Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

Torn Fascia

Posted by Elena S. on 10/26/01 at 21:18 (063664)

Hello. I've been told according to an x-ray that I have a partially torn fascia. When I walk on my heel, I feel a cracking sensation, which gets painful if I continue to walk for some time, like walking on an open sore. I feel the inflammation has gone down but I have been left with this symptom. I have had one cortisone shot 2 weeks ago. I've been told to keep walking on my foot and riding a bike to see if the fascia tears completely. If it hasn't by 15 days, I'm supposed to get another cortisone shot to see if it finishes tearing. If not, an operation to cut it is recommended. I've read that cortisone shots can diminish the fat layer on the heel. Is this true? Do you agree with trying to tear the fascia completely?

Re: Torn Fascia

Dr. Zuckerman on 10/27/01 at 23:49 (063700)

Hi,

No I don't agree with this aproach. I would need more information and an evaluation to determine if in fact it is torn.

Additional steriod injections will only damage the area. IF in fact this is a true rupture of the fascia then Boot casting, rest, and physical therapy would be my first line of treatment.

The goal is to heal any tears in the fascia not to induce or increase the hange of tearing. I doubt whether you have a true rupture of any part of the plantar fascia. The idea of trying to make it tear even more is just
off the wall in my opinion

Re: Torn Fascia

Dr. David S. Wander on 10/28/01 at 08:36 (063713)

I agree with Dr. Zuckerman. Giving injections to completely rupture the plantar fascia is bizarre and certainly not the acceptable standard of care. First, how did the doctor determine that there is a partial rupture by a traditional x-ray? The most accurate non invasive way to determine whether there is a true rupture/partial rupture would be an MRI. And although there are sugical techniques to release the plantar fascia, those techniques are via a controlled procedure via an endoscope, open incision, or under flouroscopy. Injecting cortisone to completely rupture the fascia may rupture the entire width of the fascia, which is rarely recommended in surgery. Additionally, the continued injections can cause a myriad of other complications including atrophy of the surrounding tissues. I would recommend you purchase a quality pair of running shoes......so you can run out of that doctor's office!!

Re: Torn Fascia

Dr. Zuckerman on 10/27/01 at 23:49 (063700)

Hi,

No I don't agree with this aproach. I would need more information and an evaluation to determine if in fact it is torn.

Additional steriod injections will only damage the area. IF in fact this is a true rupture of the fascia then Boot casting, rest, and physical therapy would be my first line of treatment.

The goal is to heal any tears in the fascia not to induce or increase the hange of tearing. I doubt whether you have a true rupture of any part of the plantar fascia. The idea of trying to make it tear even more is just
off the wall in my opinion

Re: Torn Fascia

Dr. David S. Wander on 10/28/01 at 08:36 (063713)

I agree with Dr. Zuckerman. Giving injections to completely rupture the plantar fascia is bizarre and certainly not the acceptable standard of care. First, how did the doctor determine that there is a partial rupture by a traditional x-ray? The most accurate non invasive way to determine whether there is a true rupture/partial rupture would be an MRI. And although there are sugical techniques to release the plantar fascia, those techniques are via a controlled procedure via an endoscope, open incision, or under flouroscopy. Injecting cortisone to completely rupture the fascia may rupture the entire width of the fascia, which is rarely recommended in surgery. Additionally, the continued injections can cause a myriad of other complications including atrophy of the surrounding tissues. I would recommend you purchase a quality pair of running shoes......so you can run out of that doctor's office!!