In this article you will find:
Patient profile
- Age: 32
- Height: 197 cm
- Weight: 93 kg
- Position on the court: Receiver
Description of the injury
After one of the training sessions, the player reported pain in the heel area to the physiotherapist. Mainly at the tip and on the medial side. Following initial physiotherapy treatment, the volleyball player did not experience any significant improvement. The symptoms recurred – sometimes more severely, sometimes less so.
Physical examination
Palpation and a medical consultation, supported by X-ray and ultrasound examinations, confirmed the presence of inflammation within the plantar fascia and visible changes in the calcaneus.
Functional limitations prior to the start of treatment
The volleyball player was unable to participate actively in training freely and without pain. Landing and sudden changes of direction triggered severe pain in the aforementioned area.
Treatment and rehabilitation
No pharmacological medication was used. Treatments were carried out using the high-power POLARIS HP S laser, the IMPACTIS M+ shockwave therapy device and the TECARIS TECAR therapy device.
The following parameters were used for laser therapy (POLARIS HP S)
| Date of treatment | Output power [W] | Operating mode | Dose [J/cm²] | Treatment area [cm²] | Duty cycle [%] | Frequency [Hz] |
|---|---|---|---|---|---|---|
|
15 Dec |
5/5 |
continuous |
30/30 |
30/30 |
– |
– |
|
16 Dec |
5/5 |
continuous |
30/30 |
30/30 |
– |
– |
|
17 Dec |
5/5 |
continuous |
30/30 |
30/30 |
– |
– |
|
18 Dec |
5/5 |
continuous |
30/30 |
30/30 |
– |
– |
|
26 Dec |
5/5 |
continuous |
30/30 |
30/30 |
– |
– |
|
27 Dec |
5/5 |
continuous |
30/30 |
30/30 |
– |
– |
|
28 Dec |
5/5 |
continuous |
30/30 |
30/30 |
– |
– |
|
29 Dec |
5/5 |
continuous |
30/30 |
30/30 |
– |
– |
|
30 Dec |
5/5 |
continuous |
30/30 |
30/30 |
– |
– |
|
31 Dec |
5/5 |
continuous |
30/30 |
30/30 |
– |
– |
No pharmacological medication was administered.
Treatments were carried out using the IMPACTIS M+ shockwave device
| Date of treatment | Pressure [bar] | Frequency [Hz] | Number of pulses |
|---|---|---|---|
|
15 Dec |
3 |
12 |
3000 |
|
22 Dec |
3.5 |
12 |
3000 |
|
30 Dec |
3 – 4 |
13 |
3000 |
The following parameters were used for TECAR therapy (TECARIS)
| Date of treatment | Operating mode | Output signal frequency [kHz] | Power level [%] | Modulation mode | Treatment duration [min] | TWS scale |
|---|---|---|---|---|---|---|
|
15 Dec |
CAP + RES |
500 + 300 |
16 -36 |
– |
10 – 20 |
|
|
16 Dec |
CAP + RES |
500 + 300 |
16 -36 |
– |
10 – 20 |
|
|
17 Dec |
CAP + RES |
500 + 300 |
16 -36 |
– |
10 – 20 |
|
|
18 Dec |
CAP + RES |
500 + 300 |
16 -36 |
– |
10 – 20 |
|
|
19 Dec |
CAP + RES |
500 + 300 |
16 -36 |
– |
10 – 20 |
|
|
26 Dec |
CAP + RES |
500 + 300 |
16 -36 |
– |
10 – 20 |
|
|
27 Dec |
CAP + RES |
500 + 300 |
16 -36 |
– |
10 – 20 |
|
|
28 Dec |
CAP + RES |
500 + 300 |
16 -36 |
– |
10 – 20 |
|
|
29 Dec |
CAP + RES |
500 + 300 |
16 -36 |
– |
10 – 20 |
|
|
30 Dec |
CAP + RES |
500 + 300 |
16 -36 |
– |
10 – 20 |
Additional rehabilitation treatments
- Sports massage
- Pinopressure
- Eccentric exercises
- Isometric exercises
- Rolling
- Dry needling
- Manual therapy
Summary of treatment
After just under two weeks of intensive therapy and work with the patient (despite an initial increase in pain at the site of the injury, which was a normal part of the treatment process), the symptoms had subsided enough to allow a return to training. The volleyball player also used insoles to relieve pressure on the painful area, which further accelerated the healing process.
Treatment for heel spurs is generally a fairly long and complex process, particularly when it involves competitive athletes. The period required for a full course of treatment is significantly shorter for someone who does not train regularly. A “race against time” is not helpful, but properly conducted physiotherapy and training under the supervision of a fitness coach, appropriate load management and recovery all determine the speed of return to activity.
An athlete’s perspective
„I am an experienced athlete who has often struggled with pain in my lower limbs. However, this particular episode was particularly troublesome, so together with the team’s physiotherapist, we decided to seek an orthopaedic consultation. Unfortunately, our suspicions were confirmed. So we continued with the treatment we’d already begun to address the symptoms caused by heel spurs and aponeurosis inflammation. It wasn’t a pleasant experience (laughs). Nevertheless, thanks in part to the equipment from ASTAR, we managed to significantly reduce my problems, and I was able to take part in the next match.”
