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Updated: May 20, 2025

Predictive Measurement for Windlass Change in Length and Selected Treatment Outcomes in Chronic Plantar Fasciitis
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Surfers' Knot Causing Foot Pain in a Competitive Surfer.

Tyler M Janitz1, Jeff P Nadwodny2,3, Kavya Nuthi2

  • 1Department of Family Medicine, Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Jacksonville, Florida.

Clinical Journal of Sport Medicine : Official Journal of the Canadian Academy of Sport Medicine
|March 26, 2025
PubMed
Summary
This summary is machine-generated.

Competitive surfers experiencing foot pain may have surfers' knots. This case study shows conservative treatments, including anti-inflammatories and footwear modifications, effectively resolved symptoms, allowing a full return to surfing.

Keywords:
foot painknotmasssurfer

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Area of Science:

  • Sports Medicine
  • Orthopedics
  • Podiatry

Background:

  • Surfers' knots, characterized by plantar nodules near metatarsophalangeal joints, can cause pain in surfers.
  • Competitive surfing involves repetitive foot pressure, increasing the risk of such conditions.

Purpose of the Study:

  • To describe a case of surfers' knots in a competitive surfer.
  • To outline effective conservative treatment strategies for this condition.

Main Methods:

  • Case presentation of a 49-year-old male competitive surfer with bilateral foot pain.
  • Diagnostic imaging (MRI) to identify fibrotic tissue consistent with surfers' knots.
  • Conservative treatment including NSAIDs, topical diclofenac, specialized footwear, and surfboard traction pad adjustment.

Main Results:

  • Magnetic resonance imaging confirmed surfers' knots adjacent to the first and fifth metatarsophalangeal joints.
  • Conservative treatment led to symptom improvement within 8 months.
  • The patient achieved a full return to competitive surfing.

Conclusions:

  • Surfers' knots are a treatable condition in competitive surfers.
  • A multimodal conservative approach can successfully manage symptoms and facilitate return to sport.
  • Recommendations for athletes include anti-inflammatory medication, topical treatments, appropriate footwear, and equipment modification.