The Lingering Injury That’s Quietly Cost You Pickleball, the Golf Course, and Hikes with the Grandkids
Advanced, Non-Surgical Treatment for Sports and Tendon Injuries — Serving Marble Falls and the Highland Lakes
You know the feeling. The morning after pickleball, you’re limping through the kitchen. The second nine at the country club is a pain-management strategy, not a round of golf. The grandkids ask if you want to walk the trail at Inks Lake, and you find a reason to stay at the house. You decline the Saturday hike with your friends because you know exactly what it will cost you for the next three days. Little by little, an injury you assumed would “work itself out” has been quietly taking things off your calendar — and the friendships built around those activities are the next thing to go.
You don’t have to live with it. And you almost certainly don’t need surgery.
Book Your Appointment Now or call (830) 265-6000 to speak with our team directlyMedicare and most major insurance plans accepted.
Dr. Henry on Sports & Tendon Injuries
Trusted by Active Patients Across the Highland Lakes and Hill Country
“My posterior tibial tendon had been giving me trouble for almost two years. I’d stopped playing pickleball entirely — and that’s when my friend group started seeing less of me. My family doctor kept suggesting anti-inflammatories and ‘rest.’ Dr. Henry actually put his ultrasound on my ankle and showed me, in real time, exactly what was wrong. Between the custom orthotics and his shockwave treatments, I was back on the court in nine weeks. I tell everyone in my Bunco group about him.”
“I’d been told I had ‘arthritis in the ball of my foot’ and that I should just accept it. For two years, I couldn’t finish 18 holes without my foot burning. Dr. Henry took one look at my foot — really looked — did the ultrasound, and told me the actual problem was a plantar plate injury that everyone else had completely missed. He explained exactly how we were going to fix it without surgery. I finished my first full round in two years six weeks into treatment. I nearly cried on the 18th green.”
“The orthopedic surgeon in Austin told me I needed ankle ligament reconstruction — six weeks in a boot, three months of rehab, and I might still have issues afterward. Something in my gut told me to get a second opinion before I agreed to surgery. Dr. Henry found that the real driver of my ‘ankle instability’ was actually a mechanical problem in my foot that was pulling the ankle out of alignment with every step. He treated it non-surgically and I’m hiking again without the brace. I drove an hour and fifteen minutes to get to him. Worth every minute.”
Where Is Your Pain?
Tap the area that matches your pain to jump to the section that explains what’s really going on — and how we treat it without surgery.
Heel Pain
Plantar fasciitis, heel spurs
Back of Heel / Calf
Achilles tendonitis, calf strain
Arch & Inner Ankle
Posterior tibial (PTTD), peroneal tendonitis
Ball of the Foot
Morton’s neuroma, metatarsalgia, plantar plate
Shin / Ankle
Shin splints, ankle instability, sprains
My Child’s Heel
Sever’s disease, young athlete pain
Why Sports and Tendon Injuries Don’t Just “Heal on Their Own”
Most of our patients come in having already been told some version of this: “Rest it. Ice it. Take some Advil. Give it time.” They followed those instructions for six weeks, then six months, then a year — and the pain is still there.
Here’s what almost no one explains to you: chronic tendon pain is a completely different problem from an acute injury. The medical term has actually changed in the last decade — we used to call these conditions tendonitis (implying active inflammation). Today we call them tendinopathy, because the research is now clear: in a chronic tendon problem, there isn’t much active inflammation. Instead, the tendon tissue itself has stopped trying to repair. The healing signal has shut off.
That is why rest alone doesn’t work. You can rest a chronic tendon for a year, and it won’t heal, because the body has quietly filed the problem away as “finished” — even though the damage is still there, waiting to flare the moment you push off again on the pickleball court or shift your weight in your golf swing.
The same is true for overloaded joints, plantar plates, and stubborn ankle injuries. Without correcting the mechanical load causing the injury and restarting the healing process, you are stuck in a cycle of flare-up and frustration.
Our job is to break that cycle — by addressing both sides of the problem at the same time.
Why the Standard Approach Has Let You Down
⚠ Important Warning on Cortisone Injections
Cortisone injections in or near a damaged tendon should be approached with caution — and in many cases, avoided entirely. This is where we differ sharply from many providers. Cortisone has been shown to weaken tendon tissue and can significantly increase the risk of tendon rupture — a catastrophic injury that often does require surgery. The Achilles tendon is the most well-documented example, but the same concern applies to the posterior tibial tendon, peroneal tendons, and plantar fascia.
If a doctor has offered you a cortisone shot for a tendon problem, please get a second opinion first. We have seen too many patients whose ruptures could have been prevented.
Why “Custom” Inserts from Retail Stores and Other Clinics Often Fail
If you’ve already spent hundreds — or even thousands — on retail brands like Good Feet Store or “custom” inserts from another clinic, and your pain still hasn’t resolved, there’s a clinical reason. And it’s not your fault.
The “Weight-Bearing” Flaw
Most retail brands and even many medical providers take molds or scans of your feet while you’re standing up. This is a fundamental engineering mistake. When you stand, your foot collapses into the exact position that causes the pain. If you mold a foot while it’s collapsed, you get a device that simply holds you in that same damaging, uncorrected position. It’s a souvenir of the problem — not a solution for it.
Comfort Product vs. Medical Orthotic
The inserts you can buy off a shelf are designed to feel good under your foot. That’s a comfort product. A true medical orthotic is a precision instrument, engineered from a non-weight-bearing scan of your foot in its optimal skeletal position. One properly made medical orthotic will typically last 15 to 20 years with periodic tune-ups — making it, counterintuitively, the most financially conservative long-term choice for a chronic foot or tendon problem.
The Conditions We Treat
Click any condition below to expand the details. Each section explains what drives the pain, how we diagnose it, and how we resolve it without surgery.
“That first step out of bed in the morning feels like a knife.”
Heel Pain & Plantar Fasciitis
Heel Pain & Plantar Fasciitis
The classic plantar fasciitis pattern — searing pain with the first steps of the morning that eases after you’ve been walking, only to come roaring back after you’ve been sitting for a while. Most patients have already tried rolling a frozen water bottle under the arch, stretching against the wall, and several pairs of “arch support” inserts. Plantar fasciitis is one of the most commonly mis-managed conditions in podiatry because it’s almost always driven by a biomechanical overload that inserts alone can’t correct. Heel spurs, when present, are rarely the pain source — they are a result of the strain, not the cause of it.
→ See our full Heel Pain & Plantar Fasciitis treatment page
“I go down the stairs sideways now. My husband noticed before I did.”
Achilles Tendonitis & Calf/Tendon Strain
Achilles Tendonitis & Calf/Tendon Strain
Pain and stiffness in the back of the heel or lower calf, often worst with the first steps in the morning or after long periods of sitting. Chronic Achilles tendinopathy is not an inflammation problem — it’s a failed healing problem, and it requires a very different treatment approach than the rest, ice, and anti-inflammatories most patients have already tried. Cortisone injections in this area are especially dangerous and should generally be avoided.
→ See our full Achilles Tendonitis treatment page
“My ankle hurts — but the shoe store said my arch is fine.”
Posterior Tibial Tendonitis, PTTD & Peroneal Tendonitis
Posterior Tibial Tendonitis, PTTD & Peroneal Tendonitis
A huge portion of our “ankle pain” patients actually have a tendon problem on the inside of the ankle — the posterior tibial tendon, which runs down the inside of the ankle and supports the arch. When this tendon starts to fail (a condition called posterior tibial tendon dysfunction, or PTTD), patients usually describe it as “my ankle hurts” — they almost never recognize it as a tendon problem, because the pain is on the ankle, not the arch. Left untreated, PTTD progressively collapses the arch and can eventually lead to a rigid flatfoot that does require surgical reconstruction. Caught early, it’s almost always manageable without surgery.
Peroneal tendonitis is the same story on the outside of the ankle — common in patients with a history of ankle sprains or anyone whose foot tends to roll outward.
Both of these conditions respond beautifully to biomechanical correction, shockwave therapy, and Class IV laser — but they have a narrow window where conservative care is still an option. That’s why we don’t wait.
“It feels like I’m walking on a wrinkle in my sock — or a hot marble.”
Morton’s Neuroma, Metatarsalgia & Plantar Plate Injury
Morton’s Neuroma, Metatarsalgia & Plantar Plate Injury
Pain in the ball of the foot is one of the most commonly misdiagnosed problems we see. Patients are often told it’s “just arthritis” or given a generic recommendation to buy wider shoes. In reality, ball-of-foot pain usually falls into one of three distinct conditions — and each one has a different treatment:
- Morton’s neuroma — a thickening of the nerve between the toes, often felt as burning, tingling, or the sensation of a “marble” underfoot, especially in closed-toe shoes.
- Metatarsalgia — overload-driven pain under the long bones of the forefoot, often from biomechanical imbalance, worn-out fat-pad cushioning, or a long second metatarsal that carries more weight than it was designed to.
- Plantar plate injury — damage to the small ligament that supports the joint at the base of the second toe, felt as a deep ache under the ball of the foot, often described as stepping on a folded sock or a marble that isn’t there. Frequently mistaken for Morton’s neuroma and treated as a nerve problem when it’s actually a joint-and-ligament problem.
Telling these three apart is what determines which treatment will actually work. We use diagnostic ultrasound at the first visit to identify which condition you have, often in real time on the screen with you.
→ See our full Plantar Plate Tear treatment page
“I keep rolling my ankle on uneven ground — and now I’m afraid to hike.”
Shin Splints, Ankle Sprains & Chronic Ankle Instability
Shin Splints, Ankle Sprains & Chronic Ankle Instability
Shin splints (medial tibial stress syndrome) are almost always a biomechanical problem, not a “weak calf” problem. And chronic ankle instability — the sensation that your ankle is going to give way on uneven ground — is rarely about ligament laxity alone. In the large majority of patients we see, the underlying driver is a foot mechanics issue that’s pulling the ankle into a vulnerable position with every step. Correct the mechanics, and the ankle often stabilizes without the reconstruction surgery many patients have been told they need.
For acute ankle sprains, we offer same-week evaluation, in-office ultrasound to rule out tendon damage, and offloading that allows most patients to stay mobile during the healing process.
For parents of active kids ages 8–15
Sever’s Disease & Young Athlete Heel Pain
Sever’s Disease & Young Athlete Heel Pain
Sever’s disease (calcaneal apophysitis) is one of the most common causes of heel pain in active children — soccer players, gymnasts, dancers, and kids in growth spurts. It’s not a “disease” at all; it’s an irritation at the growth plate of the heel, and it typically resolves completely with the right approach. We treat a steady number of young athletes from Marble Falls, Burnet, and the surrounding school districts. Kids don’t need to sit out an entire season — but they do need proper evaluation, and many will benefit from a pediatric-specific orthotic approach that protects the growth plate while letting them stay on the field.
If your child is limping after practice, complaining of heel pain after running, or walking on their toes to avoid the heel, we can help.
A Complete Approach to Resolving Sports and Tendon Injuries
Three systems, tailored to your condition and your preferences. Not every patient needs every tool — your plan is built around your specific injury, your recovery goals, and your comfort level.
Not every patient needs every tool. Some of our patients resolve their pain through biomechanical correction combined with shockwave and laser therapy alone — with no injections at all. Others benefit from a fully combined protocol. We’ll walk you through exactly what we recommend and exactly why — and you decide.
The Blueprint
High-End Custom Orthotics
Healing cannot happen on a foundation that keeps re-injuring the tissue with every step. Following a thorough biomechanical evaluation and a non-weight-bearing scan, we engineer prescription orthotics designed to precisely correct the foot mechanics overloading your tendon, joint, or plantar plate. This physically reduces the strain at the injury site so your body can finally rest and rebuild.
The Signaling
Shockwave & Class IV Laser Therapy
Extracorporeal shockwave therapy is one of the most evidence-based non-surgical interventions available for chronic tendinopathy. Shockwave works by creating a controlled mechanical signal that restarts the healing response in tissue that has stopped trying to repair itself — meaning that for many patients, this forms a complete, injection-free pathway to resolution. We pair it with Class IV laser therapy, which stimulates cellular repair at the mitochondrial level, accelerating healing and reducing pain. No needles, no downtime.
The Amplifier
Advanced Restorative Injection Therapy (when indicated)
For patients whose tissue needs an even stronger biological signal to fully restart the repair process, advanced restorative injection therapy delivers that signal directly to the injury site, triggering the tendon or soft tissue to begin laying down healthy, organized fibers again. This is an option within your plan — not a requirement. Many of our patients achieve excellent outcomes with orthotics, shockwave, and laser alone. When advanced restorative injections are indicated, we explain exactly why and what to expect — so the decision is always yours.
Meet Dr. Frank J. Henry, DPM, FACFAS
“After 30 years as a foot and ankle surgeon, I’ve learned that the tendon and sports injuries that ‘won’t go away’ almost never need a scalpel — they need someone willing to actually sit down, figure out what’s driving the injury mechanically, and then give the tissue the biological nudge it needs to finish healing. My job is to fix it properly, the first time — so we can keep you on the pickleball court, on the trail, and out of the operating room entirely.”
Dr. Frank Henry, DPM, is a board-certified Foot and Ankle Surgeon and a Fellow of the American College of Foot and Ankle Surgeons. Over more than 30 years of practice and 40,000 patients treated, he maintains a 95% surgery avoidance rate. Today, Dr. Henry uses his extensive surgical background to do the opposite of what many specialists do — he keeps patients out of the operating room.
You’ll never feel rushed in his office. You’ll get a real evaluation, a real explanation, and a real plan.
What to Expect at Your First Visit
We know how frustrating rushed, ten-minute medical appointments can be. Your first visit with us is different — and for a sports or tendon injury, it’s designed to answer two critical questions in the same visit: What is actually wrong, and will this respond to conservative care?
- A thorough, unhurried evaluation. We sit down with you, listen carefully to your history, and take the time to understand exactly how the injury is affecting the activities that matter to you.
- Biomechanical evaluation. We examine how your foot loads during standing, walking, and push-off — because in almost every sports or tendon injury, the mechanical pattern driving the problem is the real target.
- In-office digital X-rays, reviewed with you at the screen. No waiting for a radiologist’s report days later. We show you exactly what we see and explain what it means.
- Live diagnostic ultrasound. For tendons, plantar plates, and soft-tissue injuries, we look at the structure in real time, right in the exam room. We can see exactly where the damage is, how severe it is, and whether there’s a threat to the integrity of the tissue.
- Offloading strapping test. For many conditions, we perform a specialized strapping technique that temporarily reduces strain on the injured structure. If you feel meaningful relief, it confirms to both of us that your injury can be managed by correcting the mechanics. The relief from the strapping is short-lived and diagnostic by design — a preview of response, not a cure.
- An honest, spoken-out-loud assessment. At the end of your visit, we’ll tell you — directly — what we believe is going on, what your options are, and what we’d recommend.
Frequently Asked Questions
Questions specific to sports and tendon injuries — distinct from the FAQs on our Achilles and Heel Pain pages.
What’s the difference between an acute sports injury and chronic tendon pain?
What’s the difference between an acute sports injury and chronic tendon pain?
An acute injury — like a sudden ankle sprain or a pull during a pickleball match — happens at a specific moment and triggers a normal inflammatory healing response. Chronic tendon pain (tendinopathy) is different: it’s an injury where the body has stopped trying to repair the damaged tissue, sometimes for months or years. Both respond extremely well to our approach, but the treatment protocol is different for each, which is why an accurate in-office ultrasound evaluation matters.
Can I stay active during treatment?
Can I stay active during treatment?
In almost every case, yes — and staying moderately active actually helps you heal faster. We may ask you to modify how you’re active for a few weeks (for example, walking on level ground while we treat an ankle, or adjusting your golf swing mechanics). We’re explicit about which activities are safe to continue and which ones are delaying your recovery. The idea that you have to stop everything is usually wrong.
How long before I can get back to pickleball, golf, or hiking?
How long before I can get back to pickleball, golf, or hiking?
It depends on the condition and how long you’ve had it, but most of our patients begin returning to their favorite activities within 6 to 12 weeks of starting a full protocol. Patients with very chronic injuries (a year or more) may take longer; patients caught early often progress much faster. We give you a realistic timeline at your first follow-up visit — not a generic promise.
I’ve had this injury for over a year. Is it too late for non-surgical treatment?
I’ve had this injury for over a year. Is it too late for non-surgical treatment?
Almost never. The length of time you’ve had the injury matters less than the current state of the tissue, which we can see with in-office diagnostic ultrasound. Many of our most satisfying outcomes are in patients who were told years ago to “just live with it.” As long as the tissue is still structurally viable, the right combination of mechanical correction, restorative signaling, and shockwave/laser therapy can restart the healing process.
My orthopedic surgeon in Austin told me I need surgery. Should I get a second opinion?
My orthopedic surgeon in Austin told me I need surgery. Should I get a second opinion?
Absolutely. We see second-opinion patients every week from Austin, Lakeway, Bee Cave, Spicewood, and the surrounding areas — patients who were told they needed tendon repair, ligament reconstruction, or joint surgery. In the majority of these cases, surgery was being recommended before a thorough conservative evaluation had been done. We are not anti-surgery — Dr. Henry is a board-certified foot and ankle surgeon with decades of operating room experience. We simply believe that with a 95% surgery avoidance rate across 40,000 patients, most of the surgeries being recommended today are preventable.
Do you treat sports injuries in teenagers and young athletes?
Do you treat sports injuries in teenagers and young athletes?
Yes. We regularly treat young athletes from Marble Falls, Burnet, and the surrounding school districts for conditions like Sever’s disease, growth-plate heel pain, shin splints, and acute ankle injuries. Young athletes generally respond very quickly to treatment — the key is catching the injury early and not letting it drag through an entire season.
What if I’ve already failed physical therapy?
What if I’ve already failed physical therapy?
“Failed PT” is one of the most common reasons patients find us. Physical therapy is valuable, but it’s one piece of the puzzle — and for a chronic tendon or plantar plate injury, PT alone usually isn’t enough, because it doesn’t address the failed healing signal inside the tissue itself. That’s why we combine biomechanical correction, advanced restorative interventions, and shockwave/laser therapy. The combination is what allows chronic injuries to finally resolve.