athlete who suffers from tennis elbow? Contrary to popular opinion, most people who suffer from tennis elbow do not even play tennis. They get this condition, which is a torn tendon in the elbow, from the strain of using the same motions with the arm, repeatedly. If you have tennis elbow, you understand how the pain can disrupt your day.