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Clinical Case 13
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1

JK is a 43 year-old man who has come in to the office for evaluation of pain in his right ankle. He had a similar episode 4 years ago following a series of road races. He is a runner and has recently increased mileage in preparation for a marathon in July. He states that he tries to stretch before all of his training runs, but may not have been doing this as much lately. He reports no trauma to his ankle. He routinely changes his running shoes every 3-4 months and began wearing his current pair 3 weeks ago. His pain is located in the ankle just above the point of the heel. He notes tenderness and mild swelling to the affected area. Pain is worse with dorsiflexion of the foot. There is no pain with forced inversion at the ankle. No tenderness is noted over either malleolus or other bony prominences. His ankle is not loose or unstable on examination.

Which of the following treatments is most appropriate for JK?
A)Rest with ice applied to the affected area
B)Warm compresses
C)Steroid injection
D)Casting of the foot
E)Change of running shoes more frequently





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