Plantar What?

Plantar Fasciitis (pronounced "PLAN-ter fash-ee-EYE-tus"), one of the most common causes of heel pain, presents itself when there is an issue with the long band of tissue that runs across the bottom of the foot. This long band is called the plantar fascia, and it creates the arch of the foot by connecting the heel bone to the toes.

If your plantar fascia is irritated or inflamed, a likely result is heel pain often described as a stabbing feeling in the foot. Most patients agree that the pain is triggered after long periods of rest. For example, they might feel pain in their foot when they take their first steps out of bed or after sitting or lying down for a while. Other patients, such as athletes, feel pain after prolonged periods of activity or exercise (but not during).

Along with plantar fasciitis, many patients suffer from heel spurs, a bony projection in the heel.  A common misconception is that heel spurs cause plantar fasciitis, but most heel spurs cause no symptoms and many go undetected for years.

The following are risk factors for developing plantar fasciitis:

• Being overweight/ obese
• Age (between ages of 40 and 60)
• Tight calf muscles
• Faulty foot mechanics such as high arches or flat feet
• Impact activity from running or other sports
• New or increased activity
• Occupations that require you to spend long hours on feet

Some simple treatments that you can do from the comfort of your home include rolling a frozen water bottle underneath your foot and stretching your calf muscles multiple times a day. You could also do a towel stretch by using a towel to pull the top part of your foot back towards you while sitting down.

If you suffer from a more severe case of heel pain, come see us. Some of our treatments include taking an oral anti-inflammatory, cortisone injections, shoe orthotics, and night splints. Call our office to schedule an appointment today.

Community Foot Specialists - Podiatrists/Foot & Ankle Surgeons Serving Dayton and Springfield, Ohio Call today to schedule your appointment! (937) 426-9500

Joakim Noah and Plantar Fasciitis

Joakim Noah

How would you like to run around feeling like you have hundreds of needles underneath your feet? Doesn't sound very pleasant, does it? Well that’s what Chicago Bulls Center Joakim Noah is dealing with right now. This is called plantar fasciitis.

Plantar fasciitis is a painful inflammatory process of the plantar fascia, the connective tissue on the sole (bottom surface) of the foot. Plantar fasciitis is one of the most common causes of heel pain. Plantar fasciitis is caused by straining the ligament that supports your arch. Repeated strain can cause tiny tears in the ligament. This is more likely to happen if your feet roll inward too much when you walk, you walk, stand or run for long periods of time, especially on hard surfaces.

Most people with plantar fasciitis have pain when they take their first steps after they get out of bed or sit for a long time. As the injury advances into later stages, the pain will begin to feel like little needles sticking you in the bottom of your heel with each step.

There is no instant cure for plantar fasciitis but immediate intervention is very important so it does not get worse. Your podiatrist will likely recommend adequate rest to take the strain off the Plantar Fascia and allow the affected tissues time to heal. There are also exercises your podiatrist may recommend, such as:

• Stretching your foot by flexing it up and down 10 times before standing.
• Do toe stretches to stretch the plantar fascia.
• Use a towel to stretch the bottom of your foot.
• Use a rolling pin or tennis ball. While seated, roll the rolling pin or ball with the arch of your foot. If you are able to, progress to doing this exercise while you are standing up.

Your podiatrist may also recommend custom made JM orthotics to be worn in your shoe to support your arch.

As for Joakim Noah, he’s still playing for the Bulls during the playoffs. The series is currently at 3-1, with Miami in the lead.Noah was quoted a couple of weeks ago telling reporters, "It really sucks. It feels like you have needles underneath your foot while you're playing. You need to run, you need to jump (and) you need to do a lot of things while you're playing basketball. So you don't want needles on your feet, right?”

According to the ChicagoTribune, Noah is receiving treatment for his plantar fasciitis. Aside from resting when he can, he has tried platelet rich plasma injections, sleeping in a splint and three seasons ago- shock wave therapy. He most recently received cortisone shots. Although these treatments might be beneficial, they are far from the typical prescribed treatments. For those of us who are not Joakim Noah or a pro-athlete during their mid-playoff stride, it is recommended that, first and foremost, you go and see a podiatrist. It is also recommended that you rest and stretch as much and often as you can. It is imperative that you do not put unwarranted stress on the heel of your foot. 

Community Foot Specialists - Podiatrists/Foot & Ankle Surgeons Serving Dayton and Springfield, Ohio Call today to schedule your appointment! (937) 426-9500

Common Foot Conditions and Treatments

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IngrownToenail- When a toenail is ingrown, the nail is curved downward and grows into the skin, usually at the nail borders (the side of the nail). This “digging in” of the nail irritates the skin, often creating pain, redness, swelling, and warmth in the toe. If an ingrown nail causes a break in the skin, bacteria may enter and cause an infection in the area, which is often marked by drainage and a foul odor. However, even if your toe isn’t painful, red, swollen, or warm, a nail that curves downward into the skin can progress to an infection.

Treatment- If an infection is present, an oral antibiotic may be prescribed. A simple procedure, often performed in the office, is commonly needed to ease the pain and remove the offending nail. Surgery may involve numbing the toe and removing a corner of the nail, a larger portion of the nail, or the entire nail. A chemical or the entire root is taken out to make sure the ingrown is permanently removed.

HeelPain- is most often caused by plantar fasciitis. 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 podiatric foot and ankle surgeon is best trained to distinguish between all the possibilities and determine the underlying source of your heel pain.

Treatment- Stretching exercises. Exercises that stretch out the calf muscles help ease pain and assist with recovery. Avoid going barefoot. When you walk without shoes, you put undue strain and stress on your plantar fascia. Ice. Putting an ice pack on your heel for 10 minutes several times a day helps reduce inflammation. Limit activities. Cut down on extended physical activities to give your heel a rest. Shoe modifications. Wearing supportive shoes that have good arch support and a slightly raised heel reduces stress on the plantar fascia. Your shoes should provide a comfortable environment for the foot. Lose weight. Extra pounds put extra stress on your plantar fascia. Padding and strapping. Placing pads in the shoe softens the impact of walking. Strapping helps support the foot and reduce strain on the fascia. Orthotic devices. Custom orthotic devices that fit into your shoe help correct the underlying structural abnormalities causing the plantar fasciitis. Injection therapy. In some cases, corticosteroid injections are used to help reduce the inflammation and relieve pain. Removable walking cast. A removable walking cast may be used to keep your foot immobile for a few weeks to allow it to rest and heal. Night splint. Wearing a night splint allows you to maintain an extended stretch of the plantar fascia while sleeping. This may help reduce the morning pain.

Plantar Warts- A wart is a small growth on the skin that develops when the skin is infected by a virus. Warts can develop anywhere on the foot, but typically they appear on the bottom (plantar side) of the foot. A solitary wart is a single wart. It often increases in size and may eventually multiply, forming additional “satellite” warts. Mosaic warts are a cluster of several small warts growing closely together in one area. Mosaic warts are more difficult to treat than solitary warts.

Treatment-  The foot and ankle surgeon may use topical or oral treatments, laser therapy, cryotherapy (freezing), or surgery to remove the wart. Regardless of the treatment approaches undertaken, it is important that the patient follow the surgeon’s instructions, including all home care and medication that has been prescribed, as well as follow-up visits with the surgeon. Warts may return, requiring further treatment.

If you or someone you know is experiencing any of these foot problems, contact your Dayton/Springfield podiatrist at Community Foot Specialists. 937-426-9500

Question of the Week: All About Shoe Comfort!

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By: Dr. Belinda M. Dotter

One of the most common questions asked in my Dayton area Podiatry office involves shoes.  What shoes are good?   How do I buy shoes? Am I doing the right thing about my shoe wear?

Shoes are near and dear to almost every woman's heart and many of us have at one time, preferred to be crippled but gorgeous, as opposed to comfortable but not-so-cute.  With these guidelines, perhaps we can find a happy medium.

•          Shoe sizes differ between manufacturers.  You can have your shoe size measured, but use it as a guideline.  Try half a size up or down your measurement.  Buy shoes later in the day, to accommodate for swelling.  Have your feet measured once per year, as age, pregnancy, and weight gain may increase shoe sizes.  If you lose weight, your feet also get smaller.  Not only will you need new clothing, but new shoes too (bonus!).  Do not buy tight shoes thinking that they will "break-in" later on.  Buy shoes that are comfortable from the start.
•          3 inch heel limit.  Stacked heels, wedges are vastly better than stiletto heels.  If you have "weak" ankles, or history of ankle sprains, strictly avoid stilettos as you will further injure your ankles.  Chronic stiletto heel wearers regularly develop achilles tendonitis and contraction of the achilles tendon, making it too tight and causing pain with every step.
•         Pick shoes with thicker soles.  More cushion, more support.  Constantly wearing flip-flops during the summer may cause many a foot pain.  Notice that when you wear them, your toes grip or flex, to try and hold the flip-flop in place.  You may develop plantar fasciitis (arch pain or heel pain) or hammertoes!
•          Limit wearing the same shoes every day.  It puts repeated pressure on identical areas of the foot, causing irritation and letting deformities further develop or worsen (such as bunions or hammertoes).  You may also re-infect your foot continually if you have athlete's foot!
•          Finally, orthotics.  There is a controversy about their increasing use, especially since custom orthotics cost hundreds of dollars and is not regularly covered by insurance.  Many foot problems are prevented and alleviated by orthotic wear, but some foot problems caused by overuse, overtraining, and being overweight won't be helped by them. Using orthotics heavily depends on the primary cause of your foot pain so discuss with your podiatrist how the orthotics will help you.
•        As a final note, Studies by Irene Davis, professor of physical therapy at the University of Delaware, found that "semi-custom" models (the lab uses a mold of the patient's feet to identify the best-fitting prefabricated insole) work as well as the totally customized, built-from-scratch kind.

If you are still having a hard time figuring out which shoes work best for you, stop by or call one of our six Dayton and Springfield Community Foot Specialists locations to speak with a podiatrist. We're here to get you (comfortably!) back on your feet! Call today, 937-426-9500