JoieCriscione's blog

Nothing will end war unless the people themselves refuse to go to war.

Adult Aquired Flat Feet Do I Suffer AAF?

Overview

Some people have always had flat feet from a young age. Unfortunately as people reach their fifties they will suddenly have one foot with a flatter arch than the other foot. This situation is termed adult acquired flatfoot. Adult acquired flatfoot is a painful condition occurring in one foot. The common patient profile is a female over the age of 50 with pre-existing flatfeet, high blood pressure, high cholesterol, diabetes and obesity. All of these underlying problems will lead to a weakening of the support structures of the arch. If you have adult acquired flat foot you will not be able to lift your heel off the ground while standing on one leg. Adult acquired flatfoot may develop due to trauma or degeneration of major tendons ankle & foot. Weakness or paralysis of leg muscles can also create a flatfoot deformity.Flat Feet




Causes

Posterior tibial tendon dysfunction is the most common cause of acquired adult flatfoot deformity. There is often no specific event that starts the problem, such as a sudden tendon injury. More commonly, the tendon becomes injured from cumulative wear and tear. Posterior tibial tendon dysfunction occurs more commonly in patients who already have a flat foot for other reasons. As the arch flattens, more stress is placed on the posterior tibial tendon and also on the ligaments on the inside of the foot and ankle. The result is a progressive disorder.




Symptoms

Symptoms are minor and may go unnoticed, Pain dominates, rather than deformity. Minor swelling may be visible along the course of the tendon. Pain and swelling along the course of the tendon. Visible decrease in arch height. Aduction of the forefoot on rearfoot. Subluxed tali and navicular joints. Deformation at this point is still flexible. Considerable deformity and weakness. Significant pain. Arthritic changes in the tarsal joints. Deformation at this point is rigid.




Diagnosis

The history and physical examination are probably the most important tools the physician uses to diagnose this problem. The wear pattern on your shoes can offer some helpful clues. Muscle testing helps identify any areas of weakness or muscle impairment. This should be done in both the weight bearing and nonweight bearing positions. A very effective test is the single heel raise. You will be asked to stand on one foot and rise up on your toes. You should be able to lift your heel off the ground easily while keeping the calcaneus (heel bone) in the middle with slight inversion (turned inward). X-rays are often used to study the position, shape, and alignment of the bones in the feet and ankles. Magnetic resonance (MR) imaging is the imaging modality of choice for evaluating the posterior tibial tendon and spring ligament complex.




Non surgical Treatment

Get treated early. There is no recommended home treatment. While in stage one of the deformity, rest, a cast, and anti-inflammatory therapy can help you find relief. This treatment is followed by creating custom-molded foot orthoses and orthopedic footwear. These customized items are critical in maintaining the stability of the foot and ankle. Once the tendon has stretched and deformity is visible, the chances of success for non-surgical treatment are significantly lower. In a small percentage of patients, total immobilization may arrest the progression of the deformity. A long-term brace known as an ankle foot orthosis is required to keep the deformity from progressing. The Richie Brace, a type of ankle foot orthosis, shows significant success as a treatment for stage two posterior tibial dysfunction. It is a sport-style brace connected to a custom corrected foot orthodic that fits into most lace-up footwear (including athletic shoes). It is also light weight and more cosmetically appealing than traditionally prescribed ankle foot orthosis. The Arizona Brace, California Brace or Gauntlet Brace may also be recommended depending on your needs.

Acquired Flat Feet




Surgical Treatment

In cases of PTTD that have progressed substantially or have failed to improve with non-surgical treatment, surgery may be required. For some advanced cases, surgery may be the only option. Symptomatic flexible flatfoot conditions are common entities in both the adolescent and adult populations. Ligamentous laxity and equinus play a significant role in most adolescent deformities. Posterior tibial tendon dysfunction (PTTD) is the most common cause of adult acquired flatfoot. One should consider surgical treatment for patients who have failed nonoperative therapy and have advancing symptoms and deformities that significantly interfere with the functional demands of daily life. Isolated Joint Fusion. This technique is used for well reducible flat foot by limiting motion at one or two joints that are usually arthritic. The Evans Anterior Calcaneal Osteotomy. This is indicated for late stage II adult acquired flatfoot and the flexible adolescent flatfoot. This procedure will address midtarsal instability, restore the medial longitudinal arch and reduce mild hind foot valgus. The Posterior Calcaneal Displacement Osteotomy (PCDO). This technique is indicated for late stage I and early stage II PTTD with reducible Calcaneal valgus. This is often combined with a tendon transfer. A PCDO is also indicated as an adjunctive procedure in the surgical reconstruction of the severe flexible adolescent flatfoot. Soft tissue procedure. On their own these are not very effective but in conjunction with an osseous procedure, soft tissue procedures can produce good outcome. Common ones are tendon and capsular repair, tendon lengthening and transfer procedures. Flat foot correction requires lengthy post operative period and a lot of patience. Your foot may need surgery but you might simply not have the time or endurance to go through the rehab phase of this type of surgery. We will discuss these and type of procedures necessary for your surgery in length before we go further with any type of intervention.

The Major Causes And Treatments For Achilles Tendinitis

Overview

Achilles TendonAchilles tendinitis describes an inflammatory change of the Achilles tendon without a tear of the tendon. Achilles tendinitis may be acute or chronic. The onset of pain is usually unilateral but may be found bilaterally. Achilles tendinitis is common in the third or fourth decade of life in patients who are active with sports or in jobs that require physical labor. Pain is described at the insertion of the tendon in the heel bone or in the body of the tendon.

Causes

Tendons are the tough fibres that connect muscle to bone. Most tendon injuries occur near joints, such as the shoulder, elbow, knee, and ankle. A tendon injury may seem to happen suddenly, but usually it is the result of many tiny tears to the tendon that have happened over time. Health professionals may use different terms to describe a tendon injury. You may hear, Tendonitis (or Tendinitis): This actually means "inflammation of the tendon," but inflammation is rarely the cause of your tendon pain.

Symptoms

The main symptom of Achilles tendonitis is a feeling of pain and swelling in your heel as you walk or run. Other symptoms include tight calf muscles and limited range of motion when flexing the foot. This condition can also make the skin in your heel feel overly warm to the touch.

Diagnosis

A doctor or professional therapist will confirm a diagnosis, identify and correct possible causes, apply treatment and prescribe eccentric rehabilitation exercises. An MRI or Ultrasound scan can determine the extent of the injury and indicate a precise diagnosis. Gait analysis along with a physical assessment will identify any possible biomechanical factors such as over pronation which may have contributed to the achilles tendonitis and training methods will be considered. Biomechanical problems can be corrected with the use of orthotic inserts and selection of correct footwear.

Nonsurgical Treatment

The latest studies on Achilles tendonitis recommend a treatment plan that incorporates the following three components. Treatment of the inflammation. Strengthening of the muscles that make up the Achilles tendon using eccentric exercise. These are a very specific type of exercise that has been shown in multiple studies to be a critical component of recovering from Achilles tendonitis. Biomechanical control (the use of orthotics and proper shoes). Shockwave therapy.

Achilles Tendonitis

Surgical Treatment

In most surgeries, damaged tissue is cleaned out before surgeons make the necessary repairs. However, a new minimally-invasive surgery to repair a torn Achilles tendon actually uses the damaged tissue to help repair the tear. The percutaneous Achilles repair system, or PARS technique, enables surgeons to better repair a torn Achilles tendon through a smaller incision. This procedure was recently performed at Houston Methodist Hospital to treat an NFL cornerback, getting him back on field for this season.

Prevention

Although Achilles tendinitis cannot be completely prevented, the risk of developing it can be lowered. Being aware of the possible causes does help, but the risk can be greatly reduced by taking the following precautions. Getting a variety of exercise - alternating between high-impact exercises (e.g. running) and low-impact exercise (e.g. swimming) can help, as it means there are days when the Achilles tendon is under less tension. Limit certain exercises - doing too much hill running, for example, can put excessive strain on the Achilles tendon. Wearing the correct shoes and replacing them when worn - making sure they support the arch and protect the heel will create less tension in the tendon. Using arch supports inside the shoe, if the shoe is in good condition but doesn't provide the required arch support this is a cheaper (and possibly more effective) alternative to replacing the shoe completely. Stretching, doing this before and after exercising helps to keep the Achilles tendon flexible, which means less chance of tendinitis developing. There is no harm in stretching every day (even on days of rest), as this will only further improve flexibility. Gradually increasing the intensity of a workout - Achilles tendinitis can occur when the tendon is suddenly put under too much strain, warming up and increasing the level of activity gradually gives your muscles time to loosen up and puts less pressure on the tendon.

Learning To Live With Diabetic Feet

A study published in the "British Journal of Nutrition" in April 2011 began with researchers feeding garlic - along with ginger and other spices - to diabetic rats, and they discovered it warded off blood glucose spikes. Researchers theorize garlic may also reduce the risk of cardiovascular problems common in diabetes. The staff of the DFMC is commited to providing you with the most comprehensive podiatric medical and surgical services available in your community with special emphasis on diabetic foot management, wound care and limb salvage. It's very surprising to see an increase in the number of diabetic men every year.Plantar Fasciitis,Pes Planus,Mallet Toe,High Arched Feet,Heel Spur,Heel Pain,Hammer Toe,Hallux Valgus,Foot Pain,Foot Hard Skin,Foot Conditions,Foot Callous,Flat Feet,Fallen Arches,Diabetic Foot,Contracted Toe,Claw Toe,Bunions Hard Skin,Bunions Callous,Bunion Pain,Ball Of Foot Pain,Back PainPlantar Fasciitis,Pes Planus,Mallet Toe,High Arched Feet,Heel Spur,Heel Pain,Hammer Toe,Hallux Valgus,Foot Pain,Foot Hard Skin,Foot Conditions,Foot Callous,Flat Feet,Fallen Arches,Diabetic Foot,Contracted Toe,Claw Toe,Bunions Hard Skin,Bunions Callous,Bunion Pain,Ball Of Foot Pain,Back Pain

Diabetes weight control diabetes food supplements type 2 diabetes and stress management lower cholesterol diabetic diet Treato results for Insulin Resistance and Type 2 Diabetes. If diabetes diabetes information in creole runs in your family you have a slight risk factor.

There is the specific broken ankle recovery occasion any particular one should know. This really is to help no cost your ex in the popular broken ankle recovery oversight that will other folks happen to be doing. Eventhough it can be simple to comprehend that you could really hope his or her foot to mend quick, she must likewise agree to the reality that broken ankle recovery moment probably won't match their preference.

Also, the article references studies that show that MRSA increases the cost of treatment and can keep you in the hospital longer. If you do have an open sore, see your health care provider right away. With good hygiene practices and good foot care , you can reduce your risk for infections, including MRSA. Keeping your blood sugar under control can also help by lowering your risk of all foot complications including sores, ulcers and neuropathy. A foot physician must both get comprehensive instruction for that therapy of the various foot problems equally by medical in addition to operative means. This motion-control coach is designed with supreme padding and both utmost stability therefore the stabilization is very good, plus they always keep your foot in right position. Fundamentally the body determines that it takes more assistance inside of the foot.

The differentiating aspect of DSCI as an investment is that the wound care products business, in my opinion, makes DSCI an attractive long term investment even if DSC-127 fails. A recent US study by The Analysis Group showed that foot ulcers led to large medical bills for diabetics - almost double the other costs of treating the condition, according to health portal McKnight'. The study analysed just over 30 000 patients with and without foot ulcers over a 12-month period and showed that foot ulcers contribute to major medical expenses for diabetics. Take care of toenails by cutting them regularly after bathing. As of now, there is no cure for neuropathy.

Drink at least 64 oz. of fluid each day to prevent dry skin and cracks. Diabetics are more likely to become dehydrated than those with stable blood glucose levels, which means a greater Bunion Pain intake of water is necessary to keep the skin hydrated. The University of Iowa recommends wearing shoes at all times to prevent injury and infection of open sores or cracks.

What Triggers Heel Discomfort To Surface

Feet Pain

Overview

Plantar fasciitis is the most common cause of pain on the bottom of the heel. Approximately 2 million patients are treated for this condition every year. Plantar fasciitis occurs when the strong band of tissue that supports the arch of your foot becomes irritated and inflamed. The plantar fascia is a long, thin ligament that lies directly beneath the skin on the bottom of your foot. It connects the heel to the front of your foot, and supports the arch of your foot.




Causes

Plantar fasciitis symptoms are usually exacerbated via "traction" (or stretching) forces on the plantar fascia. In simple terms, you plantar fascia is repeatedly overstretched. The most common reason for the overstretching are an elongated arch due to either poor foot biomechanics (eg overpronation) or weakness of your foot arch muscles. Compression type plantar fascia injuries have a traumatic history. Landing on a sharp object that bruises your plantar fascia is your most likely truma. The location of plantar fasciitis pain will be further under your arch than under your heel, which is more likely to be a fat pad contusion if a single trauma caused your pain. The compression type plantar fasciitis can confused with a fat pad contusion that is often described as a "stone bruise".




Symptoms

The main symptom of plantar fasciitis is heel pain when you walk. You may also feel pain when you stand and possibly even when you are resting. This pain typically occurs first thing in the morning after you get out of bed, when your foot is placed flat on the floor. The pain occurs because you are stretching the plantar fascia. The pain usually lessens with more walking, but you may have it again after periods of rest. You may feel no pain when you are sleeping because the position of your feet during rest allows the fascia to shorten and relax.




Diagnosis

The health care provider will perform a physical exam. This may show tenderness on the bottom of your foot, flat feet or high arches, mild foot swelling or redness, stiffness or tightness of the arch in the bottom of your foot. X-rays may be taken to rule out other problems.




Non Surgical Treatment

Treatment for heel pain usually involves using a combination of techniques, such as stretches and painkillers, to relieve pain and speed up recovery. Most cases of heel pain get better within 12 months. Surgery may be recommended as a last resort if your symptoms don't improve after this time. Only 1 in 20 people with heel pain will need surgery. Whenever possible, rest the affected foot by not walking long distances and standing for long periods. However, you should regularly stretch your feet and calves using exercises such as those described below. Pain relief. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can be used to help relieve pain. Some people also find applying an ice pack to the affected heel for 5-10 minutes can help relieve pain and inflammation. However, do not apply an ice pack directly to your skin. Instead, wrap it in a towel. If you do not have an ice pack, you can use a packet of frozen vegetables.

Plantar Fascia




Surgical Treatment

Surgery should be reserved for patients who have made every effort to fully participate in conservative treatments, but continue to have pain from plantar fasciitis. Patients should fit the following criteria. Symptoms for at least 9 months of treatment. Participation in daily treatments (exercises, stretches, etc.). If you fit these criteria, then surgery may be an option in the treatment of your plantar fasciitis. Unfortunately, surgery for treatment of plantar fasciitis is not as predictable as a surgeon might like. For example, surgeons can reliably predict that patients with severe knee arthritis will do well after knee replacement surgery about 95% of the time. Those are very good results. Unfortunately, the same is not true of patients with plantar fasciitis.

What Is Heel Pain And The Best Ways To Cure It

Heel Discomfort

Overview

Plantar fasciitis is a condition that causes heel and arch pain through inflammation on the bottom of the foot. The part that’s inflamed (swollen) is actually the plantar fascia, which is the connective tissue or ligament that stretches from the base of the toes, across the arch of the foot, and inserts into the heel bone. This painful condition can interfere with your daily activity and severely decrease your quality of life.




Causes

Plantar Fasciitis often leads to heel pain, heel spurs, and/or arch pain. The excessive stretching of the plantar fascia that leads to the inflammation and discomfort can be caused by the following: Over-pronation (flat feet) which results in the arch collapsing upon weight bearing A foot with an unusually high arch A sudden increase in physical activity Excessive weight on the foot, usually attributed to obesity or pregnancy Improperly fitting footwear Over-pronation (flat feet) is the leading cause of plantar fasciitis. Over-pronation occurs in the walking process, when a person's arch collapses upon weight bearing, causing the plantar fascia to be stretched away from the heel bone. With Plantar Fasciitis, the bottom of your foot usually hurts near the inside of the foot where the heel and arch meet. The pain is often acute either first thing in the morning or after a long rest, because while resting the plantar fascia contracts back to its original shape. As the day progresses and the plantar fascia continues to be stretched, the pain often subsides.




Symptoms

The main symptom of plantar fasciitis is heel pain when you walk. You may also feel pain when you stand and possibly even when you are resting. This pain typically occurs first thing in the morning after you get out of bed, when your foot is placed flat on the floor. The pain occurs because you are stretching the plantar fascia. The pain usually lessens with more walking, but you may have it again after periods of rest. You may feel no pain when you are sleeping because the position of your feet during rest allows the fascia to shorten and relax.




Diagnosis

Most cases of plantar fasciitis are diagnosed by a health care provider who listens carefully to your description of symptoms. During an examination of your feet, your health care provider will have to press on the bottom of your feet, the area most likely to be painful in plantar fasciitis. Because the pain of plantar fasciitis has unique characteristics, pain upon rising, improvement after walking for several minutes, pain produced by pressure applied in a specific location on your foot but not with pressure in other areas, your health care provider will probably feel comfortable making the diagnosis based on your symptoms and a physical examination. Your health care provider may suggest that you have an X-ray of your foot to verify that there is no stress fracture causing your pain.




Non Surgical Treatment

Shoe therapy, finding and wearing shoes that allow your feet to be in their natural position, is the most important treatment for plantar fasciosis. Shoes that possess a flat heel, are wide in the toe box, lack toe spring, and have flexible soles are most appropriate for this foot problem. An increasing number of shoe companies are producing shoes with these design characteristics, but shoes that include all these features are still difficult to find. For some suggested footwear models, see our clinic’s shoe list. Most conventional footwear can be modified by stretching the shoe’s upper, stretching out the toe spring, removing the shoe’s liner, and cutting the shoe at certain key points to allow more room for your foot. Visit your podiatrist to help you with these shoe modifications. Correct Toes is another helpful conservative treatment method for plantar fasciosis. Correct Toes addresses the root cause of your plantar fasciosis by properly aligning your big toe and reducing the tension created by your abductor hallucis longus on the blood vessels that feed and "cleanse" the tissues of your plantar fascia. Your plantar fasciosis-related pain will diminish when the dead tissue is washed away. A rehabilitation program, which includes targeted stretches and other exercises, for your foot may be helpful too. Dietary changes and aerobic exercise are particularly important for overweight individuals who have plantar fasciosis. Water aerobics may be most appropriate for those individuals whose pain does not allow them to walk or cycle. Physical therapy may be another helpful treatment modality for this problem, and includes ultrasound, electrical stimulation, contrast baths, and range-of-motion exercises. Massage, acupuncture, reflexology, and magnet therapy are holistic approaches that may be helpful.

Heel Pain




Surgical Treatment

Although most patients with plantar fasciitis respond to non-surgical treatment, a small percentage of patients may require surgery. If, after several months of non-surgical treatment, you continue to have heel pain, surgery will be considered. Your foot and ankle surgeon will discuss the surgical options with you and determine which approach would be most beneficial for you. No matter what kind of treatment you undergo for plantar fasciitis, the underlying causes that led to this condition may remain. Therefore, you will need to continue with preventive measures. Wearing supportive shoes, stretching, and using custom orthotic devices are the mainstay of long-term treatment for plantar fasciitis.

What May Cause Pain Under The Heel And How To Deal With It

Feet Pain

Overview

Plantar fasciitis is the most common cause of pain on the bottom of the heel. Approximately 2 million patients are treated for this condition every year. Plantar fasciitis occurs when the strong band of tissue that supports the arch of your foot becomes irritated and inflamed. The plantar fascia is a long, thin ligament that lies directly beneath the skin on the bottom of your foot. It connects the heel to the front of your foot, and supports the arch of your foot.




Causes

Training on improper, hard and/or irregular surfaces as well as excessive track work in spiked shoes, or steep hill running, can stress the plantar fascia past its limits of elasticity, leading to injury. Finally, failure in the early season to warm up gradually gives the athlete insufficient time for the structures of the foot to re-acclimate and return to a proper fitness level for intensive exercise. Such unprepared and repeated trauma causes microscopic tearing, which may only be detected once full-blown plantar fasciitis and accompanying pain and debilitation have resulted. If the level of damage to the plantar fascia is significant, an inflammatory reaction of the heel bone can produce spike-like projections of new bone, known as heel spurs. Indeed, plantar fasciitis has occasionally been refereed to as heel spur syndrome, though such spurs are not the cause of the initial pain but are instead a further symptom of the problem. While such spurs are sometimes painless, in other cases they cause pain or disability in the athlete, and surgical intervention to remove them may be required. A dull, intermittent pain in the heel is typical, sometimes progressing to a sharp, sustained discomfort. Commonly, pain is worse in the morning or after sitting, later decreasing as the patient begins walking, though standing or walking for long periods usually brings renewal of the pain.




Symptoms

The most common symptoms of plantar fasciitis include pain on the bottom of the foot near the heel, pain with the first few steps after getting out of bed in the morning, or after a long period of rest, such as after a long car ride. The pain subsides after a few minutes of walking. Greater pain after (not during) exercise or activity.




Diagnosis

After you describe your symptoms and discuss your concerns, your doctor will examine your foot. Your doctor will look for these signs. A high arch, an area of maximum tenderness on the bottom of your foot, just in front of your heel bone. Pain that gets worse when you flex your foot and the doctor pushes on the plantar fascia. The pain improves when you point your toes down. Limited "up" motion of your ankle. Your doctor may order imaging tests to help make sure your heel pain is caused by plantar fasciitis and not another problem. X-rays provide clear images of bones. They are useful in ruling out other causes of heel pain, such as fractures or arthritis. Heel spurs can be seen on an x-ray. Other imaging tests, such as magnetic resonance imaging (MRI) and ultrasound, are not routinely used to diagnose plantar fasciitis. They are rarely ordered. An MRI scan may be used if the heel pain is not relieved by initial treatment methods.




Non Surgical Treatment

The following recommendations are appropriate. Wear shoes with adequate arch support and cushioned heels; discard old running shoes and wear new ones; rotate work shoes daily. Avoid long periods of standing. Lose weight. Stretch the plantar fascia and warm up the lower extremity before participating in exercise. For increased flexibility, stretch the plantar fascia and the calf after exercise. Do not exercise on hard surfaces. Avoid walking barefooted on hard surfaces. Avoid high-impact sports that require a great deal of jumping (eg, aerobics and volleyball). Apply ice for 20 minutes after repetitive impact-loading activities and at the end of the day. Limit repetitive impact-loading activities such as running to every other day, and consider rest or cross-training for nonrunning days.

Plantar Fascia




Surgical Treatment

When more conservative methods have failed to reduce plantar fasciitis pain, your doctor may suggest extracorporeal shock wave therapy, which is used to treat chronic plantar fasciitis. Extracorporeal shock wave therapy uses sound waves to stimulate healing, but may cause bruises, numbness, tingling, swelling, and pain. When all else fails, surgery may be recommended to detach the plantar fascia from the heel bone. Few people need surgery to treat the condition.




Prevention

Factors that help prevent plantar fasciitis and reduce the risk of recurrence include. Exercises to strengthen the muscles of the lower leg and ankle. Warming up before commencing physical activity. Maintaining a healthy body weight. Avoiding high heeled footwear. Using orthotic devices such as arch supports and heel raises in footwear, particularly for people with very high arches or flat feet. Daily stretches of plantar fascia and Achilles tendon.

What May Cause Heel Discomfort And The Way To Remedy It

Pain Of The Heel

Overview

Heel pain is most often caused by plantar fasciitis, a condition that is sometimes also called heel spur syndrome when a spur is present. Heel pain may also be due to other causes, such as a stress fracture, tendonitis, arthritis, nerve irritation, or, rarely, a cyst. Because there are several potential causes, it is important to have heel pain properly diagnosed. A foot and ankle surgeon is able to distinguish between all the possibilities and determine the underlying source of your heel pain. Plantar fasciitis is an inflammation of the band of tissue (the plantar fascia) that extends from the heel to the toes. In this condition, the fascia first becomes irritated and then inflamed, resulting in heel pain.




Causes

Patients with tight calf muscles will suffer with excessive pulling of the muscle group on the back of the heel. This in turn creates pulling of other structures that are attached to the heel, including the Plantar Fascia. When the pulling continues for long enough, then inflammation will develop and lead to Plantar Fasciitis. This causes Heel Pain. It is extremely common for patients who increase their level of activity to develop Plantar Fasciitis. Boot camp, running, zumba, recreational walking or other quick movement sports such as tennis or touch football are typical causes of Heel Pain. The sharp increase in exercise is too much for the foot to cope with and the stress on the Plantar Fascia causes inflammation. The Heel Pain that is caused by this inflammation is known as Plantar Fasciitis.




Symptoms

The main symptom of plantar fasciitis is heel pain when you walk. You may also feel pain when you stand and possibly even when you are resting. This pain typically occurs first thing in the morning after you get out of bed, when your foot is placed flat on the floor. The pain occurs because you are stretching the plantar fascia. The pain usually lessens with more walking, but you may have it again after periods of rest. You may feel no pain when you are sleeping because the position of your feet during rest allows the fascia to shorten and relax.




Diagnosis

Plantar fasciitis is one of many conditions causing "heel pain". Some other possible causes include nerve compression either in the foot or in the back, stress fracture of the calcaneus, and loss of the fatty tissue pad under the heel. Plantar fasciitis can be distinguished from these and other conditions based on a history and examination done by a physician. It should be noted that heel spurs are often inappropriately thought to be the sole cause of heel pain. In fact, heel spurs are common and are nothing more than the bone's response to traction or pulling-type forces from the plantar fascia and other muscles in the foot where they attach to the heel bone. They are commonly present in patients without pain, and frequently absent from those who have pain. It is the rare patient who has a truly enlarged and problematic spur requiring surgery.




Non Surgical Treatment

Plantar fasciitis can be a difficult problem to treat, with no panacea available. Fortunately, most patients with this condition eventually have satisfactory outcomes with nonsurgical treatment. Therefore, management of patient expectations minimizes frustration for both the patient and the provider.

Heel Pain




Surgical Treatment

The majority of patients, about 90%, will respond to appropriate non-operative treatment measures over a period of 3-6 months. Surgery is a treatment option for patients with persistent symptoms, but is NOT recommended unless a patient has failed a minimum of 6-9 months of appropriate non-operative treatment. There are a number of reasons why surgery is not immediately entertained including. Non-operative treatment when performed appropriately has a high rate of success. Recovery from any foot surgery often takes longer than patients expect. Complications following this type of surgery can and DO occur! The surgery often does not fully address the underlying reason why the condition occurred therefore the surgery may not be completely effective. Prior to surgical intervention, it is important that the treating physician ensure that the correct diagnosis has been made. This seems self-evident, but there are other potential causes of heel pain. Surgical intervention may include extracorporeal shock wave therapy or endoscopic or open partial plantar fasciectomy.




Stretching Exercises

Stretching exercises for your foot are important. Do the stretches shown here at least twice a day. Don't bounce when you stretch. Plantar fascia stretch. To do the plantar fascia stretch, stand straight with your hands against a wall and your injured leg slightly behind your other leg. Keeping your heels flat on the floor, slowly bend both knees. You should feel the stretch in the lower part of your leg. Hold the stretch for 10 to 15 seconds. Repeat the stretch 6 to 8 times. Calf stretch. Stand with your hands against a wall and your injured leg behind your other leg. With your injured leg straight, your heel flat on the floor and your foot pointed straight ahead, lean slowly forward, bending the other leg. You should feel the stretch in the middle of your calf. Hold the stretch for 10 to 15 seconds. Repeat the stretch 6 to 8 times. Other exercises. You can also strengthen your leg muscles by standing on the ball of your foot at the edge of a step and raising up as high as possible on your toes. Relax between toe raises and let your heel fall a little lower than the edge of the step. It's also helpful to strengthen the foot by grabbing a towel with your toes as if you are going to pick up the towel with your foot. Repeat this exercise several times a day.