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.
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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 or collapse 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