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Pain at start of heel classically in early morning
examine from back and look for over-pronation
find the neutral place for the talus and ask them to lift their toe compared to standing normally
Mx
stretching if not painful
injection - into where heel changes to forefoot in point of maximal tenderness
Use 1ml - 0.5 of 1% lignocaine and 0.5 of 40mg in 1 ml of kenalog
Initially it may feel worse and the pain should settle over the next week
risks of injection - infection and tendon rupture