Jamie L. Lynch, M.D. - Orthopaedic Surgeon
Northeast Orthopaedics & Sports Medicine - Jamie L. Lynch, M.D. - Orthopaedic Surgeon
 

Patient Info

Plantar Fasciitis

Plantar Fasciitis

Plantar fasciitis is a common problem that causes pain under the heel bone often with lengthy walks and prolonged standing. It is most often seen in middle-aged men and women.

Plantar fascia is a thick band of tissue that lies at the bottom of the foot. It runs from the heel bone to the toe and forms the arch of the foot. The plantar fascia functions as a shock absorber and also supports the arch of the foot.

Causes

Too much of pressure over the fascia may damage or tear away the tissue and can be a cause of heel pain. It is also possible that when the plantar fascia gets overstretched or overused repeatedly, there may be irritation or inflammation of the fascia. Inflammation of the plantar fascia causes plantar fasciitis.

The risk factors that can make you more prone to develop plantar fasciitis include obesity, foot arch problems such as flat feet and high arch, activities such as long-distance running, ballet dancing and dance aerobics, occupations that necessitate walking or standing on hard surfaces for long period of time and wearing shoes with poor arch support or thin-soled shoes.

Symptoms

The most common symptom of plantar fasciitis is stabbing pain on the bottom of the foot near the heel. The pain develops gradually and may involve either one or both feet at the same time. Pain is usually worse in the morning or may aggravate after standing up for a long time.

Diagnosis

Your doctor will examine your foot and will check for the signs of flat feet or high arches, tenderness, swelling and redness of the foot and stiffness or tightness of the arch in the bottom of your foot.

Your doctor may suggest an X-ray or MRI scan to rule out other causes of heel pain such as a stress fracture or pinched nerve.

Treatment

Most patients with plantar fasciitis are effectively treated with the following measures:

  • Medications: Your doctor may prescribe non steroidal anti-inflammatory drugs (NSAIDs) as they can reduce your pain and inflammation. Corticosteroids can be injected directly into the plantar fascia which may offer pain relief and reduce inflammation.
  • Rest: Decrease or avoid the activities that worsen the pain.
  • Ice: Apply ice pack over the painful area for at least twice a day for 10 - 15 minutes, for the first few days.
  • Night splints: Use of night splints is beneficial as it stretches the plantar fascia and allows it to heal.
  • Supportive shoes and orthotics: Your doctor may recommend you to wear shoes with good support and cushioning. Custom orthotics (shoe inserts) may also be helpful.
  • Physical therapy: Your physical therapist may suggest you an exercise program that focuses on stretching your plantar fascia and achilles tendon. These exercises may help to strengthen the muscles of lower leg. In addition to exercises application of athletic taping to support the bottom of your foot is also taught.
  • Extracorporeal shock wave therapy: During this procedure, sound waves are targeted to the painful area to stimulate the healing process in the damaged plantar fascia tissue.

Surgery: Rarely, surgery to release the tight plantar fascia may be needed. However it is recommended only after all nonsurgical measures have failed.

Preventive measures such as stretching exercise programs and footwear modifications can help prevent plantar fasciitis. But if it occurs proper treatment is essential as otherwise it can become a long-term problem.

Ankle Sprain

Ankle Sprain

A sprain is stretching or tearing of ligaments, which connect adjacent bones in a joint and provides stability to the joint. An ankle sprain is a common injury and occurs when you fall or suddenly twist the ankle joint or when you land your foot in an awkward position after a jump. It most commonly occurs when you participate in sports or when you jump or run on a surface that is irregular. Ankle sprains can cause pain, swelling, tenderness, bruising, and stiffness, numbness in the toes, and inability to walk or bear weight on the ankle.

The diagnosis of an ankle sprain is usually made by asking the history of injury and physical examination of the ankle. X-ray of your ankle may be needed to confirm if a fracture is present.

The most common treatment recommended for ankle sprains is rest, ice, compression and elevation (RICE).

  • Rest: You should not move or use the injured part to help to reduce pain and prevent further damage. Crutches may be used that help in walking
  • Ice: An ice-pack should be applied over the injured area up to 3 days after the injury. You can use a cold pack or crushed ice wrapped in a towel. Ice packs helps to reduce swelling and relieve pain. Never place ice directly over the skin
  • Compression: Compression of the injured area helps to reduce swelling and bruising. This is usually accomplished by using an elastic wrap for few days to weeks after the injury
  • Elevation: Place the injured part above heart level to reduce swelling. Elevation of an injured leg can be done for about 2 to 3 hours a day

The doctor may also use a brace or splint to reduce motion of the ankle. Anti-inflammatory pain medications may be prescribed to help reduce the pain and control inflammation.

You may need to use an ankle brace or wrap to support and protect your ankle during sports activities. Avoid pivoting and twisting movements for 2 to 3 weeks.

To prevent further sprains or re-injury you may need to wear a semi-rigid ankle brace during exercise, special wraps, and high-top tennis shoes. A program of ankle exercises will also help to prevent re-injury by making the ankles strong and flexible.

American Academy of Orthopaedic sergions - Jamie L. Lynch, M.D. - Orthopaedic Surgeon Arthroscopy Association of North America - Jamie L. Lynch, M.D. - Orthopaedic Surgeon AOSSM - Jamie L. Lynch, M.D. - Orthopaedic Surgeon THE PERRY INITIATIVE - Jamie L. Lynch, M.D. - Orthopaedic Surgeon
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