Heel Pain

Heel Pain

Heel Pain is one of the most common foot conditions among runners and other athletes. In fact, the population in general complains of heel pain more than other foot condition and there are several causes. Proper diagnosis and treatment are paramount in order to correct the problem.

A major cause of heel pain is Plantar Fasciitis. Plantar Fasciitis is an inflammation or irritation in the arch of the foot. The arch generally feels tight and the pain will worsen with excessive activity. Heel Spurs are another common cause of heel pain as well as the nerve condition called Tarsal Tunnel Syndrom. Twists and fractures are cause severe heel pain and are usually impact or pressure related.

Treatment of heel pain will depend upon the cause and treatments do vary so make sure to describe symptoms to a podiatrist or health care professional. During bouts of heel pain you may experience difficulty walking, pain during times of inactivity, pain lasting several days, swelling and infection. Any of these symptoms alone should compel you to seek treatment.

Again treatment for heel pain will vary and depending upon the severity of the condition and can range rest to surgery. Avoiding painful activities and resting can be all it takes to reduce the pain. Other home remedies include the application of ice, stretches, and/or over the counter anti-inflammatory medication.

Shoe inserts are often recommended but self diagnosing and choosing drugstore insoles could do more harm than good. Custom Foot Orthotics are available and are fabricated from a mold of your actual foot. Your podiatrist can recommend which type of orthoses will benefit your specific source of heel pain. Please seek treatment if you symptoms persist.

Achilles Tendonitis

Achilles Tendonitis

The largest tendon in the human body is the Achilles tendon and it is designed to handle over 1,000 pounds of force. The Achilles tendon is also the most often ruptured or injured tendon. Achilles tendonitis is an inflammation of the tendon resulting from overuse.

Achilles tendonitis can flare up for several reasons including increasing running distances or speed too quickly, attacking hills too aggressively during training, returning to heavy activity too soon after extended periods of rest, and lack of flexibility in the calf muscles. The condition can also appear after sudden calf muscle contraction during activity.

People experiencing Achilles tendonitis may feel dull pain after exercise that increasingly worsens over time. There may be severe pain along the tendon during or following exercise. Sufferers may feel tenderness in the morning in the lower calf or stiffness that will loosen as the area warms up with activity.

There are several treatments for Achilles tendonitis and they depend on the severity of the condition. Rest is the most immediate treatment but anti-inflammatory medication, stretching, message and ultrasound treatments prove helpful. The use of orthoses, more specifically, custom foot orthotics can dramatically improve the condition and prevent future flare ups.

Of course surgery to heal Achilles tendonitis is an option but should be considered as a treatment of last resort. Surgery will reduce friction between the tendon and its covering sheath which may have built up thick tissue. Also during surgery any tears can be repaired. Recovering from such procedures can be slow and will require rehabilitation to strengthen the area and prevent new injury.

Prevention is always the best medicine. It is very important to use the right shoes which will provide cushion and support during activity. A prescribed custom foot orthotic will change the alignment of misaligned heel bone and greatly reduce the chances of of experiencing Achilles tendonitis. A solid routine of warm up, stretch and cool down is always recommended .

Preventing Injury and Increasing Your Performance

Athletes often neglect their number one supporter: their feet. Many of us rarely give them a second thought until they cause us pain. We force them into shoes that don’t fit, pound them into the ground and neglect to care for them properly. Yet, a small abnormality in foot function can have a large impact on the entire body causing pain, discomfort and interrupting an athlete’s game. With the strenuous activity athletes’ bodies endure, it is important to understand how to treat sports injuries, maintain treatment and ensure the feet receive the extra T.L.C. they deserve.

Athletes must not only be aware of sports related injuries but more importantly, how to prevent them before they occur. As proper biomechanics begins to gain more popularity and importance in the sports world, trainers and athletes are beginning to think more pro-actively about how to care for the feet. Yet, many are unaware that the symmetrical alignment of their feet affects their entire body. Any deviation can create a deleterious effect on their performance. Because no one person shares the same foot structure, the ultimate solution to preventing injuries, treating existing problems and increasing athletic performance is with precise custom-made functional foot orthotics.

Functional orthotic devices are fabricated by using a neutrally balanced and stable position captured impression of the foot. They are designed by a physician, experienced and trained in the field of Clinical Biomechanics. Medically prescribed, their purpose is to limit excessive motion and align the rear foot to forefoot. It is important that custom-made, functional foot orthotics are not confused with arch-support devices sold at pharmacies or shoe and sporting goods stores. Over-the-counter arch supports are a one-size-fits-all version that provides support to a patient’s arch based on average foot shape and function.

In our practice, we use the latest diagnostic technology to perform my biomechanical evaluations. A thorough study incorporates a medical and family history, video gait analysis, muscle strength testing and range of motion study. The combination of this information helps to determine the best method to increase performance, prevent and/or address injuries.

Some of the most common athletic ailments that we have encountered that could have possibly been prevented with the use of functional foot orthotics are:

Heel Pain

The most frequent cause of heel pain is plantar fasciitis. Plantar Fasciitis can be caused by an abnormal motion of the foot called excessive pronation. If your heel is rotating outwards too much and your arch is lowering too much then you have excessive pronation. It is this extra stretch in the arch that causes the partial pulling, straining or tearing of the plantar fascia and the possibility of spur formation.

Plantar Fasciitis can be controlled with a combination of treatments. Strapping of the feet with the foot held in a neutral position combined with a physical therapy program and an anti-inflammatory medication will usually improve the symptoms. A custom made orthotic will control the excessive pronation and also support the arch taking the tension off the plantar fascia.

If the patient continues to have pain, a physician could conduct injection therapy, the injection of a small amount of cortisone to decrease the inflammation. The patient could receive several injections while still performing the conservative treatment for several weeks or months. For the remaining small percentage of patients who fail to be relieved of the pain, the patient may choose to have Extra-Corporeal Shock Wave Therapy (ESWT). This innovative, 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. ESWT can be done in the office (low energy) and without the need for an anesthetic. Surgical correction is the last choice of treatment. Surgical corrections consist of releasing the part of the plantar fascia from the attachment to the heel bone.

Shin Splints

Medial Tibial Stress Syndrome (MTSS) is commonly known as Shin Splints. The people who are at the greatest risk for developing MTSS are beginning runners, people who over-train and people with a poor selection of shoe gear.

The usual mechanical factors that lead to MTSS are an imbalance between the posterior and anterior muscle groups. The posterior muscles may be both too tight and too strong. The effect of the tight musculature has an impact on the gait cycle at two points, just before and after heel contact and when the foot is leaving the ground at toe off. These stresses cause a repetitive inflammation in the muscle or at the attachment of the muscle to the bone. Other factors that may cause MTSS are continual running on a hard surface and a biomechanical abnormality in the foot such as excessive pronation.

The initial treatment for MTSS is decreasing the amount of training, adequate stretching exercises before and after running and proper shoe gear with shock absorption. Running on hard surfaces should be avoided. Icing immediately after exercise should also be done to control inflammation.

A physician should conduct a thorough evaluation of the training schedule, training surface, shoe gear being used and the biomechanics of the foot and ankle. If a biomechanical fault is found in the lower extremity a custom foot orthotic could help eliminate the fault and reduce the pain.

Leg Length Discrepancy

Another common problem that has been encountered are leg length discrepancies. During our evaluation, we can determine whether this is a functional or structural problem or combination of both. With a length discrepancy an athlete could experience pain in the knees, hips, lower back and neck. These difficulties and biomechanical faults can easily be accommodated with custom-made orthotics.

Turf Toe

Turf Toe is an injury that can occur in all types of athletics. The injury occurs when there is excessive motion behind the big toe which causes the tendon and ligaments of the first metatarsal phalangeal joint to become disrupted. If this injury is not addressed it can lead to a severe limitation of motion, fractures and early arthritis. This also can be treated with a functional foot orthotic with long term excellent results.

Other Injuries

Back and knee pain, ankle sprains, strains, instability and metatarsal issues can also be treated with foot orthotic therapy.

Case Study

In February 2007, Drew Stanton, a quarterback from Michigan State, was referred to Footcare Express to seek treatment for a persistent foot problem. A thorough examination was performed and functional foot orthotics were created to control his foot and accommodate his pain. With the orthotics in place Stanton was able to achieve the fastest time for a quarterback in the 40-meter dash at the 2007 NFL Combine. Stanton was later drafted to the Detroit Lions in the 2007 NFL Draft.

No matter your status on the playing field, it is important that you take care of your feet and not neglect clinical biomechanical problems. It is especially important that the coaches and parents of youth athletes understand the symptoms of sports related injuries.

As athletes improve performance and maximize efficiency, they rely on sports medicine to surpass their performance thresholds. Custom foot orthoses are increasingly making their way onto professional and recreational playing fields as sports medicine is focusing more on biomechanics and kinesthetic awareness to prevent and treat lower extremity injuries. When properly prescribed, foot orthoses can enable the body to work to its potential. Once an athlete’s entire system is in balance, he or she should notice improved performance and enjoy lower risk of injury.

Footcare Express Annouces New Pedorthist

AVENTURA, FL (January 4, 2008) – Footcare Express, a team of physicians, pedorthists, and biomechanical experts, proudly announces that they have expanded their team of pedorthists with the addition of Vahe Mike Sarkisian to their Aventura, Florida office.

In his role as a Pedorthist, Sarkisian will be seeing patients and filling a variety of physician prescriptions.  Sarkisian will be responsible for measuring, designing, fabricating, fitting and servicing pedorthic devices ordered by a physician.  Sarkisian joined Footcare Express in 2007 as a Lab Supervisor with 11 years of financial business experience and two years of pedorthist experience behind him.

His recent career experience hailed from Pedorthics at Eneslow Foot Comfort center and XL Health Inc. in New York, one of the nation’s largest Diabetic Preventive Care centers, where he fitted and cast patients for shoes and other orthotics, custom footwear and braces as a practicing pedorthist. Sarkisian graduated with a BBA in Finance Investments from Baruch College, Zicklin School of Business, CUNY, New York, NY and became a certified Financial Advisor.  Upon completing Eneslow Pedorthic Institute and the New York College of Podiatric Medicine course, Mr. Sarkisian became a certified Pedorthist in 2005.

Offering a variety of services, including a full service podiatry practice, Footcare Express also includes an extensive retail business and a Pedorthic facility.  The Aventura-based facility is fully accredited by the American Board for Certification in Orthotics, Prosthetics and Pedorthics which ensures that Footcare Express provide the highest standards in fulfilling patient prescriptions for therapeutic footwear and/ or other durable medical equipment including but not limited to foot orthotics, braces and other foot and ankle related modalities.  The physicians and pedorthists at Footcare Express work with various NFL, MLB, NBA and NHL teams and players, including several colleges and universities.

Footcare Express also has its own on-site state-of-the-art Custom Foot Orthotic Laboratory that allows the doctor and technicians to use technology to digitize the foot, allowing for a more accurate replica of the foot, making prescriptions more accurate as well.  Doctors and technicians use the latest technology to diagnose and treat foot problems including the F-Scan, which allows the clinician a split-second perspective on all phases of the walking cycle or gait cycle and through Video Motion Analysis, which captures the gait cycle using fame-by-frame imaging.

Footcare Express opened its Aventura-based office in 2000.  In just 6 short years, Footcare Express has successfully launched a retail portion of its business and increased its availability with various professional sports teams. The company prides itself on offering the most advanced services in the industry.  Footcare Express is a family owned business founded by Dr. Harold Reinhartz and his son Jarett Reinhartz.  Dr. Charles Mutschler is the Medical Director of Footcare Express.  For more information onFootcare Express please call 877.687.3338 or visit www.FootcareXpress.com.