Basketball player with acute foot pain

Patient

Q: I have been experiencing severe foot pain in the bottom of my foot, more towards the outside of the bottom of it than the inside of the arch. It has been pretty consistent the past 5 days, pain level decreasing when I sit but increasing as I walk. It has been causing me to limp due to the pain. However, I noticed that I can jog if I remain on the balls of my foot because the pain is is barely noticeable. Any idea what I may have done to it? I am a basketball player, but only about 3 days a week

Doctor

A:    
The most common cause of foot pain is plantar fasciitis. It is usually caused by a biomechanical imbalance resulting in tension along the plantar fascia (arch). The diagnosis is typically based on the history and the finding of localized tenderness. Treatment consists of medial arch support, anti-inflammatory medications, ice massage and stretching. Corticosteroid injections and casting may also be tried. Surgical fasciotomy should be reserved for use in patients in whom conservative measures have failed despite correction of biomechanical abnormalities. Some useful measures following: placing a medial arch pad directly against the skin and taping the  foot from a plantar medial to a plantar lateral direction using 3-in wide tape. These temporary devices provide greater biomechanical support than over-the-counter heel cups or heel pads. Stretching the Achilles tendon facing a wall with one foot approximately 6 in from the wall and the other foot about 2 ft from the wall, and then lean toward the wall while keeping both heels on the floor. This exercise stretches the heel cord of the limb that is farther from the wall. It should be performed with both legs forward for two minutes each, three to five times daily. Each night for 10 to 14 days, you should apply an ice pack to the plantar arch 15 to 20 minutes before going to bed. An alternative approach is to massage the plantar fascia with an ice block (made up of water frozen in a paper cup) for 15 minutes per day for two weeks. And of course try to avoid those activities that worsen the pain, this will allow healing time and will prevent re injuries.

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