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Surgical decisions in athletes' subcalcaneal pain

Sports Medicine Center, St. Anthony Orthopaedic Clinic, St. Paul, Minnesota

A group of 182 patients with subcalcaneal pain related to sports activity was studied to determine injury types and patterns. Running/jogging produced the greatest percentage of subcalcaneal injuries, 76%. A survey was done of the specific types of heel pain, plantar fasciitis and median calcaneal neuritis. A review of each entity was given and surgical approach was detailed. Subcal caneal surgical decision making is based on six specific tenets: 1) correct diagnosis; 2) approximately 12 months of conservative treatment; 3) EMG for diagno sis and appropriate nerve blocks; 4) thorough knowl edge of the anatomy or complete review; 5) patient understanding that surgery may not give a good enough result to allow the return to high performance athletics; and 6) correct and appropriately directed sur gery.

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