Extracorporeal Shock Wave Therapy in Miami Florida

Extracorporeal Shock Wave Therapy (ESWT) or Extra Corporeal Activation Technique (EPAT) in Miami Florida

Footcare Express of Miami, Florida, provides to its patients a breakthrough solution to alleviate pain in the feet.  This non-invasive procedure in which shock waves are used is known as Extra-Corporeal Shock Wave Therapy (ESWT) or also known as Extra Corporeal Activation Technique (EPAT).

This procedure has been used to treat over 2.5 million patients. This non-surgical treatment involves the delivery of sound energy or shock waves to affected areas of the body triggering the body’s own natural repair mechanisms and stimulating healing.

This treatment is performed when a therapeutic flow of energy is transferred directly to the ailing area through a handheld applicator used by the physicians at Footcare Express. This highly effective treatment may yield complete results after 3-4 sessions, each lasting less than 5-10 minutes and scheduled 7-10 days apart.

At Footcare Express, our goal is to help you conquer pain as we have done for professional athletes all over the country. We understand how frustrating it is when you have tried everything from multiple steroid injections to medications, splints, braces, strapping, taping with little to no relief. Extracorporeal Shock Wave Therapy (ESWT) or Extra Corporeal Activation Technique (EPAT) is the non-invasive solution for conditions not helped by anti-inflammatory or immobilization devices.

What are the benefits of ESWT or EPAT for you?

No surgical risks, no downtime, no time and money wasted on treatments that don’t work. Extracorporeal Shock Wave Therapy or Extra Corporeal Activation Technique (EPAT) is proven, effective pain relief and the healthcare professionals at Footcare Express are here to help you with your pain or injury.

ESWT or EPAT offers PAIN RELIEF & RESTORATION of MOBILITY in:
•    TENDON Injuries
•    LIGAMENT Injuries
•    MUSCLE Pain
•    Delayed BONE Healing / Stress Fractures
•    JOINT disease such as Osteoarthritis

Contact us to schedule an appointment or learn more about ESWT or EPAT therapy NOW! Phone: 877.687.3338

Platelet Rich Plasma Therapy

Footcare Express Integrates Platelet Rich Plasma Therapy

The medical staff at FootCare Express is pleased to announce the integration of Platelet Rich Plasma therapy to promote faster healing of soft tissue injuries.

PRP received a lot of Publicity after Pittsburgh Steeler star Hines Ward used the therapy to recover from a nagging knee injury in time to help the Steelers win last year’s Super Bowl. This was not the first use of Platelet Rich Plasma therapy but it certainly created quite a buzz.

The medical community has begun widely using PRP as an alternative to surgery to help in many conditions. The theory is this a patients own blood is used and the platelets are separated in a centrifuge. Once the blood components are separated, the patients own plasma with a high concentrations of platelets is injected into the injured area. It is believed the Platelet Rich Plasma Injection will stimulate healing in conditions such as arthritis, plantar fasciitis, tennis elbow, knee problems, and the strengthening of damaged tendons.

In a nut shell, Platelet Rich Plasma Injections of one’s own platelets have characteristics which encourage the natural healing process. When high concentrations are placed into a specific area, the healing process shows extraordinary results.

A major advantage of this therapy is the low incidence of rejection because the platelets belong to the patient being treated. The reason this is done by direct injection is because most injuries the therapy targets are located in areas with little blood flow, or at least not enough to carry the concentrated platelets to the points they are most beneficial. So their has been minor irritation reported at the injection sites but the results of PRP therapy for outweigh the mild discomfort which may be experienced.

For a detailed discussion of Platelet Rich Plasma Therapy watch the video below, or Call Footcare Express to discuss your treatment options with our medical staff.

Choosing the Right Orthotic

How to Choose the Right Prefabricated Orthotic

There are many different types prefabricated arch supports and inserts to choose from in today’s marketplace. Each of these over-the-counter products promises to be “band-aids” and relieve pain and discomfort for foot, knee, leg, hip and back pain. The balancing act here is the middle of the road individual who requires cushioning but some support. In these instances, fit and feel is always the best litmus test. This is the trial and error of the prefabricated arch supports and insoles. A person must know how they feel the most accommodated, whether it is a high arch they need or a low arch or whether they feel more comfortable with lots of cushion or hardly any at all. And then there are the multiple combinations of all of the above that are commonly found in stores and available to consumers.

Therefore, it is important to know your foot type when choosing the correct prefabricated arch support or insert. Some of these products are firm or rigid where others are soft or flexible. Individuals who have flat and flexible type feet are generally more comfortable with products that provide some type of arch support. Flat feet normally tend to be due to overpronation, which may be a case where the foot is absorbing too much shock and lacking support. The pronated foot is one in which the heel bone angles inward and the arch tends to collapse. A “knock-kneed” person has overly pronated feet. This flattens the arch as the foot strikes the ground in order to absorb shock when the heel hits the ground, and to assist in balance during mid-stance. If habits develop, this action can lead to foot pain as well as knee pain, shin splints, achilles tendinitis, posterior tibial tendinitis, and plantar fasciitis. Prefabricated arch supports and insoles for these types of persons are usually designed with some firmness in the arch area of the foot to provide some support and stability in the arch area of the foot.

In contrast, Individuals who have high arch and inflexible feet are more comfortable with products that provide mostly cushion. These types of feet are generally more rigid and tend to be more supinated. Supination (or underpronation) is the insufficient inward roll of the foot after landing. This places extra stress on the foot and can result in iliotibial band syndrome of the knee, Achilles tendinitis, plantar fasciitis. Usually, a person who has a very high arch foot lacks that ability to absorb shock, therefore, they are more comfortable with products that are much softer and provide more cushioning.

The above should be used as a guide. Prefabricated arch supports and insole use with different footwear can also be a factor. It is always best to consult with an expert for the most appropriate product for the best results.

Our First Steps – Flat Feet

I often hear people tell me that they have the “flattest feet” or their feet are “flat as a board”. In truth, the only people that truly have normal “flatfeet” are infants.

Flatfoot may be defined as an absence of the arch upon standing or walking. It is often associated with excessive inward “rolling” of the foot known as pronation. It is well accepted that children under the age of 7-10 years normally do not possess a significant arch or one that resembles the average adult foot. James Losito, D.P.M., Professor of Biomechanics at Barry University and a team physician for the Miami Heat, University of Miami and Barry University Intercollegiate Athletic Programs and Medical Director for Pro-Tech Sports Medicine, has had lots of experience with care of common pediatric pathologies. ” It is for this reason, that pain and function be emphasized rather than the cosmetic appearance of the foot when determining if a child’s foot is abnormally flat,” says Dr. Losito.

Dr. Losito states that a history of fatigue, cramping, pain, excessive shoewear or “sloppy” gait are the most reliable indicators that an abnormality is present. Several different causes of flatfoot exist including, ligamentous laxity, tightness of the Achilles tendon (equinus), muscular weakness or spasticity, and pigeon-toed gait. In the adult, excessive pronation (flattening of the arch) may produce many problems including tendinitis, fascitis, shin splints and stress fractures. Therefore, treatment of a symptomatic pediatric flatfoot should not be ignored. In some cases, treatment such as muscular strengthening or stretching is the key to improving the flatfoot condition. However, in many instances a functional orthotic device may be used in conjunction with exercises or used alone.

For example, children who walk pigeon-toed (intoed) or slew-foot (out-toed) suffer from severe pronation (flattening of the arch) as compensation during gait. A functional foot orthosis helps prevent the excessive pronation, which can lead to a structural flatfoot. In those children who trip, stumble or are clumsy, the orthotic can be fabricated to reduce the degree and severity of the abnormal gait pattern.

Children who suffer from equinus, defined as a tight Achilles tendon almost always suffer from excessive pronation and a flatfoot. This requires rigorous stretching exercises or surgery to eliminate the abnormal force creating the flatfoot. Functional foot orthosis are useful in eliminating any residual pronation and supporting the foot if any permanent structural changes have occurred.

Shoes and functional foot orthosis are not necessary for normal development of the child’s foot. However, when the aforementioned symptoms are present, functional foot orthotic devices are a proven and successful option that families can benefit from to help correct and prevent future problems.

Neuroma Pain: A Common Problem

Neuroma pain is typically described as a burning, tingling pain of the forefoot and toes.  It can also be felt as an aching or shooting pain in the forefoot.  Patients with this problem commonly state that it feels like they are walking on a pebble under their forefoot.  The patients usually state that removing their shoes and massaging the forefoot relieve the discomfort.   The pain that is present is usually present following a long period of standing, walking, or running.

A neuroma is formed by an enlargement of the sheath surrounding a nerve that runs between the metatarsal bones in the forefoot (just behind the toes).  The most common location that this occurs is between the third and fourth metatarsals.  Neuromas may also occur between the other metatarsal bones also.  The reason that the neuroma is located in this area is that the nerve running between the bones divides here and has two branches one going to each of the toes in front of the metatarsals. It is a chronic inflammatory process that causes the enlargement of the nerve sheath.

A common cause of a neuroma is wearing shoe gear that is too tight.  Another common cause of neuromas can be pronation (turning out of the heels) of the foot.  The pronation causes a rotation of the metatarsal bones, which can cause pinching of he nerve between the adjacent bones.  It is this chronic pinching by either tight shoes or rotation of the bones that causes the enlargement of the nerve sheath.  And as the nerve sheath continues to enlarge the pain continues to get worse for the patient.

Prior to seeing a podiatrist a patient may try some of the following to relieve their pain.  A patient should first evaluate their shoes.  If the shoes are tight, then the patient should replace those shoes with a wider shoe that does not squeeze the foot.  A patient may also check the laces on the shoes to make sure they are not tied to tight.  A patient may also try to get more supportive shoes that may stop some of the pronation that may be present and adding to the problem.  A patient may also choose to try some over the counter pain medication.

Upon seeing a podiatrist the patient should expect a thorough medical and biomechanical evaluation.  After the evaluation the podiatrist can treat the neuroma several different ways.  Conservative treatments consist of placing pads under the forefoot to take the pressure off of the areas as well as to try and spread the metatarsal bones.  These pads can be placed in shoes by themselves or incorporated into a custom orthoitc.  The custom orthotic is also designed to control the pronation that may be present.   A podiatrist may also want to inject the neuroma.  A steroid injection is sometimes utilized to try and stop the inflammatory process that is occurring and causing the pain.  Another option is that the podiatrist may try sclerosing the nerve with an alcohol injection.  The goal of the sclerosing is to shrink the enlarged nerve sheath.  It may a series of several injections prior to seeing any improvement.  Finally if all the above treatments have not relieved the patient’s pain the podiatrist may choose to surgically remove the neuroma.

Neuromas are a problem that effect many patients.  It is a problem that usually responds to conservative treatment, but in some situations surgical removal is necessary.

What is a Functional Foot Orthoses?

What is a functional foot orthoses? By definition, a functional foot orthotic is a device that is contoured to the entire foot and used to reduce abnormal motion or abnormal position of the foot. A functional foot orthoses is also used to control the abnormal motion or abnormal position of the lower extremity that is affected by the position and/or motion of the foot.

Custom functional foot orthotics are essentially shoe inserts that may be prescribed by a Podiatrist, Orthopedist, Chiropractor, or any other health professional with a background in biomechanics. They are specifically designed devices that are worn inside the shoe to control abnormal foot function and/or accommodate painful areas of the foot. They can provide stability for the foot and correct injury-causing imbalances. This may result in a dramatic improvement in foot symptoms and efficiency. Other arch supports and insoles may be considered foot orthotic devices, however, they do not have the same corrective properties as a functional foot orthotic. For a professional to prescribe a functional foot orthotic, they must take a medical evaluation and perform a comprehensive biomechanical examination. It is important for the doctor to take angles of measurement, including structural and functional discrepancies in leg length, ranges of joint motion and evaluation of muscle activity. FootLabs goes one step further with the ability for the prescribing physician to analyze gait through video and computerized gait analysis.

A functional foot orthotic helps to control the movements of the foot known as pronation or supination. Pronation occurs when the heel bone angles inward and the arch collapses, while supination is the opposite. Supination and pronation are a normal part of the gait cycle. They allow the foot to absorb shock and adapt to uneven surfaces. However, too much of these motions may cause injury. Many problems with the feet, legs, knees and hips are caused by excessive pronation or supination. Orthotics may prevent injury or deformity from occurring or halt the progression of existing problems and allow healing to occur. If you suffer from sore hips, knees, shins, arches or metatarsal bones, you may need orthotics. In fact, most everyone can benefit from some type of orthotic. They are very useful in optimizing performance and enhancing comfort for athletes.

Functional foot orthotics can be made from an impression of your foot that capture the contour and alignment of the foot. A mold is generated from the impression and is modified to compensate for angular differences between the forefoot and heel, which can lead to excessive foot motion. A thermoplastic material is either milled or molded to the shape of the corrected impression and this becomes the orthotic. Once the orthotic is formed, various materials can be formed to the form to fabricate an orthotic device that is created according to certain specifications.

Foot orthotics are prescribed for many people including children up to the elderly for various pains and symptoms resulting from a biomechanical foot fault. From the sound of this, one might conclude that these types of foot orthotic devices are a medial necessity, considering the fact that no one has a perfect gait or walk. At Footcare Express, we strive to educate people as to the importance of a proper biomechanical examination and foot care. Our facility is accredited by the PFOLA (Prescription Foot Orthotic Laboratory Association). The PFOLA is the highest recognized certifying body for evaluating orthotic laboratories that produce functional foot orthotics. Footcare Express has been active with other larger wholesale accredited laboratories in the country, to come up with a set of criteria that can assist various insurance companies, physicians, and health organizations in recognizing the need for such medically necessary devices.

It is an educational process. Anyone who wears a functional foot orthotic can attest to their importance and how they have helped them become better and more efficient.

Exercise Warm-up and Cool Down

Warm-up shifts blood from the center of the body to the working muscles during the first five minutes of exercise.  If you do this too quickly, the blood vessels will not fully expand and your blood pressure and heart rate will go up too fast.  This is dangerous for people with medical conditions.  In addition, it limits performance and you will fatigue earlier if you warm-up too quickly.  Cool-down is the same as the Warm-up and must last for about five minutes before you stop completely. The ideal way to warm-up and cool-down is to perform the same exercises that you do in the middle of the workout, but do them at a slower pace.  That’s it.

Daniel Steiner, M.Ed., C.D.E., ACSM Exercise Specialist is an In Your Home Healthy Lifestyle Manager.   He designs healthy, productive workouts for persons who want to reach their potential.  For more information, phone or fax to 305.935.4905.

What are the Best Athletic Shoes?

At Footcare Express, I am asked all the time “What is the best athletic shoe? It is a question that is asked daily and has many answers. The best shoe depends on fit, comfort, construction, and the type of sports activity.

The function of an athletic shoe is to protect the foot from the many stresses of running, walking or other high impact activities. This function of footwear will help the athlete achieve his or her maximum potential. While in some parts of the world athletes run and participate in sports barefooted, most of us require and benefit from the use of sport specific shoes. The forces and motions that occur in different sports vary greatly. The type of activity that you are using them for should determine shoe purchases. For example, you would not want to buy a basketball shoe for running and visa versa. Walking and running shoes function best in a straight line where a tennis or basketball shoe requires lateral or side-to-side movements.

The majority of athletic shoes are not well designed. There are many shoes that have inflexible soles. This can cause calf muscles to work harder and can contribute to Achilles Tendonitis. If the shoe is too flexible in the midsole or they flex before the point where the toes bend, a stretch in the plantar fascia can occur and contribute to foot strain. This can be commonly referred to as Plantar Fasciitis. There are many top name companies that are cutting out the midsole of the shoe to make it lighter, however, the long term or even in some cases, the short term effects, can result in strains in the feet. Other things to look out for are inadequate support in the rearfoot or lack of room in the forefoot and poor shock absorption. In general, the most important factor is feel and fit. The best time to shop for an athletic shoe is at the end of the day when your feet are somewhat larger from the day’s walking. Also, make sure that there is a finger’s width at the front of the shoe. This will help prevent runner’s toe.

When shopping for the perfect shoe, it is also important to go to a place where the sales representative has knowledge of the appropriate footwear that matches the foot type. A person with a low arch needs footwear with a lot of support and good rearfoot control. Whereas, as person with a high arch needs more shock absorption and footwear that has a narrower heel. A wide heel may cause the rearfoot to move around too much in the shoe. A person with a “normal” foot would probably work best with a combination of the control and shock absorption. Believe it or not, most of the high-end athletic shoe companies have various styles of shoes that will accommodate different foot structures.

Shoes are not made to last forever, especially with the rigorous activity we put them through. A shoe’s midsole only lasts so long. The soft materials the are used in the shoe normally compress over a period of time and wear out. Eventually, the materials breakdown and no longer serve the function they once had when they were new. Most doctors will suggest that running shoes be replaced every 350 to 550 miles. This means that if you are running 20 miles a week, you should consider changing very 20 to 25 weeks. Many people feel that if they don’t see the sole wear down, then the shoe is still in good shape. The materials can be worn down without the shoe wear even being noticeable.

So it is very important to wear the proper footwear, especially during sports. Sometimes even the best footwear will not solve or help each person’s condition. At FootLabs, we try to help with these types of questions and create custom inserts for solving those hard to answer questions. Everyone has different make-ups and unique biomechanics. The best athletic shoes are those that are the best for you.

How often should I change my running shoes?

How often should I change my running shoes?

Most sports doctors conclude that running shoes should be replaced every 200-400 miles, as the materials which supply shock absorption and stability, wear out.

- Dr. Charles A. Mutschler, Podiatric Consultant for Footcare Express

Foot Orthotics – Give the Gift of Foot Pain Relief

This year give someone you love a gift that will last a lifetime.  Those suffering from foot pain, heel pain, knee pain and back pain would love nothing more to find relief this holiday season.

A pair of custom foot orthotics from Footcare Express is exactly what the doctor ordered. Literally! A custom orthotic device will bring the foot and ankle into proper alignment an in many cases allow a person to walk, run, or bend properly for the very first time in their lives.

Not everyone is able to offer a truly custom foot orthotic and it CANNOT be found in any drugstore or infomercial. To be custom, a mold of each foot must be cast and analyzed by a professional Pedorthist or Podiatrist and then fabricated by an experienced lab technician according to a prescription.

It is very rare for one of our feet to exactly match the other so the chances of your foot or the foot of someone you love to match an orthotic insert that is already made is slim to none.

Here is how Footcare Express can deliver a truly custom fit orthotic to your door for Christmas. First we send our Quickmeasure Kit to be wrapped and placed under the tree. When the gift is opened the recipient will make a custom mold of their foot according to the included instructions and have a perfect foot cast molded in seconds. Then they simply return the foot cast to Footcare Express in the pre-paid packaging and pain relief will arrive in a matter of days.

It is a particularly good time of year to send Custom Foot Orthotics as a gift because many people we love are about to embark on their New Year’s Resolutions of good health through exercise. Orthoses will help prevent the type of injuries suffered from over exertion or bad form.  These injuries include shin splints, ankle sprains and strains, torn ligaments and muscles and knee, hip and back pain.

Everyone can use the gift of proper foot care and pain relief. Whether it is a grandparent who suffers minor pain or stiffness while walking, a nephew looking for an advantage on the soccer field or a runner looking to run pain free, give the gift that will change someone’s life forever.

Get Your Custom Foot Orthotics right here Online! or Call 1-877-OUR-FEET

We carry a full line of custom foot orthotics! Sports orthotics, Dress Orthotics, Causal Orthotics, Express Correct Foot Orthotics and Orthotics for Sandals. Additional we have created the finest high tech pre-designed foot orthotics on the market. Take care of your feet with our custom foot orthotic, arch supports, shoe insoles and footwear! Visit our online Foot Orthotics Store!

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