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Does Over-Pronation Involve Surgical Treatments

Overview

Pronation is the natural motion of the foot as it roles inward after the foot makes contact with the ground. It gives the foot the opportunity to act as a shock absorber for the body and adapt to the contour of the ground. Too much pronation will cause the arch of the foot to flatten excessively placing stress and pressure on tissues and ligaments of the foot. Over pronation can lead to numerous foot problems including plantar fasciitis, ankle pain, shin pain, knee pain, bunions, mortons neuroma, chondromalcia patallae and lower back pain.Over-Pronation

Causes

There are many causes of flat feet. Obesity, pregnancy or repetitive pounding on a hard surface can weaken the arch leading to over-pronation. Often people with flat feet do not experience discomfort immediately, and some never suffer from any discomfort at all. However, when symptoms develop and become painful, walking becomes awkward and causes increased strain on the feet and calves.

Symptoms

Because pronation is a twisting of the foot, all of the muscles and tendons which run from the leg and ankle into the foot will be twisted. In over-pronation, resulting laxity of the soft tissue structures of the foot and loosened joints cause the bones of the feet shift. When this occurs, the muscles which attach to these bones must also shift, or twist, in order to attach to these bones. The strongest and most important muscles that attach to our foot bones come from our lower leg. So, as these muscles course down the leg and across the ankle, they must twist to maintain their proper attachments in the foot. Injuries due to poor biomechanics and twisting of these muscles due to over-pronation include: shin splints, Achilles Tendonitis, generalized tendonitis, fatigue, muscle aches and pains, cramps, ankle sprains, and loss of muscular efficiency (reducing walking and running speed and endurance). Foot problems due to over-pronation include: bunions, heel spurs, plantar fasciitis, fallen and painful arches, hammer toes, and calluses.

Diagnosis

You can test for pronation by looking at the leg and foot from the back. Normally you can see the Achilles Tendon run straight down the leg into the heel. If the foot is pronated, the tendon will run straight down the leg, but when it lies on the heel it will twist outward. This makes the inner ankle bone much more prominent than the outer ankle bone.Overpronation

Non Surgical Treatment

The following exercises help retrain the foot and ankle complex to correct overpronation. Step Up and Over. This exercise is designed to integrate skills learned in the Duck Stand, Big Toe Pushdowns and Side Step with Opposite Reach exercises to mimic walking and even running. Using the gluteal muscles and big toe in tandem will prevent overpronation while moving back and forth over the BT in a more effective, balanced motion. Movement Directions. Stand with left foot on top of the BT dome. (Note: For added balance, the right foot can tap on the ground, if needed). Extend right foot backwards to the ground and drop hips into a lunge position. Make sure that the right arm rotates across the left leg (this will activate the gluteal muscles on the left side). Now, step through and over the BT into a front lunge with the right leg forward. While lunging forward, the torso and left arm now rotate over the right leg. Throughout the exercise, push big toe down into the BT. Perform 8 to 10 repetitions on both sides.

Prevention

Custom-made orthotics supports not only the arch as a whole, but also each individual bone and joint that forms the arch. It is not enough to use an over-the-counter arch support, as these generic devices will not provide the proper support to each specific structure of the arch and foot. Each pronated foot?s arch collapses differently and to different degrees. The only way to provide the support that you may need is with a custom-made device. This action of the custom-made orthotic will help to prevent heel spurs, plantar fasciitis, calluses, arch pain, and weakness of the entire foot.

Severs Disease Physical Therapy

Overview

If your child is limping, having difficulty walking, complaining of pain in their heels upon waking up in the morning or experiencing swelling or redness in the heel, it’s extremely important that you pay attention to their symptoms and seek expert medical help as soon as possible. Heel pain in adolescents is frequently a sign of a condition known as Sever’s Disease (Calcaneal Apophysitis), and while this is not a life-threatening condition, it can lead to debilitating symptoms for your child which should be remedied as quickly as possible. This article provides an easy-to-read introduction to the causes of and treatment options for Sever’s Disease. By educating yourself on this important topic, you will be ready to seek the right help for your child so that he or she can regain their health and be free of pain again.

Causes

Overuse and stress on the heel bone through participation in sports is a major cause of calcaneal apophysitis. The heel?s growth plate is sensitive to repeated running and pounding on hard surfaces, resulting in muscle strain and inflamed tissue. For this reason, children and adolescents involved in soccer, track, or basketball are especially vulnerable. Other potential causes of calcaneal apophysitis include obesity, a tight Achilles tendon, and biomechanical problems such as flatfoot or a high-arched foot.

Symptoms

The symptoms include pain, tenderness, swelling or redness in the heel, and they might have difficulty walking or putting pressure on the heel. If you notice that your child suddenly starts walking around on their toes because their heels hurt, that?s a dead giveaway. Kids who play sports might also complain of foot pain after a game or practice. As they grow, the muscles and tendons will catch up and eventually the pressure will subside along with the pain. But in the meantime, it can become very uncomfortable.

Diagnosis

It is not difficult for a doctor to diagnose Sever’s disease in a youngster or teenager. A personal history and a physical examination are usually all it takes to determine the cause of heel pain.

Non Surgical Treatment

The aims are to reduce trauma to the heel, allow rest/recovery and prevent recurrence. Most cases are successfully treated using physiotherapy and exercises, eg to stretch the gastrocnemius-soleus complex, to mobilise the ankle mortise, subtalar joint and medial forefoot. Soft orthotics or heel cups. Advice on suitable athletic footwear. Other modes of treatment are in severe cases, temporarily limiting activity such as running and jumping. Ice and non-steroidal anti-inflammatory drugs (NSAIDs), which can reduce pain. In very severe cases, a short period of immobilisation (eg 2-3 weeks in a case in mild equinus position) has been suggested.

Recovery

Sever?s disease is self-recovering, meaning that it will go away on its own when the foot is used less or when the bone is through growing. The condition is not expected to create any long-term disability, and expected to subside in 2-8 weeks. Some orthopedic surgeons will put the affected foot in a cast to immobilize it. While symptoms can resolve quickly, they can recur. Sever’s disease is more common in boys than girls the average age of symptom onset is nine to eleven years.

Do I Suffer Adult Aquired Flat Foot ?

Overview

The posterior tibial tendon serves as one of the major supporting structures of the foot, helping it to function while walking. Posterior tibial tendon dysfunction (PTTD) is a condition caused by changes in the tendon, impairing its ability to support the arch. This results in flattening of the foot. PTTD is often called adult acquired flatfoot because it is the most common type of flatfoot developed during adulthood. Although this condition typically occurs in only one foot, some people may develop it in both feet. PTTD is usually progressive, which means it will keep getting worse, especially if it isn?t treated early.Adult Acquired Flat Feet


Causes

Obesity – Overtime if your body is carrying those extra pounds, you can potentially injure your feet. The extra weight puts pressure on the ligaments that support your feet. Also being over weight can lead to type two diabetes which also can attribute to AAFD. Diabetes – Diabetes can also play a role in Adult Acquired Flatfoot Deformity. Diabetes can cause damage to ligaments, which support your feet and other bones in your body. In addition to damaged ligaments, uncontrolled diabetes can lead to ulcers on your feet. When the arches fall in the feet, the front of the foot is wider, and outer aspects of the foot can start to rub in your shoe wear. Patients with uncontrolled diabetes may not notice or have symptoms of pain due to nerve damage. Diabetic patient don?t see they have a problem, and other complications occur in the feet such as ulcers and wounds. Hypertension – High blood pressure cause arteries narrow overtime, which could decrease blood flow to ligaments. The blood flow to the ligaments is what keeps the foot arches healthy, and supportive. Arthritis – Arthritis can form in an old injury overtime this can lead to flatfeet as well. Arthritis is painful as well which contributes to the increased pain of AAFD. Injury – Injuries are a common reason as well for AAFD. Stress from impact sports. Ligament damage from injury can cause the bones of the foot to fallout of ailment. Overtime the ligaments will tear and result in complete flattening of feet.


Symptoms

PTTD begins with a gradual stretching and loss of strength of the posterior tibial tendon which is the most important tendon supporting the arch of the human foot. Left untreated, this tendon will continue to lengthen and eventually rupture, leading to a progressive visible collapse of the arch of the foot. In the early stages, patients with PTTD will notice a pain and swelling along the inner ankle and arch. Many times, they are diagnosed with ?tendonitis? of the inner ankle. If the foot and ankle are not properly supported during this early phase, the posterior tibial tendon can rupture and devastating consequences will occur to the foot and ankle structure. The progressive adult acquired flatfoot deformity will cause the heel to roll inward in a ?valgus? or pronated direction while the forefoot will rotate outward causing a ?duckfooted? walking pattern. Eventually, significant arthritis can occur in the joints of the foot, the ankle and even the knee. Early diagnosis and treatment is critical so if you have noticed that one, or both, of your feet has become flatter in recent times come in and have it checked out.


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

Treating PTTD is almost always easier the earlier you catch it. So, the first step in treatment is to see your doctor as soon as you begin experiencing painful symptoms. However, once your condition has been diagnosed, your podiatrist will likely try to give the upset tendon a bit of a break so it?ll calm down and stop being so painful. This can often be accomplished by immobilizing the foot using tape and padding, braces, or casts, depending on what your podiatrist believes will work best for you, and depending on the severity of your condition. You may also be instructed to reduce inflammation by applying ice to the area (usually 40 minutes on and 20 minutes off, with a thin

towel between you and the ice). Or, you might take anti-inflammatory medications like ibuprofen (steroidal anti-inflammatory meds are actually likely to make this problem worse, and are not usually recommended in treating PTTD), or use ultrasound therapy. Once the inflammation has gone down a bit, your podiatrist may recommend using orthotics (prescription shoe inserts) to support your damaged arch. Ankle braces can also be helpful.

Acquired Flat Foot


Surgical Treatment

Surgical intervention for adult acquired flatfoot is appropriate when there is pain and swelling, and the patient notices that one foot looks different than the other because the arch is collapsing. As many as three in four adults with flat feet eventually need surgery, and it?s better to have the joint preservation procedure done before your arch totally collapses. In most cases, early and appropriate surgical treatment is successful in stabilizing the condition.

Coping With Achilles Tendon Pain

Overview

Achilles TendinitisThe Achilles tendon camera.gif connects the calf muscle to the heel bone. It lets you rise up on your toes and push off when you walk or run. The two main problems are, Achilles tendinopathy. This includes one of two conditions, Tendinitis. This actually means “inflammation of the tendon.” But inflammation is rarely the cause of tendon pain. Tendinosis. This refers to tiny tears (microtears) in the tissue in and around the tendon. These tears are caused by overuse. In most cases, Achilles tendon pain is the result of tendinosis, not tendinitis. Some experts now use the term tendinopathy to include both inflammation and microtears. But many doctors may still use the term tendinitis to describe a tendon injury. Problems with the Achilles tendon may seem to happen suddenly. But usually they are the result of many tiny tears in the tendon that have happened over time. Achilles tendinopathy is likely to occur in men older than 30. Most Achilles tendon ruptures occur in people 30 to 50 years old who are recreational athletes (“weekend warriors”). Ruptures can also happen in older adults.

Causes

As ?overuse? disorders, Achilles tendonitis and tendonosis are usually caused by a sudden increase of a repetitive activity involving the Achilles tendon. Such activity puts too much stress on the tendon too quickly, leading to micro-injury of the tendon fibers. Due to this ongoing stress on the tendon, the body is unable to repair the injured tissue. The structure of the tendon is then altered, resulting in continued pain. Achilles4Athletes are at high risk for developing disorders of the Achilles tendon. Achilles tendonitis and tendonosis are also common in individuals whose work puts stress on their ankles and feet, such as laborers, as well as in ?weekend warriors?-those who are less conditioned and participate in athletics only on weekends or infrequently. In addition, people with excessive pronation (flattening of the arch) have a tendency to develop Achilles tendonitis and tendonosis due to the greater demands placed on the tendon when walking. If these individuals wear shoes without adequate stability, their over-pronation could further aggravate the Achilles tendon.

Symptoms

There are several types of Achilles tendinitis symptoms, but all of them are closely related. People who suffer from Achilles tendon pain typically have swelling in the Achilles tendon, and that pain can be chronic as the microscopic tears in the area become more prevalent over time. The most intense pain is typically located just a few centimeters above the area where the tendon meets the heel. This area is called the watershed zone, and the amount of blood moving through it is what gives it the highest potential for injury, especially for athletes. Most of the Achilles tendinitis symptoms in people with the condition will happen immediately after they have been inactive for a fairly significant amount of time. That means that the most pain will generally be felt after sitting or lying down for an extended period, or right after waking up in the morning and getting moving. If you aren?t positive that you are suffering specifically from Achilles tendinitis symptoms, consult a doctor to make sure.

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

Supportive shoes and orthotics. Pain from insertional Achilles tendinitis is often helped by certain shoes, as well as orthotic devices. For example, shoes that are softer at the back of the heel can reduce irritation of the tendon. In addition, heel lifts can take some strain off the tendon. Heel lifts are also very helpful for patients with insertional tendinitis because they can move the heel away from the back of the shoe, where rubbing can occur. They also take some strain off the tendon. Like a heel lift, a silicone Achilles sleeve can reduce irritation from the back of a shoe. If your pain is severe, your doctor may recommend a walking boot for a short time. This gives the tendon a chance to rest before any therapy is begun. Extended use of a boot is discouraged, though, because it can weaken your calf muscle. Extracorporeal shockwave therapy (ESWT). During this procedure, high-energy shockwave impulses stimulate the healing process in damaged tendon tissue. ESWT has not shown consistent results and, therefore, is not commonly performed. ESWT is noninvasive-it does not require a surgical incision. Because of the minimal risk involved, ESWT is sometimes tried before surgery is considered.

Achilles Tendinitis

Surgical Treatment

Achilles tendon repair surgery is often used to repair a ruptured or torn Achilles tendon, the strong fibrous cord that connects the two large muscles in the back of your calf to your heel bone. These muscles (the gastrocnemius and the soleus) create the power needed to push off with your foot or rise up on your toes. Achilles tendon ruptures are quite common. Most happen during recreational activities that require sudden bursts of muscle power in the legs. Often a torn Achilles tendon can be diagnosed with a physical examination. If swelling is present, the orthopaedist may delay the Achilles tendon surgery until it subsides.

Prevention

You can take measures to reduce your risk of developing Achilles Tendinitis. This includes, Increasing your activity level gradually, choosing your shoes carefully, daily stretching and doing exercises to strengthen your calf muscles. As well, applying a small amount ZAX?s Original Heelspur Cream onto your Achilles tendon before and after exercise.

What Exactly Leads To Plantar Fasciitis

Painful Heel

Overview

Plantar fasciitis is the most common cause of heel pain. The plantar fascia camera.gif is the flat band of tissue (ligament) that connects your heel bone to your toes. It supports the arch of your foot. If you strain your plantar fascia, it gets weak, swollen, and irritated (inflamed). Then your heel or the bottom of your foot hurts when you stand or walk. Plantar fasciitis is common in middle-aged people. It also occurs in younger people who are on their feet a lot, like athletes or soldiers. It can happen in one foot or both feet.


Causes

It is common to see patients with Plantar Fasciitis who have been wearing shoes that are too soft and flexible. The lack of support can be stressful on the heel for those patients who’s feet aren’t particularly stable. If these ill fitting shoes are worn for long enough, the stress will lead to Heel Pain as the inflammation of the fascia persists. Footwear assessment and advice will be essential in order to get on top of the Plantar Fasciitis. It may surprise some people to learn that high heeled shoes are not the cause of Plantar Fasciitis, although they can cause tight calf muscles. High arches can lead to Plantar Fasciitis. This is due to the lack of contact under the sole of the foot. Even sports shoes which appear to have good arch support inside are often too soft and not high enough to make contact with the arch of the foot. Hence, the plantar fascia is unsupported. This can lead to Heel pain and Plantar Fasciitis. Flat feet can lead to Plantar Fasciitis. Flat feet is caused by ligament laxity and leads to foot instability. Other structures such as muscles, tendons and fascia work harder to compensate for this instability. Heel pain or Plantar Fasciitis arises when the instability is too great for these other structures to cope with. The strain on the fascia is too severe and the inflammation sets in. Over stretching can lead to Plantar Fasciitis. Certain calf stretches put the foot into a position that creates a pulling sensation through the sole of the foot. This can cause Plantar Fasciitis which can cause pain in the arch of the foot as well as Heel Pain.


Symptoms

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. You may have less stiffness and pain after you take a few steps. But your foot may hurt more as the day goes on. It may hurt the most when you climb stairs or after you stand for a long time. If you have foot pain at night, you may have a different problem, such as arthritis, or a nerve problem such as tarsal tunnel syndrome.


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

Reducing inflammation in the plantar fascia ligament is an important part of treatment, though this does not address the underlying damage to the ligament. Initial home treatment includes staying off your feet and applying ice for 15 to 20 minutes three or four times a day to reduce swelling. You can also try reducing or changing your exercise activities. Using arch supports in your shoes and doing stretching exercises may also help to relieve pain. Nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen (i.e. Motrin or Advil) and naproxen (i.e. Aleve), are often used to reduce inflammation in the ligament. If home treatments and over-the-counter anti-inflammatory drugs don’t ease the pain, an injection of a corticosteroid directly into the damaged section of the ligament can be given. Your doctor can do this in his or her office. Your doctor may use an ultrasound device to help determine the best place for the injection. Corticosteroids can also be administered on the skin of your heel or the arch of your foot, and then a painless electrical current is applied to let the steroid pass through your skin and into the muscle. Physical therapy is an important part of treatment for planter fasciitis. It can help stretch your plantar fascia and Achilles tendons. A physical therapist can also show you exercises to strengthen your lower leg muscles, helping to stabilize your walk and lessen the workload on your plantar fascia. If pain continues and other methods aren’t working, your doctor may recommend extracorporeal shock wave therapy. Sound waves are bombarded against your heel to stimulate healing within the ligament. This treatment can result in bruises, swelling, pain, and numbness, and has not been proven to be consistently effective in relieving symptoms.

Foot Pain


Surgical Treatment

Most patients have good results from surgery. However, because surgery can result in chronic pain and dissatisfaction, it is recommended only after all nonsurgical measures have been exhausted. The most common complications of release surgery include incomplete relief of pain and nerve damage.


Prevention

It is not always possible to prevent heel pain, but there are measures you can take to help avoid further episodes. Healthy weight. Being overweight can place excess pressure and strain on your feet, particularly on your heels. This increases the risk of damaging your feet and heels. If you are overweight, losing weight and maintaining a healthy weight by combining regular exercise with a healthy, balanced diet can be beneficial for your feet. You can calculate your body mass index (BMI) to find out whether you are a healthy weight for your height and build. To work out your BMI, divide your weight in kilograms by your height in metres squared. A BMI of less than 18.5 means that you are underweight, 18.5-24.9 means that your weight is healthy, 25-29 means that you are overweight, 30-40 means that you are obese, over 40 means that you are morbidly obese. You can also use the BMI healthy weight calculator to work out your BMI. Healthy feet. You should always wear footwear that is appropriate for your environment and day-to-day activities. Wearing high heels when you go out in the evening is unlikely to be harmful. However, wearing them all week at work may damage your feet, particularly if your job involves a lot of walking or standing. Ideally, you should wear shoes with laces and a low to moderate heel that supports and cushions your arches and heels. Avoid wearing shoes with no heels.

What Can Cause Painful Heel To Surface

Foot Pain

Overview

Plantar fasciitis is the most common cause of heel pain. Pain from plantar fasciitis is often most noticeable during the first few steps after getting out of bed in the morning. The plantar fascia is a thick band of tissue in the sole of the foot. Microtearing at the origin of the plantar fascia on the heel bone (calcaneus) can occur with repetitive loading. This microtearing leads to an inflammatory response (healing response) which produces the pain. Risk factors for plantar fasciitis include excessive standing, increased body weight, increasing age, a change in activity level, and a stiff calf muscle. Plantar fasciitis can be managed non-operatively in the vast majority of patients. The main components of an effective non-operative treatment program are: calf stretching with the knee straight, plantar fascia stretching, activity modification (to avoid precipitating activities), and comfort shoe wear.


Causes

Plantar fasciitis occurs when the ligament in your foot arch is strained repeatedly, which causes tiny tears and significant pain. There are several possible causes for this condition. Excessive pronation, or overpronation, which happens when your feet roll excessively inward as you walk. Flat feet or high arches. Walking, standing, or running for long periods of time, particularly on hard surfaces (a common problem for athletes). Excess weight, such as overweight or obesity. Shoes that are worn out or don’t fit well. Tight calf muscles or Achilles tendons.


Symptoms

The major complaint of those with plantar fasciitis is pain and stiffness in the bottom of the heel. This develops gradually over time. It usually affects just one foot, but can affect both feet. Some people describe the pain as dull, while others experience a sharp pain, and some feel a burning or ache on the bottom of the foot extending outward from the heel. The pain is usually worse in the morning when you take your first steps out of bed, or if you’ve been sitting or lying down for a while. Climbing stairs can be very difficult due to the heel stiffness. After prolonged activity, the pain can flare-up due to increased inflammation. Pain is not usually felt during the activity, but rather just after stopping.


Diagnosis

To diagnose plantar fasciitis, your doctor will physically examine your foot by testing your reflexes, balance, coordination, muscle strength, and muscle tone. Your doctor may also advise a magnetic resonance imaging (MRI) or X-ray to rule out other others sources of your pain, such as a pinched nerve, stress fracture, or bone spur.


Non Surgical Treatment

In many instances, plantar fasciitis can be treated with home care. Changing your physical activities, resting the foot, and applying ice to the area are common remedies. Taking over the counter medications such as ibuprofen or acetaminophen can help reduce pain and inflammation that may have developed. An orthotic device placed in your shoes can also significantly help to reduce pain. In addition, orthotics can also help promote healing to reverse plantar fasciitis. If pain from plantar fasciitis continues despite conservative treatments, you may need to visit a doctor or podiatrist. It’s important to seek medical advice before heel pain and damage becomes worse. If the condition is allowed to worsen, more serious or invasive forms of treatment may be required to stop pain. A visit to a doctor may reveal other conditions affecting the foot as well, such as Achilles tendonitis, heel spurs, or other heel pain conditions. An x-ray may also be taken, which can reveal the presence of a heel spur. In rare cases surgery may be required to release tension on the plantar fascia, or to remove a portion of a heel spur. But again, most heel pain conditions can be resolved using conservative treatment.

Heel Pain


Surgical Treatment

Surgery is rarely needed in the treatment of plantar fasciitis. The vast majority of patients diagnosed with plantar fasciitis will recover given ample time. With some basic treatment steps, well over 90% of patients will achieve full recovery from symptoms of plantar fasciitis within one year of the onset of treatment. Simple treatments include anti-inflammatory medication, shoe inserts, and stretching exercises. In patients where a good effort with these treatments fails to provide adequate relief, some more aggressive treatments may be attempted. These include cortisone injections or extracorporeal shock wave treatments.


Prevention

It is not always possible to prevent heel pain, but there are measures you can take to help avoid further episodes. Healthy weight. Being overweight can place excess pressure and strain on your feet, particularly on your heels. This increases the risk of damaging your feet and heels. If you are overweight, losing weight and maintaining a healthy weight by combining regular exercise with a healthy, balanced diet can be beneficial for your feet. You can calculate your body mass index (BMI) to find out whether you are a healthy weight for your height and build. To work out your BMI, divide your weight in kilograms by your height in metres squared. A BMI of less than 18.5 means that you are underweight, 18.5-24.9 means that your weight is healthy, 25-29 means that you are overweight, 30-40 means that you are obese, over 40 means that you are morbidly obese. You can also use the BMI healthy weight calculator to work out your BMI. Healthy feet. You should always wear footwear that is appropriate for your environment and day-to-day activities. Wearing high heels when you go out in the evening is unlikely to be harmful. However, wearing them all week at work may damage your feet, particularly if your job involves a lot of walking or standing. Ideally, you should wear shoes with laces and a low to moderate heel that supports and cushions your arches and heels. Avoid wearing shoes with no heels.

What Is Pain On The Heel

Plantar Fascia

Overview

Plantar fasciitis often occurs in middle-age. It also occurs in people who spend long hours standing on their feet at work, like athletes or soldiers. It can happen in one foot or both feet. It is common in sports like long distance running, dancing etc. Athletes who overpronate (rolling in or flattening feet) are especially at risk as the biomechanics of their feet place more stress to the band. Plantar fasciitis can take a long time to heal. Six months is the average time reported in medical research. There are some who will get cured after a few weeks and for others it will take more than a year. It can also become a chronic condition in which case some sort of treatment will always be needed to prevent the pain from coming back. As sooner as the condition is treated chances are it will not get chronic or in other words if you treat plantar fasciitis sooner you will get cured faster.


Causes

A variety of causes exist for plantar fasciitis. Some of the most common causes include excessive weight load on the foot due to obesity or prolonged standing, mechanical imbalances of the foot, osteoarthritis and rheumatoid arthritis, sudden increase in body weight (e.g., pregnancy), sudden increase in walking or running, tight calf muscles is a very common cause of the disorder, wearing shoes with poor support, including flip-flops. Another cause of pain is the shortening of the plantar fascia overnight due to the ankle bending, causing the toes to point towards the ground. The plantar fascia stretches in the morning when you stand. The act of lengthening it causes a great deal of pain. However, this is not limited to an overnight occurrence, it can happen any time the foot is flexed (i.e., pointed) for extended periods of time. For example, driving in the car for long periods can cause fasciitis in the right foot, which steps on the accelerator.


Symptoms

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. You may have less stiffness and pain after you take a few steps. But your foot may hurt more as the day goes on. It may hurt the most when you climb stairs or after you stand for a long time. If you have foot pain at night, you may have a different problem, such as arthritis, or a nerve problem such as tarsal tunnel syndrome.


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

Conservative treatment is almost always successful, given enough time. Traditional treatment often includes, rest, NSAIDs, and new shoes or heel inserts. Some doctors also recommend avoiding walking bare-footed. This means you’d have to wear your shoes as soon as you wake up. Certain foot and calf exercises are often prescribed to slowly build strength in the ligaments and muscles that support the arch of the foot. While traditional treatment usually relieves pain, it can last from several months to 2 years before symptoms get better. On average, non-Airrosti patients tend to get better in about 9 months.

Heel Discomfort


Surgical Treatment

In unusual cases, surgical intervention is necessary for relief of pain. These should only be employed after non-surgical efforts have been used without relief. Generally, such surgical procedures may be completed on an outpatient basis in less than one hour, using local anesthesia or minimal sedation administrated by a trained anesthesiologist. In such cases, the surgeon may remove or release the injured and inflamed fascia, after a small incision is made in the heel. A surgical procedure may also be undertaken to remove bone spurs, sometimes as part of the same surgery addressing the damaged tissue. A cast may be used to immobilize the foot following surgery and crutches provided in order to allow greater mobility while keeping weight off the recovering foot during healing. After removal of the cast, several weeks of physical therapy can be used to speed recovery, reduce swelling and restore flexibility.


Prevention

Being overweight can place excess pressure and strain on your feet, particularly on your heels. Losing weight, and maintaining a healthy weight by combining regular exercise with a healthy, balanced diet, can be beneficial for your feet. Wearing appropriate footwear is also important. Ideally, you should wear shoes with a low to moderate heel that supports and cushions your arches and heels. Avoid wearing shoes with no heels.