Plantar Fasciitis: Distal Tarsal Tunnel (Baxter's Nerve) in the Athlete

Abstract

Plantar medial inferior heel pain is a common complaint in athletes and is frequently caused by plantar fasciitis and/or distal tarsal tunnel syndrome (Baxter's neuropathy). Obtaining an accurate diagnosis is crucial but may be challenging due to a similar site of pain and overlapping symptoms. While both conditions often resolve with nonoperative management, they may present with a prolonged symptomatic course that can last 10-12 months. Consequently, providers treating athletes should understand the various therapies proposed to address these pathologies as no one optimal treatment strategy has emerged. Stretching exercises, orthotic devices, extracorporeal shock wave therapy , plasma-rich protein injections, and endoscopic plantar fascia release have garnered the most attention for the management of plantar fasciitis. Rest, non-steroidal anti-inflammatories , and open distal tarsal tunnel release have been employed for the treatment of Baxter's neuropathy. This review summarizes recent literature on the diagnosis, numerous nonoperative treatment options, and surgical management of plantar fasciitis and distal tarsal tunnel syndrome.