Robert Rosenstein, DPM
Michael Coppers, DPM
CONDITIONS AND TREATMENTS
TENNIS
Plantar fasciitis is the term commonly used to refer to heel and arch pain traced to an inflammation on the bottom of the foot. More specifically, plantar fasciitis is an inflammation of the connective tissue, called plantar fascia, that stretches from the base of the toes, across the arch of the foot, to the point at which it inserts into the heel bone. Overpronation is the most common cause of plantar fasciitis. As the foot rolls inward excessively when walking, it flattens the foot, lengthens the arch, and puts added tension on the plantar fascia. Over time, this causes inflammation.
Also known as heel spur syndrome, the condition is often successfully treated with conservative measures, such as the use of anti-inflammatory medications, ice packs, stretching exercises, orthotic devices, and physical therapy. Note: Please consult your physician before taking any medications. In persistent cases, Extracorporeal Shock Wave Treatment (ESWT) may be used to treat the heel pain.
Extracorporeal Shock Wave Therapy (ESWT) is used to treat chronic heel pain (plantar fasciitis). "Extracorporeal" means "outside of the body." During this noninvasive procedure, sonic waves are directed at the area of pain using a device similar to that currently used in nonsurgical treatment of kidney stones.
Extracorporeal Shock Wave Therapy is prescribed for patients who have experienced plantar fasciitis for an extended period of time -- six months or more -- and have not benefited from other conservative treatments. The brief procedure lasts about 30 minutes and is performed under local anesthesia and/or "twilight" anesthesia. Strong sound waves are directed at and penetrate the heel area to stimulate a healing response by the body. ESWT is performed on an outpatient basis. Although there are no bandages, someone will need to drive the patient home.
People who are not candidates for ESWT include pregnant women and individuals with neurological foot disease, vascular foot disease, pacemakers, or people taking medications that interfere with blood clotting (such as Coumadin).
This therapy is a safe and effective alternative treatment for heel pain and only requires a short recovery time. Clinical studies show a 70 percent success rate for treatment of plantar fasciitis using Extracorporeal Shock Wave Therapy.
Quick starts and stops and lots of movements from side to side are the characteristics that make tennis challenging -- and stressful on your feet. Amateur and professional tennis players alike are prone to injuries of the foot and ankle, primarily from repeated lateral motions and quick stopping and starting. Clay and crushed stone courts help players slide better, and are considered the safest surfaces on which to play. Asphalt, concrete, rubberized, or carpeted courts don't allow sliding, and are not as healthy for your feet.
Common tennis injuries include ankle sprains, stress fractures, plantar fasciitis, and tennis toe. If you experience recurring or persistent pain, please contact our office for an evaluation.
The best way to prevent foot injuries from tennis is to make sure you condition yourself. This includes building all-around body strength and flexibility; stretching the muscles (particularly in your calves) before, during and after play; drinking lots of water; and wearing the right shoes.
Tennis Shoes
Tennis shoes need lots of cushioning and shock absorption to deal with all the forces placed on your feet during play and to keep your foot and ankle stable. Be sure to choose shoes specifically for racquet sports; running shoes, for example, don't have the support needed for the side-to-side movements common to tennis. Look for a tennis shoes that have a reinforced toe, wiggle room in the toe box, padding at the ball of the foot, sturdy sides, a low, well-cushioned heel that is not flared, and a firm heel counter for support.
When shopping for tennis shoes, follow these tips:
- Try on shoes with the socks you normally wear to make sure the fit is right.
- Go shopping at the end of the day when your feet are larger and fit your shoes to the larger of your two feet.
- Let your feet be your guide to fit. Choose only shoes that are comfortable in the store -- don't expect a wear-in period. The shoes should feel supportive, cushioned. and flexible, with some resistance in the heel for greater stability.
- Walk around the store in each pair you try on. Be sure to walk on a hard-surface, not just a carpeted floor. Emulate tennis play by jumping up and down in the shoes and making some fast turns to see how the shoes will really perform.



