The Center for Podiatric Care and Sports Medicine

Triathlon Injury-Plantar Fasciitis

Posted by on Wednesday, July 20th, 2011


In March I was invited to speak to TRIARQ,a community of physicians,patients and physical therapists, on Plantar Facsiitis. I would like to share some of the salient points of the lecture. Plantar Fasciitis is a condition whose cause is primarily biomechanical in nature.The pain associated with plantar fasciitis is usually located to one of three areas on the foot. The attachment of the fascia to the heel,under the center of the heel or along the arch.The pain of plantar fasciitis is usually delayed. What I mean is that in the early stages of plantar fasciitis you can run without pain but the pain occurs about 1-2 hours after your run.The pain is usually worse the next morning ,especially the first steps out of bed and is bad after periods of inactivity.When the condition becomes more chronic the pain can occur during a run as well as afterwards.
In 1998,Dr. Lai and I presented a paper at the annual meeting of the American College of Foot and Ankle Surgeons entitled Conservative treatment of Plantar Fasciitis and Intermetatarsal Neuroma with Orthotic Devices.The purpose of the paper was to present a retrospective review of 53 consectutive neuroma and 107 consecutive plantar fascial patients who were prescibed orthotic devices for treatment.We concluded that orthotic devices are an effective treatment for neuroma and plantar fasciitis. The significance of our paper was that neuromas and plantar fasciitis are common foot problems which should be treated conservatively first with orthotic devices before considering surgery.The results of our paper concluded that most cases of plantar fasciitis and intermetatarsal neuromas improved or resolved with conservative treatment. The corrections on the orthotic must be very specific for the patients biomechanical problems and condition in order to be successful and that 92% of patients did not require surgery.
Since 1998 we have found that with the advent  of newer technologies including Extracorporeal Shockwave Therapy,Platelet Rich Plasma Therapy injections and biopuncture with plant based injectables we have increased our success rate even more.We now operative on less than 3% of patients with plantar fasciitis.In those patients who require surgery we either will do a coblation(Topaz) procedure or an Endoscopic Plantar Fascial release through a minimal incisional approach.


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.