Plantar Fasciitis

  • Stretching

    Plantar fascia stretching exercises are crucial in managing conditions like plantar fasciitis. These aim to alleviate tension in the thick band of tissue that runs along the bottom of the foot. Effective stretches include dorsiflexion of the ankle, rolling a frozen water bottle under the arch, and using a towel to gently pull the toes towards the body. These activities should be performed regularly, especially in the morning and before weight-bearing activities. Emphasize gradual, controlled movements to avoid overstretching. Additionally, advising patients to wear supportive footwear can complement these exercises. Consistency and proper technique are key for optimal results in alleviating foot discomfort.

  • Night Splint

    A night splint in plantar fasciitis treatment is a specialized device worn during sleep. It maintains the foot in a dorsiflexed position, gently stretching the plantar fascia and Achilles tendon. This prevents the tissue from contracting overnight, reducing morning pain and stiffness. Dr. Husein recommends patients use it consistently for optimal results. It complements daytime exercises and is particularly beneficial for those with severe symptoms or tight calf muscles. Advise wearing socks to enhance comfort. Regular follow-ups should evaluate progress and adjust treatment accordingly.

  • OTC Orthotic

    Over-the-counter (OTC) orthotics are prefabricated insoles designed to provide arch support and alleviate plantar fasciitis discomfort. They offer a cost-effective and accessible option for patients. Dr. Husein suggests selecting OTC orthotics with adequate arch support and cushioning to distribute pressure evenly. They should fit comfortably in the patient's shoes and be replaced periodically to maintain effectiveness. While not as personalized as custom orthotics, OTC versions can offer significant relief for mild to moderate cases. It's important to educate patients on proper usage and monitor their progress during follow-up appointments.

Steroid Injection

Dr. Husein, the goals of a plantar fasciitis steroid injection are to alleviate pain and inflammation in the plantar fascia, facilitating improved function and mobility for the patient. This treatment is indicated when conservative measures like stretching exercises and orthotics have not provided sufficient relief. The steroid, typically cortisone, is injected directly into the affected area to reduce inflammation and ease discomfort. It aims for a targeted and rapid response.

However, it's crucial to inform patients of potential risks. These may include temporary pain at the injection site, a slight risk of infection or bleeding, and very rarely, fat pad atrophy or plantar fascia rupture. Emphasize that such risks are minimal and the potential benefits often outweigh them. Routine follow-up evaluations are recommended to monitor progress and adjust the treatment plan if necessary.

Tenex Procedure


The Tenex procedure, also known as percutaneous tenotomy, is a minimally invasive technique used to treat plantar fasciitis. It involves the use of ultrasound guidance to locate and remove damaged tissue in the plantar fascia. A specialized tool is inserted through a small incision to precisely target and break down the affected areas. This promotes healing and reduces inflammation.

The procedure is performed on an outpatient basis and typically takes about 20-30 minutes. It offers the advantage of minimal downtime and a quicker recovery compared to traditional surgery. While generally considered safe, potential risks include infection, nerve damage, or incomplete relief.

Follow-up care should include monitoring for any signs of complications and assessing the patient's progress in managing their plantar fasciitis.

Endoscopic Plantar Fascia Release (EPFR)

Endoscopic Plantar Fascia Release (EPFR) procedure is a surgical intervention used to address severe or refractory cases of plantar fasciitis. It involves making small incisions near the heel and ankle through which an endoscope is inserted. This allows for direct visualization of the plantar fascia.

Using specialized instruments, the surgeon then releases tension in the fascia by making precise incisions. This procedure aims to alleviate pain and improve mobility by reducing tension on the plantar fascia. EPFR is considered less invasive than traditional open surgery, leading to a potentially faster recovery and reduced risk of complications.

However, it's important to discuss potential risks with patients. These may include infection, nerve damage, or incomplete relief. Patient selection and proper technique are crucial for successful outcomes. Post-operative care should include monitoring for any signs of complications and assessing the patient's progress in managing their plantar fasciitis.