Monthly Archives: January 2015

What May Cause Painful Heel

Plantar Fascitis

Overview

A common condition that affects people of all ages. Symptoms include heel pain that is worse upon arising in the morning or standing after prolonged sitting. The pain is caused by inflammation of the plantar fascia, the ligament that connects the heel bone to the toes.


Causes

Plantar fasciitis is one of those injuries that magically seems to appear for no apparent reason. However, plantar fasciitis is caused by one of two methods. They are either traction or compression injuries. Plantar fasciitis is most often associated with impact and running sports, especially those that involve toe running rather than heel running styles. It is also commonly diagnosed in individuals with poor foot biomechanics that stress the plantar fascia. Flat feet or weak foot arch control muscles are two common causes of plantar fasciitis.


Symptoms

Symptoms of plantar fasciitis can occur suddenly or gradually. When they occur suddenly, there is usually intense heel pain on taking the first morning steps, known as first-step pain. This heel pain will often subside as you begin to walk around, but it may return in the late afternoon or evening. When symptoms occur gradually, a more long-lasting form of heel pain will cause you to shorten your stride while running or walking. You also may shift your weight toward the front of the foot, away from the heel.


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

Most doctors recommend an initial six- to eight-week program of conservative treatment, including Rest, balanced with stretching exercises to lengthen the heel cord and plantar fascia. Ice massage to the bottom of the foot after activities that trigger heel pain. Avoidance of walking barefoot or wearing slippers or sandals that provide little arch support. A temporary switch to swimming and/or bicycling instead of sports that involve running and jumping. Shoes with soft heels and insoles. Taping the bottom of the injured foot. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin and other brand names), or acetaminophen (Tylenol) for pain. Physical therapy using ultrasound, electrical stimulation with corticosteroids or massage techniques. If this conservative treatment does not help, your doctor may recommend that you wear a night splint for six to eight weeks. While you sleep, the night splint will keep your foot in a neutral or slightly flexed (bent) position to help maintain the normal stretch of the plantar fascia and heel cord. If the night splint doesn’t work, your doctor may inject corticosteroid medication into the painful area or place your foot in a short leg cast for one to three months. Shock wave therapy, in which focused sound energy is applied to the sore heel, may be recommended for plantar fasciitis. The shock waves are intended to irritate or injure the plantar fascia to promote healing. The overall benefit of this approach is uncertain. Other therapies that have been tried include radiation therapy and botulinum toxin injections. But their effectiveness is unclear. If all else fails, your doctor may suggest surgery. But this is rare, and surgery is not always successful.

Plantar Fasciitis


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.

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What Brings About Heel Discomfort To Surface

Painful Heel

Overview

The plantar fascia is a strong, relatively inflexible, fibrous ligament band that runs through the bottom of the foot. That band helps to keep the complex arch system of the foot, absorb shock, plays a role in body balance and in the various phases of gait. The band transmits your weight across the bottom of the foot with each step you take. When the heel of the trailing leg starts to get off the ground, the band bears tension that is approximately twice the body weight. The tension on the band at this moment is even greater if the calf muscles are not flexible enough.


Causes

Plantar fasciitis is a painful disorder in the lower part of your foot usually around the heel. That pain usually hurts as you get up in the morning when you try to stand on your feet, or after any periods of inactivity. It is a disorder of a tough and strong band that connects the heel bone to the toes. Plantar Fasciitis is caused by injuring that tough band on the bottom of the foot. The following may be the causes of plantar fasciitis. Tight calf muscles or tight Achilles tendon produces repetitive over-stretching of the plantar fascia. Gait and balance Problem may be a dominant cause of this disorder. Many people have a special style of walking, with something unique that causes some kind of imbalance in their body. It might be something like locked knees, feet that turn-out, a weak abdomen etc. This imbalance may place some pressure on the fascia, which eventually causes plantar fasciitis. Weak foot muscles don’t give enough support to the plantar fascia. The small muscles in the foot give the foot its shape by keeping the bones in place and by expanding and contracting to make a movement. Weak foot muscles will allow greater stress on the fascia. Foot anatomical problems such as flat feet or high arches can make the fascia ligament work or stretch abnormally. Flattening of the fat pad at the sole of the feet under the heels is a Degeneration process that is caused by poor footwear or by age. Shoes that have no proper heel cup can flatten that fat pad quite quickly and cause this disorder. Walking in shoes which do not have good arch support is considered to be a cause of plantar fasciitis. Wearing inadequate or worn out shoes may place more stress on the fascia ligament. If you wear shoes that don’t fit you by size or width, you may put your feet under excessive stress. Overweight Men and women are more vulnerable to developing the condition because of the excess weight on the foot. Pregnant women are at risk due to gaining weight through pregnancy and due to the pregnancy hormones that make ligaments loosen and relax. Sudden increase of activity like starting to run long distance or complete change of daily activity can cause heel pain and this disorder. Practice of repetitive athletic activities, like long distance running, playing a ball game, dancing or jumping, is a common cause for the disorder. Actually it is considered as one of the most common running injuries. Spending long periods of time on your feet everyday can cause plantar fasciitis. Working on your feet a few hours a day evey day may be the reason for your heel pain.


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 usually diagnosed by a health care provider after consideration of a person’s presenting history, risk factors, and clinical examination. Tenderness to palpation along the inner aspect of the heel bone on the sole of the foot may be elicited during the physical examination. The foot may have limited dorsiflexion due to tightness of the calf muscles or the Achilles tendon. Dorsiflexion of the foot may elicit the pain due to stretching of the plantar fascia with this motion. Diagnostic imaging studies are not usually needed to diagnose plantar fasciitis. However, in certain cases a physician may decide imaging studies (such as X-rays, diagnostic ultrasound or MRI) are warranted to rule out other serious causes of foot pain. Bilateral heel pain or heel pain in the context of a systemic illness may indicate a need for a more in-depth diagnostic investigation. Lateral view x-rays of the ankle are the recommended first-line imaging modality to assess for other causes of heel pain such as stress fractures or bone spur development. Plantar fascia aponeurosis thickening at the heel greater than 5 millimeters as demonstrated by ultrasound is consistent with a diagnosis of plantar fasciitis. An incidental finding associated with this condition is a heel spur, a small bony calcification on the calcaneus (heel bone), which can be found in up to 50% of those with plantar fasciitis. In such cases, it is the underlying plantar fasciitis that produces the heel pain, and not the spur itself. The condition is responsible for the creation of the spur though the clinical significance of heel spurs in plantar fasciitis remains unclear.


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.

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

Do your best to maintain healthy weight. Plantar fasciitis is caused by wear and tear on your feet. Being overweight drastically increases the pounding your feet take every day. Even losing a few pounds can help reduce heel pain. Avoid jobs that require walking or standing for long periods of time. Having your body weight on your feet all day puts a lot of pressure on your plantar fascia tissue. Replace your shoes on a regular basis. Buy new shoes when the old ones are worn-out. Make sure your shoes will fit your foot size comfortably at the end of the day. Pay attention to the width as well as the length. Use good supportive shoes that will help you with your original problem like arch support, motion control, stability, cushioning etc. Stretch regularly as part of your daily routine. There are a few special stretching techniques for the prevention. Choose soft surfaces for your exercise routine to walk, jog or run on. Rest and elevate your feet every chance you have. Strengthen your foot muscles as part of your exercise routine. Strong foot muscles provide a good support to the plantar fascia. Change your shoes during the work week. Don’t wear the same pair of shoes every day. Perform Warm up exercises such as a short period of walking, a light jog or other easy movement and then stretch before starting the main exercise. Try to avoid dramatic changes in your exercise routine. Increase your exercise level gradually. Don’t run long distance if you are used to walk. Make the change slowly and gradually. Pay attention to your foot pain, do not ignore it. Visit your doctor if the pain continues. Avoid the activities that cause you pain. Use over-the-counter Orthotics or inserts that your doctor may prescribe. Off-the-shelf or custom-fitted arch supports (orthotics) will help distribute pressure to your feet more evenly. Try to avoid barefoot walking, since it may add stress on the plantar fascia ligament.

What Leads To Heel Discomfort To Flare Up

Foot Pain

Overview

Plantar fasciitis is a condition characterised by damage and inflammation to the plantar fascia (i.e. the connective tissue on the sole of the foot forming the inner arch. This usually occurs at the attachment of the plantar fascia to the heel bone. Plantar fasciitis is the most common cause of heel pain seen in clinical practice. During walking or running, tension is placed through the plantar fascia. When this tension is excessive (often due to poor foot biomechanics such as flat feet or if it is too repetitive or forceful, damage to the plantar fascia can occur. Plantar fasciitis is a condition where there is damage to the plantar fascia with subsequent inflammation and degeneration. This may occur traumatically due to a high force going through the plantar fascia beyond what it can withstand or, more commonly, due to gradual wear and tear associated with overuse. Occasionally, a heel spur may develop in association with plantar fasciitis.


Causes

Your plantar fascia (fay-sha) supports the arch of your foot as you run or walk. It is a thick, inelastic, fibrous band that starts in your heel, runs along the bottom of your foot, and spreads out to your toes. Plantar fasciitis is an inflammation of this fibrous band. If you are female or have a job that requires a lot of walking or standing on hard surfaces you are more at risk for plantar fasciitis. Additional causes include Being overweight, Having flat feet or high arches, Wearing shoes with poor support, Walking or running for exercise, Tight calf muscles that limit how far you can flex your ankles, Running on soft terrain, Increase in activity level, Genetic predisposition.


Symptoms

When plantar fasciitis occurs, the pain is typically sharp and usually unilateral (70% of cases).Heel pain worsens by bearing weight on the heel after long periods of rest. Individuals with plantar fasciitis often report their symptoms are most intense during their first steps after getting out of bed or after prolonged periods of sitting. Improvement of symptoms is usually seen with continued walking. Numbness, tingling, swelling, or radiating pain are rare but reported symptoms. If the plantar fascia continues to be overused in the setting of plantar fasciitis, the plantar fascia can rupture. Typical signs and symptoms of plantar fascia rupture include a clicking or snapping sound, significant local swelling, and acute pain in the sole of the foot.


Diagnosis

Plantar fasciitis is usually diagnosed by a health care provider after consideration of a person’s presenting history, risk factors, and clinical examination. Tenderness to palpation along the inner aspect of the heel bone on the sole of the foot may be elicited during the physical examination. The foot may have limited dorsiflexion due to tightness of the calf muscles or the Achilles tendon. Dorsiflexion of the foot may elicit the pain due to stretching of the plantar fascia with this motion. Diagnostic imaging studies are not usually needed to diagnose plantar fasciitis. However, in certain cases a physician may decide imaging studies (such as X-rays, diagnostic ultrasound or MRI) are warranted to rule out other serious causes of foot pain. Bilateral heel pain or heel pain in the context of a systemic illness may indicate a need for a more in-depth diagnostic investigation. Lateral view x-rays of the ankle are the recommended first-line imaging modality to assess for other causes of heel pain such as stress fractures or bone spur development. Plantar fascia aponeurosis thickening at the heel greater than 5 millimeters as demonstrated by ultrasound is consistent with a diagnosis of plantar fasciitis. An incidental finding associated with this condition is a heel spur, a small bony calcification on the calcaneus (heel bone), which can be found in up to 50% of those with plantar fasciitis. In such cases, it is the underlying plantar fasciitis that produces the heel pain, and not the spur itself. The condition is responsible for the creation of the spur though the clinical significance of heel spurs in plantar fasciitis remains unclear.


Non Surgical Treatment

Usually, the pain will ease in time. ‘Fascia’ tissue, like ‘ligament’ tissue, heals quite slowly. It may take several months or more to go. However, the following treatments may help to speed recovery. A combination of different treatments may help. Collectively, these initial treatments are known as ‘conservative’ treatments for plantar fasciitis. Rest your foot. This should be done as much as possible. Avoid running, excess walking or standing, and undue stretching of your sole. Gentle walking and exercises described below are fine. Footwear. Do not walk barefoot on hard surfaces. Choose shoes with cushioned heels and a good arch support. A laced sports shoe rather than an open sandal is probably best. Avoid old or worn shoes that may not give a good cushion to your heel. Heel pads and arch supports. You can buy various pads and shoe inserts to cushion the heel and support the arch of your foot. These work best if you put them in your shoes at all times. The aim is to raise your heel by about 1 cm. If your heel is tender, cut a small hole in the heel pad at the site of the tender spot. This means that the tender part of your heel will not touch anything inside your shoe. Place the inserts/pads in both shoes, even if you only have pain in one foot. Pain relief. Painkillers such as paracetamol will often ease the pain. Sometimes anti-inflammatory medicines such as ibuprofen are useful. These are painkillers but also reduce inflammation and may work better than ordinary painkillers. Some people find that rubbing a cream or gel that contains an anti-inflammatory medicine on to their heel is helpful. An ice pack (such as a bag of frozen peas wrapped in a tea towel) held to your foot for 15-20 minutes may also help to relieve pain. Exercises. Regular, gentle stretching of your Achilles tendon and plantar fascia may help to ease your symptoms. This is because most people with plantar fasciitis have a slight tightness of their Achilles tendon. If this is the case, it tends to pull at the back of your heel and has a knock-on effect of keeping your plantar fascia tight. Also, when you are asleep overnight, your plantar fascia tends to tighten up (which is why it is usually most painful first thing in the morning). The aim of these exercises is to loosen up the tendons and fascia gently above and below your heel. Your doctor may refer you to a physiotherapist for exercise guidance.

Pain On The Heel


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.

What Causes Heel Pain

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 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

During the physical exam, your doctor checks for points of tenderness in your foot. The location of your pain can help determine its cause. Usually no tests are necessary. The diagnosis is made based on the history and physical examination. Occasionally your doctor may suggest an X-ray or magnetic resonance imaging (MRI) to make sure your pain isn’t being caused by another problem, such as a stress fracture or a pinched nerve. Sometimes an X-ray shows a spur of bone projecting forward from the heel bone. In the past, these bone spurs were often blamed for heel pain and removed surgically. But many people who have bone spurs on their heels have no heel pain.


Non Surgical Treatment

Careful attention to footwear is critical. Every effort should be made to wear comfortable shoes with proper arch support, fostering proper foot posture. Should arch supports prove insufficient, an orthotic shoe should be considered. Fortunately, most cases of plantar fasciitis respond well to non-operative treatment. Recovery times however vary enormously from one athlete to another, depending on age, overall health and physical condition as well as severity of injury. A broad period between 6 weeks and 6 months is usually sufficient for proper healing. Additionally, the mode of treatment must be flexible depending on the details of a particular athlete’s injury. Methods that prove successful in one patient, may not improve the injury in another. Early treatment typically includes the use of anti-inflammatory medication, icing, stretching activities, and heel inserts and splints. Cortisone injections may be necessary to achieve satisfactory healing and retard inflammation. In later stages of the rehabilitation process, typically after the first week, ice should be discontinued and replaced with heat and massage.

Painful Heel


Surgical Treatment

The most common surgical procedure for plantar fasciitis is plantar fascia release. It involves surgical removal of a part from the plantar fascia ligament which will relieve the inflammation and reduce the tension. Plantar fascia release is either an open surgery or endoscopic surgery (insertion of special surgical instruments through small incisions). While both methods are performed under local anesthesia the open procedure may take more time to recover. Other surgical procedures can be used as well but they are rarely an option. Complications of plantar fasciitis surgery are rare but they are not impossible. All types of plantar fasciitis surgery pose a risk of infection, nerve damage, and anesthesia related complications including systemic toxicity, and persistence or worsening of heel pain.

Workout Plans For Sesamoiditis

Pain across the bottom of the foot at any point between the heel and the ball of the foot is often referred to as “arch pain” Although this description is non-specific, most arch pain is due to strain or inflammation Foot Pain of the plantar fascia (a long ligament on the bottom of the foot). Wearing inappropriate footwear or foot problems like athlete’s foot and Morton’s neuroma are some of the factors that cause burning feet sensation.

TOE CONDITIONS: Ingrown toenails, blood accumulation under the nail plate (subungual hematoma), corns and calluses are all often seen as a result of playing baseball. It is important that good foot hygiene be practiced with washing between the toes and drying the feet well after bathing. Topical antifungals work well to treat athletes foot. ORTHOPEDIC INJURIES: Most orthopedic baseball foot and ankle injuries are acute or sudden. If an individuals foot or ankle is injured, seek immediate evaluation with one of our doctors. If your athlete has a baseball related injury, call our specialists at Advanced Foot and Ankle Center in McKinney and Prosper Texas at 972-542-2155. However, toe numbness and pain occurring together is one such problem that you cannot afford to ignore. Common symptoms are flat feet knee problems , burning sensation, numbness.

Those affected by inflammatory conditions such as rheumatoid arthritis and Achilles tendonitis are also likely to experience pain and swelling in the ankles. If the joints in the feet get affected by osteoarthritis, it gives rise to pain, stiffness, swelling in or around the joint, and restricted range of motion. Since pain in the feet could be caused due to a variety of reasons, the treatment will depend on the underlying cause. Many a time, pain could be experienced by people who perform high-impact exercises such as running, jogging and other sports. Those who have been experiencing pain while running must make sure that they wear a good quality footwear. Painkillers or steroids might be prescribed for the treatment of a sprained ankle.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 Pain

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During the average lifetime our feet cover over 70,000 miles, the equivalent of walking four times around the world., so it’s not surprising that problems can occur. Indeed around three-quarters of all adults will experience some sort of problem with their feet at some time. And without treatment most foot complaints will become gradually worse with time. This means people often endure painful conditions for far too long, and the problem can get worse. People often assume nothing can be done to help their condition, but in fact these conditions are extremely treatable. Swollen lump on big toe joint; lump may become numb but also make walking painful.