Plantar Fascia Ruptures in Athletes

by Amol Saxena, DPM, PAMF and Brian Fullem, DPM Palo Alto Medical Foundation, Department of Sports Medicine, Palo Alto, California

Objective: To educate sports medicine practitioners as to length of time for an athlete to return to activity after sustaining a rupture of the plantar fascia.

Methods: Athletic patients sustaining plantar fascia ruptures and subsequent treatment were reviewed. Diagnosis was based on clinical findings, although radiographic studies were done. Patients were treated for 2 to 3 weeks with a below-knee or high-top boot, nonweightbearing, with an additional 2 to 3 weeks of weightbearing in the boot. Patients used physical therapy.

Results: Eighteen athletes, including 6 elite athletes, were evaluated. Mean age was 40.9 ± 13.2 years. There were 12 males and 6 females. Mean postinjury follow-up was 42 months. Duration of prior plantar fascia symptoms ranged from 0 to 52 weeks. All but 2 ruptures were of the medial portion. Four patients had injections prior to rupture. Five patients wore orthoses preinjury; 14 wore orthoses postinjury. All patients returned to activity after 2 to 26 weeks (mean, 9.1 ± 6.0 weeks). Running athletes predominantly composed the cohort; others played tennis, volleyball, and basketball.

Conclusion: Using the treatment protocol, patients sustaining plantar fascia rupture can achieve favorable results with complete return to activity. None of the 18 patients sustained reinjury, had postinjury sequelae, or necessitated surgery, contrary to other studies.

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