Name:
Plantar Fascitis Injection Technique
Description:
Plantar Fascitis Injection Technique
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Duration:
T00H06M26S
Embed URL:
https://stream.cadmore.media/player/8123338e-56ad-42d4-af72-f128a83b3f2b
Content URL:
https://cadmoreoriginalmedia.blob.core.windows.net/8123338e-56ad-42d4-af72-f128a83b3f2b/Plantar Fascitis Injection Technique.mp4?sv=2019-02-02&sr=c&sig=SV1mPMPvdRYzMqywRn7SlU6BnQahi9awRKuJqEfsDss%3D&st=2024-11-23T09%3A52%3A54Z&se=2024-11-23T11%3A57%3A54Z&sp=r
Upload Date:
2024-06-01T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
Hello today, I'm going to demonstrate you with a technique in which I will show you how to inject a plantar fascia for a clinical condition called plantar fasciitis. Now, plantar fasciitis is an extremely common condition both in developed as well as developing country, and the patient will report pain in his or her heel. That will be worse first thing in the morning.
So as soon as patient wakes up and puts the feet on the ground, they will report a lot of pain. And as the day goes on, the pain will get better, but it will still be there. Now Plantar fasciitis is usually a self-limiting condition, which gets better on its own by painkillers and various exercises and other treatment modalities, and 90% of the patients do get better. Up to a duration of around one year, a small percentage of patients you are required to inject either steroid or platelet rich plasma in order to make their pain go away.
And less than 5% of the cases require surgical intervention. So today I'm going to show you how I do my injection for plantar fasciitis. A patient is on its position. We have cleaned the area with betadine and chlorhexidine solution. Now where do you inject? Now you should inject in the most tender spot, but I will try to give you a landmark.
So if I draw up, this is the medial malleolus. So this is the a border, and this is the positive border. So draw a line going straight down. Following the posterior border of the medial malleolus, and the second line is usually a finger breadth about so this is the finger debatable. And so if I draw a line here. Roughly, you saw as I draw the patient winced, so usually this will be the most tender spot.
So this is the point at which we are going to do our injection. So other finding that you will see in a lot of patients with plantar fasciitis, if I don't see flex the foot or solve the toe, you will see the medial border of the plantar fascia becoming prominent. So if I just show you here, you can see the medial border of the plantar fascia is getting promoted.
Usually, it's the medial side, which is inflamed, and hence when you press on the medial side, you get the typical tenderness of plantar fasciitis. Now, in terms of approaches, there are two commonly used approaches. One is you can go through the sole like here and the other you can go through the medial side. Now I would recommend that you don't use the approach through the sole for two reasons.
First are the sole skin of the sole is very thick. And if you pierce it, it's very, very painful for the patient. Secondly, it leads to a higher percentage of fatty atrophy, so I would never recommend you to do injection through the sole, even though it is a direct approach. But I would recommend that you don't use it. So the approach that we are going to use today is the medial approach, and I have shown you how to come to that area of interest or area of injection.
Now, in terms of cocktail, if you are doing an ultrasound guided technique, you can just use 40 milligrams of diplomat drone with fewer Mils of 1% or 2% As I look in planes, I look in. However, since we are doing this blind, I usually use a slightly larger volume. So this has got 40 milligrams or a drone, and I have mixed it with around two or three miles of 1% xylo cane.
So now I'm going to show you how to do this injection. So now this is our mixture loaded, I'm just going to give it a shake, try to use a smaller gauge needle because then patients will feel less pain. So we are going through our area that we have identified. And we'll just. Take it deep and you want to aspirate and then slowly inject.
While injection, you have to be sure that you don't want to inject majority of it in the fat or directly into the plantar fascia, so it's slightly discomforting for the patient. But as soon as the fact of local anesthetic starts to take over, the patient will report that the pain is much better. So this is the injection gone.
So just take this away, and that is your injection done now, the advantage of the medial approach is the patient can straightaway walk after this procedure and has got. A very low incidence of fatty atrophy, and it is much, much, much less painful for the patient. So we was this was a demonstration on how I do my plantar fascia injection for plantar fasciitis. I think it's extremely important that you combine these injections with lifestyle modifications such as soft footwear or silica gel pads, along with heel drop exercises.
I think heel drop exercises are extremely, extremely crucial in treating this condition, so we will thank you for watching this video. If you like this video, give us a thumbs up. Do subscribe and to share our channel.
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