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What do I do with a ruptured medial plantar fascia?

 

Question: What do I do with a ruptured medial plantar fascia?

I found this site by googling and was directed to an article about rugby players with ruptured plantar fascia after sprained ankles. That's, in a nutshell, what happened to me.

Three ligament grade 2 sprain last September; immobilized in aircast then soft cast for two months, caused massive tendinitis in my achilles and plantar fascia; much PT and stretching and it seemed better. Two days ago SNAP during martial arts training, no lateral stability anymore, bruising underneath and on the side where the medial connects, etc.

My well meaning but youthful and unknowledgeable PCP said it was probably "just a flare up" which of course it isn't since I know what flare ups feel like and they don't pop and cause me to collapse and put no weight on it. Especially not with bruising. Waiting for a referral to a specialist.

In the meantime, what the heck do I do? I can't keep ALL weight off it -- I have to work, drive, get dressed, etc., I don't have a hard cast and even if I did that's what started this whole episode to begin with. If I really tore it clear through what do I do to rebuild it? Do I need surgery? How do I avoid having this put additional pressure on my main PF that runs from my heel up to my toes, instead of just this side one that runs along the inside of my ankle?

Help?

Answer:

I have just picked up your post and seeing as i wrote that article i thought i would throw my opinion in.

Believe it or not, rupturing your plantar fascia if it has been in pain long term (ie, chronically degenerated) is actually a good thing. When you recover from this set back you will actually find you have no further problems (ie pain) with it. No surgery is needed.

It will take about 4 weeks for the pain and swelling to subside and after that you should be right to go. Those rugby players mentioned in that piece played within 3-4 weeks post injury.

However, to make sure you have no arch problems long term or any functional issues, you need to do a number of things.

Firstly, have a physio/podiatrist strap your arch for the next 4 weeks to protect it. This is called a low dye strap. This will allow you to walk without too much discomfort after the 1st week. No need for splinting or an aircast boot.

Next at 4 weeks post injury, see a podiatrist to have an orthotic made up to control your pronation. You need to be walking without a limp when you have this done.

Next, you will need to train the small intrinsic foot muscles that will be needed to support your arch in the absence of the plantar fascia. Do some monkey tricks. Pick up small objects with your toes by grasping them by clenching up the toes.

Let us know how you go.

Regards
Chris Mallac

Answer:

OK,
I agree with above .
Now ...
I also have injured my plantar fascia medial band. It is tender and has a fusiform hypoechoic swelling on the media side 1cm from origin on calcaneus on US. I think it happened snowboarding 8 weeks ago and aggravated 4 weeks ago. I am using non prescription orthotics, tried stretching, massage, rest, acupuncture, topical nsaids, but swelling pain and tenderness persist. Any thoughts on which way to go from here? Am considering autologous blood. Seems like a tendinosis of sorts.

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