Posts for tag: plantar fasciitis
Understanding Heel Pain with Help from Your Podiatrist
- Wear shoes that fit well
- Wear proper shoes for each activity
- Do not wear shoes with excessive wear on heels or soles
- Prepare properly before exercising by stretching and warming up
- Pace yourself when you participate in athletic activities
- Don’t underestimate your body’s need for rest and good nutrition
- Lose excess weight
Heel pain is most often caused by plantar fasciitis, an inflammation of the long, dense band of connective tissue (the plantar fascia) that runs from the heel to the ball of the foot.
Repeated strain on the plantar fascia can cause tiny tears in the ligament. As tension and tearing increases, so does inflammation and irritation of the affected area. Risk factors of plantar fasciitis include foot arch problems (flat foot and high arches); excess weight; running; and a tight Achilles tendon.
The most common symptom of plantar fasciitis is gradually developing pain on the bottom of the heel. The pain is usually worst in the morning and after sitting or standing for a long period of time. For some, the pain subsides after walking or stretching.
To reduce pain associated with plantar fasciitis:
- Rest. Limit and/or avoid activities that make your heel hurt.
- Ice. Reduce pain and swelling by icing the affected area each day.
- Stretch. Stretch your heel throughout the day, especially when you first wake up in the morning.
- Footwear modifications. Wear shoes that provide good arch support and a cushioned sole. Ask your podiatrist about pads and shoe inserts to relieve your heel pain.
When conservative treatments aren't effective, or your pain persists for more than a few weeks, schedule an appointment to discuss your symptoms and treatment options. A podiatrist can recommend an appropriate treatment plan for your individual needs. This may include stretching exercises, shoe padding, orthotic devices, night splints or therapy. Most patients respond to non-surgical treatments, but for pain that won't go away, surgery may be required.
With proper rest and treatment, recovering from plantar fasciitis can take just a few months. Visit us when you first experience pain for a diagnosis and an appropriate treatment plan for your individual needs.
MY HEEL HURTS
By now you have probably already diagnosed yourself with Plantar fasciitis as you have goggled heel pain. Like many people that come into the office, they will tell me that their heel pain is worse after they have been sitting and once they have taken a couple of steps it will improve.Plantar fasciitis is sometimes known as a "heel spur". The term commonly used to refer to heel and arch pain is traced to an inflammation on the bottom of the foot. More specifically, plantar fasciitis is an inflammation of the connective tissue, called plantar fascia, that stretches from the base of the toes, across the arch of the foot, to the point at which it inserts into the heel bone. Overpronation is the most common cause of plantar fasciitis. As the foot rolls inward excessively when walking, it flattens the foot, lengthens the arch, and puts added tension on the plantar fascia. Generally it is considered an overuse injury and over time, this causes inflammation. People will ask me if their weight influences their heel pain. It may if you are overweight and a decrease in approximately 10lbs can be helpful.
Generally we will take x-rays to determine if there is a spur and to check for fractures and tumors that can occur in the heel bone. We are also able to measure the amount of inflammation a patient has with an ultrasound and monitor it over time. There can be times when the planatar fascia will actually rupture and will need to be treated appropriately.
Things you can try first is stretching and most people will have already tried OTC inserts. The problem with them is that if your heel pain does not go away is that it does not brace your foot enough to help with the uncontrolled overstretching that is occuring. A true custom orthotic that properly supports and braces your arch is the mainstay of treatment. It is imperative that you also perform proper controlled stretching exercises. As with any inflammatory condition one can also use of anti-inflammatory medications and ice packs. Often times Physical therapy is also helpful. There are times when your pain is so great that in order to calm things down a steroid injection is necessary.
So what if you have done all these things and you are not better. You may need to allow the foot to rest and decrease your activity with immobilization. Well doc, I have done that, now what. There are times when your heel pain needs to be addressed with surgery and depending on how your pain presents to your doctor you may need to have an open release along with lengthening your gastroc (heel cord area). Sometimes there is a nerve that also gets entrapped and we will look for that. There can be an alternative to the open release and that may be the use of Topaz and PRP. What does that mean you may ask. It essentially works at trying to convert your chronic inflammation to acute to get the body to heal itself. It is done through tiny holes about the size of a large needle and a wand is introduced that stimulates the fascia. PRP or platelet rich plasma is take from your own blood and the good things ie platelet is injected back into your heel to help the process along. It is up to your doctor to make the plan that is right for you depending on what is going on with your feet because often times more than than one thing may influence your treatment protocol. Here is to your feet, may they carry you through the rest of your days.
Along with the warm weather comes an increase in various foot conditions and flip-flop related injuries. Although flip-flops may make your feet feel cool, they are not a good choice for your foot & ankle wellness.
Flip-flops, for the most part, provide no support to the feet and can lead to over-use injuries such as stress fracture of the metatarsals. This is a condition in which repetitive stress to the metatarsal bones in the feet can cause a crack in the bone which occurs without injury, usually with normal activity. This type of stress fracture can lead to having to wear a fracture boot for 4-6 weeks to allow for healing.
Flip-flops can also increase the symptoms and pain of plantar fasciitis. Due to the lack of support and stability there is an increase in stress and strain on the plantar fascia. This lack of support to the feet also increases the risk of ankle injuries such as sprains and fractures.
Flip-flops also leave the toes unprotected and can cause many injuries to the toes and toe nails. Wearers of flip-flops will often scrape or stub their toe which can lead to a nail injury requiring the nail to be removed. A toe fracture can also occur and, in some cases, a fracture shoe will be needed to alleviate pain.
When choosing a shoe, if open toes are a must, please avoid the flimsy, cheap flip-flops. Look for sandals that have support to them and an indented heel cup. Straps to the sandals which can be tightened can also increase stability in the sandal as you walk. Consider moderation for the use of your flip-flops, such as wearing them just to the pool or beach for short periods of time. Please never play sports or mow the grass in your flip-flops. Contact your podiatrist if problems do occur.