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Posts for category: Sports Injuries

Plantar fasciitis is one of the most common causes of foot pain, especially among athletes, older adults, and people who spend a lot of time on their feet. If you’re overweight or if you have a certain type of foot shape or walking style you can also be more prone to plantar fasciitis.

The good news: At Carolina Foot Specialists we offer custom treatment plans to help men, women, and children eliminate the painful symptoms of plantar fasciitis/heel pain, so they can get back to the activities they love — without pain.

However, even when treated successfully plantar fasciitis can return. Dr. Brown and Dr. Saffer offer the following preventive tips.

1. Get lots of rest

Since plantar fasciitis pain is caused by irritation and inflammation, staying off your feet can be helpful in reducing both these problems, so pain is reduced too. Keep your feet elevated while you rest and limit your exercise to low-impact activities like cycling or swimming. Avoid any activities that involve running or jumping for a period of time. And if your job requires a lot of standing, see if there's a way to incorporate sitting more often or using an elevated stool to take some pressure off your feet.

2. Stretch your feet

Gently stretching the bottoms of your feet before exercise or activity can help “warm up” the plantar fascia and the muscles that surround it, so your entire foot is more flexible and therefore less prone to injury and pain. Plus, stretching improves circulation which helps the area heal. During your office visit, we can provide you with specific exercises that can help condition your foot without straining it.

3. Night Splints

Night splints are an essential part of the treatment plan to avoid reoccurring plantar fasciitis. Night splints work by stretching the calf (Gastroc-soleus muscle) and plantar fascia of the foot while you sleep. Night splints also help provided the supportive stretching the user may need throughout the day while they are on their feet. Both of our locations have various night splints and we make sure that the appropriate style and fit is made for each individual patient.

4. Lose excess weight

Extra pounds mean more load on your feet, especially on your arches. Taking off that weight can reduce the strain on your plantar fascia ligament and the other structures that support your feet. Low impact exercise such as biking, yoga, and swimming will reduce excess load on the feet while you are recovering from plantar fasciitis.

5. Wear the right shoes

Good arch support is a big part of preventing a recurrence of plantar fasciitis, and you also want to be sure your shoes provide your feet (and your ankles) with ample support as well. If you’re active, it’s really important to replace athletic footwear on a regular basis since the structure of your shoes can wear down over time. If you can, limit your use of footwear with flat bottoms, like flip-flops and slippers since these provide no arch support at all. Our Foot care specialists will recommend the appropriate athletic shoe for your specific individual activity.

6. Invest in custom orthotics

Custom orthotics (special shoe inserts custom designed and made just for you) are one of the best ways to prevent plantar fasciitis from recurring. Unlike over-the-counter inserts that use a one-size-fits-all approach, custom orthotics are based on your foot shape and on the issue, you need to have treated for far better results. Plus, they’re built to last, which means they can save you a lot of money in the long run.

7. Schedule a visit at the first sign of pain

Plantar fasciitis is very common, and there are plenty of ways to treat it. One of the best ways to prevent painful symptoms from recurring is to schedule an office visit at the first sign of discomfort so you can get early care that can prevent the problem from progressing.

Don’t let foot pain stand in your way

Plantar fasciitis is just one of the causes of chronic foot pain. No matter what’s behind your painful symptoms, one thing’s for sure: Getting prompt treatment is one of the best ways to prevent your problem from becoming a lot worse. Don’t let foot pain interfere with your lifestyle. If you’re having foot pain or other foot or ankle symptoms, the skilled team at Carolina Foot Specialists can help. To schedule your consultation and evaluation, contact the practice today.

Plantar fasciitis is one of the most common complaints that we see in our practice.  The number of patients known to have the problem is estimated to be between six and seven million.

Many patients attempt to treat the problem at home prior to seeking treatment from a doctor which is fine unless the problem has been present for an extended period of time, usually between 3-6 months. That is when they often learn about Plantar Fasciopathy for the first time.

WHAT’S THE DIFFERENCE BETWEEN PLANTAR FASCIITIS AND PLANTAR FASCIOPATHY?

 

Plantar fasciitis is actually divided into conditions with two different treatment requirements. Acute plantar fasciitis is an inflammatory condition and is associated with irritation and inflammation of the plantar fascia at its insertion on the heel region.

After six months this develops into chronic plantar fasciitis, the problem actually changes and and is referred to as plantar fasciopathy. Plantar fasciopathy is non-inflammatory and there is a lack of blood supply to the region and the body thinks of the problem as being normal. This lack of blood supply results in the body not responding to the condition and therefore a lack of healing potential in the region.

IS PLANTAR FASCIITIS AND PLANTAR FASCIOPATHY TREATED DIFFERENTLY?

Treatment for these two conditions is very different and we would like to educate you on new and improved treatments for chronic plantar fasciopathy.

If plantar fasciitis is treated early and aggressively, it is often not very difficult to treat. Treatment options include stretching, night splints, oral NSAIDS, shoe modifications to a stiffer and stronger sole, added arch support or custom orthotics, physical therapy and cortisone injection therapy.

Chronic plantar fasciopathy, there is NO inflammation present and there is a chronic scar tissue formation in the heel region with the body not responding to the region. The goal of treatment is to INCREASE inflammation and return the body’s blood supply to the region to help with healing.

Typically conservative treatments used for acute plantar fasciitis do not usually work well in these situations.

CHRONIC PLANTAR FASCIOPATHY TREATMENTS

Our common treatments in chronic plantar fasciopathy include aggressive physical therapy with additional custom arch support and shoe modifications. However, in many cases, there is a need for noninvasive and minimally invasive therapy to increase blood to the region.

Treatment options plantar Fasciopathy

Treatment options cause an irritation of the region of the plantar fascia that’s non-responsive and lacking the healing blood supply. This will result in a return of blood to the area and take the chronic condition and make it more acute which can then allow the body to heal the region.

Shockwave Therapy (EPAT)

Shockwave therapy has been around for about 30 years and is basically a small jack hammer that is hitting the heel area and breaking up scar tissue. Much like someone hitting your shoulder over and over with a punch which causes inflammation, the concept of shockwave therapy is to cause minor damage to the region and increase blood supply. It is a treatment that can work well but is somewhat obsolete. The main benefit is that the treatment is fairly simple and does not involve injection or internal treatment.

Platelet Rich Plasma and Amniotic Injections

PRP and amniotic injections are used to bring the patient’s own blood cells and healing cells to the region of chronic injury. Both treatments help recruit cells necessary to heal and have a very strong result in our hands. These treatments work well but can be somewhat painful and moderate to severe cases of scar formation may not respond well to this treatment.

Radio Frequency Ablation (TOPAZ)

There is a group of patients who have such extensive plantar fasciopathy that the PRP and amniotic injection are not strong enough to treat. In such cases, radio frequency ablation was used to break up the scar tissue with a small needle probe. The previous treatments such as Topaz used approximately 20-30 small needle holes made through the skin on the bottom of the foot to break up the scar tissue on the sole of the foot.

 

The Tenjet System for Chronic Plantar Fasciopathy (Our practice is currently researching this new technology and looking at long term studies)

 

The Tenjet system releases a high-power water jet into the region of the plantar fascia scar tissue and damage. The system is used under ultrasound guidance and the water jet which breaks up the scar tissue is connected to suction and the scar tissue is sucked out after it is broken up by the water jet.

WHAT’S THE BEST TREATMENT OPTION FOR CHRONIC PLANTAR FASCIITIS TREATMENT?

The best treatment always depends on the patient and their individual condition. So the first thing we do is separate patients into two distinct groups, those with acute plantar fascia (suffering less than six months) and those that have truly chronic plantar fascia issues.

Acute treatment for Plantar Fascia patients includes:

  • Shoe modification/recommendations
  • Custom Orthotics
  • Physical therapy
  • Tapings
  • Oral NSAIDS
  • Possible steroid injection

In conclusion, if you have been suffering from acute or chronic heel pain then please visit our Sports Podiatrist at Carolina Foot Specialists so that we can figure out the cause of your heel pain and work on solutions to resolve your pain.

Dr. Andrew Saffer-CFS Mount Pleasant 843-654-8250

Dr. Adam Brown-CFS Charleston 843-225-5575

www.carolinafootspecialists.net

Modern-Plantar-Fasciitis-Treatment-Options-Explained

I wanted to spend some time today addressing a common athletic foot injury that I see very commonly in women. The injury that I frequently see is a metatarsal stress fracture. This short blog will give you valuable information of how to recognize and treat this common sports related injury.

Typically a metatarsal stress fracture will presents acutely with pain and swelling on top of foot just at the base of the lesser toes. The most common symptom is pain and swelling to the dorsal forefoot with or without trauma. Stress fractures often result from increasing the amount or intensity of an activity too quickly. This could be due to increasing the amount of mileage associated with walking or running while training for a road race. Other factors found more commonly in women would be poor bone density (osteoporosis), low body weight,  and menstrual disturbances.

Oftentimes I will see patient's that present with pain four weeks prior and they may have initially had a X-ray that was negative for a stress fracture. When we see a patient for the first time four weeks after the symptoms manifested we then take a repeat X-rays which shows a stress fracture. It may take 10-14 for a stress fracture to be visible on X-ray examination. Typically bone callus on both sides of the metatarsal will confirm the stress fracture is healing. If a metatarsal stress fracture is not promptly treated with immobilization with a cam walker and reduction of activity this could lead to further swelling/pain and possible delayed healing of the fracture.

Stress fractures take 6-8 weeks to heal and are treated with either a surgical shoe or cam walker boot. We do advocate low impact non-weight bearing activity to keep patient's active such as swimming or biking during the healing phase.

A protein deficiency, along with an overall calorie-deficient diet can relate to associated medical problems. One of these could include loss of regular menstrual cycles. Estrogen levels decline when menustration stops. This drop in estrogen leaves the bones in the body more prone to a stress fracture.

I usually recommend that women over 40 follow up with their family doctor for a bone density test. Certain blood work can be ordered such as determination of calcium, potassium, and magnesium levels which are vital for proper bone health.

If you have noticed increased pain and swelling on the top of your foot this could be a stress fracture. This is not normal and it is essential that this be treated to ensure the fracture heals correctly.

Dr. Brown and Dr. Saffer have all the available clincial and diagostic tools to diagnosis this condition correctly and can expedite the healing of this common sports related foot injury.

If you have suffered from chronic heel pain and your symptoms have not improved with traditional conservative treatments options then we may have a solution that will cure your heel pain for good.

We are offering a new treatment modality for chronic heel pain called (EPAT) Extracorpeal pulse activation technology. Intense pulse sound waves are introduced into the soft tissues to break up scar tissue and increased blood flow to the injured area. This procedure reduces pain and inflammation as well as stimulates your own bodies healing mechanism. 

The advantages of this procedure are:

1)Painless

2)No down time

3) No anesthesia

4) In office procedure

Typically, the procedures takes 5 minutes and is done weekly for three weeks.

After the treatment you will experience decreased pain and begin to have relief from symptoms which continues to improve over a 3-5 week period.

So, if you experience chronic heel pain make an appointment with our practice to see if you are a candidate for EPAT.

https://www.carolinafootspecialists.net/heel-pain.html