Reply With QuoteAre you able to bear weight through your foot, or are you able to walk with a heel to toe gait right now?
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possible plantar rupture
I was playing basketball and felt a tear in my heel paired with a loud popping noise. This video from Toledo Med accurately describes the injury: Rupture of the Plantar Fascia - Everything You Need To Know - Dr. Nabil Ebraheim - YouTube
A 24 hour nurse line as well as a therapist from an orthopedic clinic told me the same thing: They will take an X-Ray to make sure no bone was pulled off with the tendon, and then an ultrasound or MRI to look at the location and severity of the tear. All this sounds like an extremely expensive way to have someone tell me to rest my foot.
The orthopedic clinics near me that I have called are a mandatory $200 down, plus whatever they want to charge for imaging and the visit in general. I estimate the cost would be around $3000 dollars after a $2000 MRI, $250 X ray, and whatever else they want to surprise me with based on the brief conversation with the receptionists, but they were not exactly sure. The billing offices tomorrow morning will provide the information I need.
I'm looking for alternative options such as having a referral for imaging provided by a telehealth doctor, and getting the imaging done at a radiology clinic. At that point I can see the specialist for diagnosis and treatment suggestions.
The goal is right balance between quality of treatment and economy of resources. What are the advantages of seeing the orthopedic sports clinic right away? Am I sacrificing care by trying to get the images prior to seeing them? Is all this even necessary for an injury where normal protocol is rest?
Ever since I had a doctor recommend an MRI for a condition that cleared up with a $15 antibiotic I have grown a weary of medical professionals in general. Its not that I believe they want to bilk you. It just seems that they don't always follow the MED model and recommend procedures that needlessly inflate the cost of care.
Starting Strength Coach
Are you able to bear weight through your foot, or are you able to walk with a heel to toe gait right now?
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I am able to stand and put some weight on the balls of my feet. I cannot walk normally or bear weight on the heel.Originally Posted by Will Morris
Starting Strength Coach
I'd be surprised if you actually had a full rupture. If the insertion on the heel had fully ruptured, I would not expect you to be able to bear weight on the balls of the feet, as the plantar fascia's job is to make your foot rigid when you shift the weight to the balls of the feet and / or toe off during gait.
As far as seeing someone right away.....I'm not entirely sure that would be of extreme benefit. The vast majority of providers are simply going to tell you to rest, and maybe a majority of those would put you in a CAM walking boot for 4-6 weeks. The plantar fascia is not a contractile tissue, therefore, even if fully ruptured, you aren't in danger of it retracting due to atrophy (to the best of my knowledge) which is why we repair tendon ruptures quickly.
I'm sorry I don't have specific guidance for you. A full rupture is extraordinarily rare. Partial tears not as rare, but I've never had a problem in the clinical setting with these healing well with progressive resistance training. Might be worth reporting back in a few days to see how your symptoms have changed.
✓ Member
I ended up seeing the Orthopedic clinic on Monday evening. They were pretty consistent with what you said. In hindsight its hard to say whether it was worth it or not. They did not take any images since he didn't suspect any bone damage, and diagnosed it as a tear. I've been using a walking boot and crutches I received from family and friends since Saturday. I am instructed to begin walking in just the boot w/o the crutches as soon as I am able. And to begin wearing a normal shoe after 2-3 weeks in the boot.
Every morning it feels a bit better. There has been some bruising developing, but I have been on my feet more. The first two days I was icing and elevating, and didn't see any bruising. I am still doing the RICE therapy, just less frequent. The pain has gone down significantly.
Starting Strength Coach
If nothing else, if being seen put your mind at ease that you didn't suffer a catastrophic injury, it was likely worth the clinic visit.
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Those are my general thoughts on it. When is the best time to begin training the squat and dead during this healing process?
Starting Strength Coach
I’m a bit of a maniacal madman, but if it were me, I’d consider no time like the present to start back.
✓ Member
Using a normal lifting shoe on the injured foot?
Starting Strength Coach
Just speaking for myself, but yes, yes I would.
I’d personally let the warm-ups dictate what I ended up with as far as load, and, I’d let myself continue to move up in load as long as my baseline pain didn’t stay elevated with sharper, more localized pain after more than about 30 seconds after finishing the set. If pain immediately returned to baseline, I’d keep going. But, I also have to admit that I treat myself differently than I can treat my patients.
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