Stabbing Pain in Your Heel????

Do you feel a stabbing pain in your heel with your first steps out of bed in the morning? You’re not alone! Every day, thousands of Americans suffer from this condition. Plantar fasciitis, more commonly known as heel pain, is by far, the most common complaint seen in my office.

Aching heels can truly affect your lifestyle and disrupt essential activities and prevent you, to a large extent, from playing sports or simply going for a walk. An accurate and expedient diagnosis of the cause of your symptoms will help you receive the appropriate treatment.

There are several causes of heel pain. The most common include:
Plantar Fasciitis – Inflammation of the band of fibrous connective tissue (fascia) running along the bottom (plantar) surface of the foot, from the heel to the ball of the foot. Both heel pain and heel spurs are frequently associated with plantar fasciitis.
Heel Spurs – A bony growth on the underside of the heel bone. The spur, visible by X-ray, appears as a protrusion that can extend forward as much as half an inch. Heel spurs can result from strain on the ball of the foot and repeated tearing away of the lining or membrane that covers the heel bone. Contrary to popular belief, heel spurs are generally not the cause of pain—the pain you may feel is from inflammation of the plantar fascia.
Excessive Pronation – Excessive inward motion can create an abnormal amount of stretching and pulling on the ligaments and tendons that attach to the bottom back part of the heel bone. Excessive pronation may also contribute to injury to the hip, knee, and lower back.
Achilles Tendinitis – Pain at the back of the heel is associated with Achilles tendinitis, which is inflammation of the Achilles tendon as it runs behind the ankle and inserts on the back surface of the heel bone.

Other possible causes of heel pain include rheumatoid arthritis and other forms of arthritis (e.g., gout); Haglund’s deformity (a bone enlargement at the back of the heel bone in the area where the Achilles tendon attaches to the bone); inflamed bursa (“bursitis”), a small, irritated sac of fluid; neuromas (nerve growths) or other soft-tissue growths; and bruises or contusions, which involve inflammation of the tissues that cover the heel bone. A bone bruise is a sharply painful injury caused by the direct impact of a hard object or surface on the foot.

Some contributing factors associated with heel pain are:
-Age: With increasing age, often there is decreasing flexibility.
-Any sudden change in activity: Particularly activities that increase weight bearing or pressure on the foot
-Flat, pronated feet or high-arched feet
-A sudden increase in weight: Such as pregnancy
-stress from an injury: A bruise incurred while walking, running, or jumping on hard surfaces

Seeking medical attention is the first line of defense in treating heel pain. However, there are several steps you can take to avoid heel pain in the first place:
-Wear shoes that fit well and have shock-absorbent soles, rigid shanks (the part of the shoe that supports the foot and helps give a shoe its structure), and a supportive heel counter (the rear-most part of the shoe, at the back of the heel above the sole)
-Wear the proper shoes for each activity
-Do not wear shoes with excessive wear on heels or soles
-Begin exercises slowly
-Wear athletic shoes with good shock support in the heels
-Purchase shoes that fit
-Avoid activities that may put constant strain on the foot
-Avoid going barefoot on all surfaces

A variety of treatment solutions are available to provide short and long-term pain relief. Begin treating heel pain by avoiding all sorts of pressure or tension on the inflamed area, giving your feet ample rest. Applying ice and heat packs in alternating fashion will greatly accelerate the process of healing. Another option is the use of custom insoles. Custom insoles may assist with treating active conditions of heel pain and likewise reduce the risk for reoccurrence. The custom insole will restore body balance and prevent the plantar fascia from experiencing strain when you walk. If all non-invasive treatment solutions do not work, surgery is probably the best next option.

Regular exercise for calf muscles and the plantar fascia is necessary to alleviate pain and improve flexibility of the affected muscle. These exercises are advised for both legs even if the pain is in one heel only. Some of the most beneficial exercises are:
Towel stretches – This exercise should be done every morning before you leave your bed. Make a loop with a towel and use it to pull your toes toward your body, while keeping the knee straight. Stretch each foot three times, and hold each stretch for 30 seconds, if possible.
Stair stretches – Stand tall on a staircase with the balls of both feet on
the edge of the step. Place hands on the railing or the wall for balance and support. Slowly lower heels toward the floor until you feel a stretch in your lower leg and heels. Maintain the stretch for 10 to 15 seconds. Repeat this exercise six times, and perform the stretches twice every day.
Wall-leaning Stretch – Stand an arm’s length away from a wall, place both hands on the wall at shoulder height, with the feet slightly apart and one foot in ront of the other. Your front knee should be bent, but the back knee should be straight while you lean toward the wall. Hold the position for 10 seconds at a time for up to 15 or 20 repetitions per leg.

If you are unsure of the cause of your symptoms, if pain is severe, or if you have the following symptoms, please call our office immediately:
_ Inability to bend your foot downward.
_ Inability to rise on your toes.
_ Inability to walk comfortably on the affected side.
_ Swelling or discoloration of the back of the foot.
_ Heel pain that occurs at night or while resting.
_ Heel pain that persists beyond a few days.

Heel pain does not always subside quickly after medical attention is received. Unfortunately, it may take several months before the pain is actually gone. In most cases, heel pain can be treated at home under a podiatric physician’s supervision.

If you or someone you know is suffering from heel pain, please give our office a call for consultation, 440-946-5858.

Ankle Sprain......Common Atheletic Injury....Ask Daniel "Boobie" Gibson

Daniel "Boobie" Gibson, a guard for the Cleveland Cavaliers, is benched with an ankle sprain. An ankle sprain is an injury to one or more ligaments in the ankle, usually on the outside of the ankle. Ligaments are bands of tissue – like rubber bands – that connect one bone to another and bind the joints together. In the ankle joint, ligaments provide stability by limiting side-to-side movement.

Some ankle sprains are much worse than others. The severity of an ankle sprain depends on whether the ligament is stretched, partially torn, or completely torn, as well as on the number of ligaments involved. Ankle sprains are not the same as strains, which affect muscles rather than ligaments.

Sprained ankles often result from a fall, a sudden twist, or a blow that forces the ankle joint out of its normal position. Ankle sprains commonly occur while participating in sports, wearing inappropriate shoes, or walking or running on an uneven surface. In Boobie's case, it was during a basketball game.

The symptoms of ankle sprains may include pain or soreness, swelling, bruising, difficulty walking and/or stiffness in the joint. These symptoms may vary in intensity, depending on the severity of the sprain. Sometimes pain and swelling are absent in people with previous ankle sprains. Instead, they may simply feel the ankle is wobbly and unsteady when they walk. Even if there is no pain or swelling with a sprained ankle, treatment is crucial. Any ankle sprain – whether it’s your first or your fifth – requires prompt medical attention.

There are four key reasons why an ankle sprain should be promptly evaluated and treated. First, an untreated ankle sprain may lead to chronic ankle instability, a condition marked by persistent discomfort and a “giving way” of the ankle. Weakness in the leg may also develop. Second, a more severe ankle injury may have occurred along with the sprain. This might include a serious bone fracture that, if left untreated, could lead to troubling complications. Third, an ankle sprain may be accompanied by a foot injury that causes discomfort but has gone unnoticed thus far. Fourth, rehabilitation of a sprained ankle needs to begin right away. If rehabilitation is delayed, the injury may be less likely to heal properly.

When you have an ankle sprain, rehabilitation is crucial—and it starts the moment your treatment begins.The available treatment options include:

•Rest: Stay off the injured ankle. Walking may cause further injury.
•Ice: Apply an ice pack to the injured area, placing a thin towel between the ice and the skin. Use ice for 20 minutes and then wait at least 40 minutes before icing again.
•Compression: An elastic wrap may be recommended to control swelling.
•Elevation: The ankle should be raised slightly above the level of your heart to reduce swelling.
•Early physical therapy: A rehabilitation program will be started as soon as possible to promote healing and increase your range of motion. This includes doing prescribed exercises.
•Medications: Non steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation. In some cases, prescription pain medications are needed to provide adequate relief.

In more severe cases, surgery may be required to adequately treat an ankle sprain. Surgery often involves repairing the damaged ligament or ligaments.

If you or someone who know has sustained an ankle sprain and/or commonly "rolls their ankle" please give our office a call, 440-946-5858, for evaluation and treatment, so you are not benched.

Foot Facts

* 3 out of 4 Americans experience serious foot problems in their lifetime.

* The foot contains 26 bones, 33 joints, 107 ligaments and 19 muscles.

* 1/4 of all the bones in the human body are down in your feet.


-When these bones are out of alignment, so is the rest of your body.

*Only a small percentage of the population is born with foot problems.
-It's neglect and a lack of awareness of proper care-including ill fitting
shoes that bring on problems.

* Women have about four times as many foot problems as men.
-High heels are partly to blame.

* The average person takes 8,000 to 10,000 steps a day, which adds up to
about 115,000 miles over a lifetime.
-That's enough to go around the circumference of the earth four times.

* Women on average walk 3 miles farther per day than the opposite sex.

* There are 250,000 sweat glands in a pair of feet.
-Sweat glands in the feet excrete as much as a half-pint of moisture a day.

* Your two feet may be different sizes.
-Buy shoes for the larger one.

* Your feet mirror your general health.
-Conditions such as arthritis, diabetes, nerve and circulatory disorders can show
their initial symptoms in the feet. Therefore, foot ailments can be your first
sign of more serious medical problems.

* Walking is the best exercise for your feet.
-It also contributes to your general health by improving circulation,
contributing to weight control and promoting all-around well being.

If you or someone you know is having foot problems, please give our office a call at 440-946-5858.

February is Heart Month.....So Please Read Article Below

Do you get pain in either leg when you walk?

Does the pain go away when your stop walking (within 10 minutes)?

According to the World Health Organization if you answered yes to both of these questions your likelihood of PAD is 95%

What is PAD you ask?

Commonly referred to as “poor circulation,” Peripheral Arterial Disease (P.A.D.) is the restriction of blood flow in the arteries of the leg. When arteries become narrowed by plaque (the accumulation of cholesterol and other materials on the walls of the arteries), the oxygen-rich blood flowing through the arteries cannot reach the legs and feet.

The presence of P.A.D. may be an indication of more widespread arterial disease in the body that can affect the brain, causing stroke or the heart, causing a heart attack. According to The Journal of Vascular Surgery, 60-80% of patients with PAD have blockage in one coronary vessel and 21% of these patients will have a MI, stroke, cardiovascular death or hospitalization within 1 year.
Based upon the guidelines of the American Heart Association and American College of Cardiology, the following individuals would benefit from an ABI test:

- Exertional leg symptoms
- Non-healing wounds
- Asymptomatic patients at high risk
o Adults 70 years old
o Adults 50 years of age with diabetes or tobacco use

Testing for this condition is non-invasive: It utilizes blood pressure cuffs and is painless. If interested in being tested, please call our office to schedule an appointment.

Advancements in Treatment of Big Toe Arthritis

There has been a great advancements in the treatment of great toe arthritis, also known as hallux limitus and/or hallux ridigus. The terms commonly used refer to the latin term for limited to no motion, which is the main complaint that patients will have when they present for this condition. There is no clear understanding of the cause of hallux limitus/rigidus, but the main understanding is it may be due to trauma or chronic mechanical overload of the joint with abnormal weight bearing. The limited motion in the great toe joint is due to bone spurring and arthritis of the joint which causes jamming and pain.

Presenting symptoms for this include, but are not limited, to stiffness/pain/swelling/limited motion and cracking and/or grinding of the great toe joint.

Patients who present initially with mild complaints are often treated with shoe modifications and orthotics or custom insoles. Patients will often state that this improves their pain because they are not placing as much weight through the great toe region. However, over time, a certain number of patients will get increasing pain as the arthritis gets worse. This diagnosis is made through examination and x-rays of the foot to see the level of arthritis and joint damage to the great toe. It is rare but in some cases of local cartilage damage of possible cartilage lesions of the great toe, an MRI may be performed.

In most cases, surgical treatment of bone spurs and great toe arthritis is necessary. As the arthritis gets worse, the surgery is more difficult and requires more invasive options.

Advancements in surgical options for hallux limitus/rigidus are growing and getting better and better, offering a multitude of treatment options based upon the patient's needs. These procedures can include cheilectomy of bone spur removal, osteotomy for realignment and joint decompression, midfoot fusion for 1st metatarsal repositioning, hemi base implant joint resurfacing and great toe fusion

In general, early cases of spurring with limited joint damage do well with cheilectomy. As the problem proceeds, less cartilage is avaliable to work with, therefore an implant or great toe fusion is required If the 1st metatarsal bone is very loose and seems to be drifting upwards resulting in jamming of the great toe joint, then a fusion of the metatarsal at the base is a good option to realign the first metatarsal and prevent the jamming at the great toe joint.

For more information or to schedule an appointment, please call our office at, 440-946-5858.

Can Your Feet be Trying to Tell You Something?

Fungal Nail
Reason: Trauma or infection to the nail that makes it thickened, discolored, loose or deformed. Often caused by the spread of athlete’s foot, but may also be an indication of conditions such as diabetes or arthritis.
Response: Medications, such as Ker¬alac Gel and Lamasil tablets, have proven effective treatment.

Tendonitis
Reason: Overuse due to increase in physical activity, such as an increase in walking time or distance. May also be caused by wearing worn out or improperly-fitted shoes.
Response: Rest and ice, however in some cases, over-the-counter arch supports or anti-inflam¬matories may be indicated.


Blisters
Reason: Friction from shoes that don’t fit right or are too stiff.
Response: Instruct patients to keep feet dry and wear socks with properly-fitted shoes. Additionally, instruct them never to pop a blister and if painful, to seek medical attention.

Ingrown Toenails
Reason: Improper trimming or too much pressure on feet in tight-fitting shoes, resulting in redness, pain or swelling around the nail. Can also result from poor foot structure, heredity, trauma or foot deformities.
Response: Instruct patients to avoid tight-fitting shoes and socks and inspect nails daily. Additionally, instruct patients to trim nails straight across using toenail clipper.

Bromohydrosis (Foot Odor)
Reason: Increased perspiration from the more than 250,000 sweat glands in the foot due to increased body temperature.
Response: Instruct patients to rub corn starch or spray anti-perspirant directly onto the soles of the feet and spray Lysol into shoes daily. Additionally, instruct patients to keep shoes and socks dry and change shoes regularly.

Bunion (Hallux Abducto-Valgus Deformity)
Reason: A bump at the base of the big toe that is swollen, tender or painful when in the shoe, often caused by misalign¬ment of the joints. Ill-fitting shoes, heredity, trauma, biomedical abnormalities, neuromuscular disorders, inflammatory joint disease, congenital deformities or arthritis can also be culprits.
Response: Instruct patients to avoid pointy and narrow shoes or shoes with stitching or seams that rub bony areas of the foot. If painful, bun¬ions can be surgically removed by a podiatrist.

Plantar Fasciitis
Reason: Excessive weight gain resulting in pain on the bottom of the heel or in the arch. May also be caused by bony overgrowth on the heel, muscle imbalance, high or low arched feet, improper shoe gear, exces¬sive activity or trauma.
Response: Instruct patients to exercise, stretch their feet daily and wear strong, supportive shoes that don’t put undue stress on the ball or heel. If these measures are unsuccessful in relieving pain refer to a podiatrist for further examination and treatment.

If you are experiencing any of the above conditions, please do not hesitate to call and/or schedule an appointment at our office, 440-946-5858.

Keep Your Feet Safe at the Gym in the New Year

In the New Year, don’t forget to keep your feet in tip-top shape while following through with your resolutions to get fit. Follow the tips provided below to ensure heatlhy feet and maintenance of your resolutions:

Start new workouts gradually— Increase your stamina and the length of your workouts gradually to avoid overuse injuries such as stress fractures or tendon strains and sprains. Stretching your muscles before and after workouts also helps prevent these types of injuries. If you do feel you’ve sprained your ankle, be sure to seek treatment right away: Untreated or repeated ankle sprains may lead to chronic ankle instability, a condition that causes persistent pain and a ‘giving way’ of the ankle.

Wear the right shoe and sock— Wear well-fitting athletic shoes designed for the exercise or sport. Shoes that don’t support the arch of the foot and provide cushion for the heel can cause heel pain (plantar fasciitis). Shoes that are too small can also cause a neuroma, or a thickening of the nerve tissue, in the foot and may require injections, medication or physical therapy. Wearing cotton or non-slip socks are also key to help avoid painful blisters, which can become infected and cause more serious issues.

Use good technique— Improper exercise techniques can result in injury to the tendons or ligaments in your feet and ankles. Incorrect posture or misuse of exercise equipment can cause decreased stabilization in the foot and ankle, leading to joint sprains and muscle strains.

Gym Safety- Protect yourself from bacteria—Sweaty shoes, public showers, exercise equipment and the pool deck at the gym are breeding grounds for fungus, viruses and bacteria, including drug-resistant strains like MRSA (methicillin-resistant Staphylococcus aureus) which has become increasingly more common. Never go barefoot while in public areas; water shoes can provide a great barrier between your feet and the wet surfaces. “It’s also best to cover cuts and cracks in the skin or ingrown toenails since these minor tears in the skin’s surface can act as entry points for bacteria. If you have a cut or scrape that becomes red or swollen and is not healing in a timely manner, don’t hesitate to call our office for an appointment.

Above all, it’s important to listen to your body. If you experience an injury or pain, call our office at 440-946-5858 for an evaluation immediately!