By Dr. Bruce Pinker

Pain in the bottom part of the heel and arch of the foot is a very common condition, known as plantar fasciitis. Typically, the plantar fascial ligament that spans the foot, originating in the heel and traveling down toward the toes, becomes aggravated or inflamed. There are several reasons why this occurs, and many effective ways to prevent and treat it.

In addition to plantar fasciitis, many individuals endure heel pain due to a heel spur, a spike that develops on the calcaneus (heel bone). This is usually caused by excessive force on the plantar fascial ligament which produces high tension levels at the origin of the ligament, causing a tearing of the bone, coupled with bleeding and calcification to produce a physical bone spur. Based upon many years of research, we know that the culprit is the increased stress on the plantar fascia. Therefore, most heel spurs do not need to be removed and can be treated conservatively via physical therapy and custom-made orthotics. Occasionally, cortisone injections may be of some benefit but usually produce only short-term relief. Ninety percent of all cases of plantar fasciitis and heel spurs can be treated non-surgically.

For those complicated cases, there is the Extra Corporeal Shock Wave Therapy (ESWT). This non-invasive approach to heel pain is FDA-approved and highly effective, typically yielding success in 90 of every 100 cases. The procedure is performed in our office in one visit as we own and operate the high-energy model (there is also a low-energy version that requires several treatments and we do not endorse it). ESWT is similar to the lithotripsy procedure that is performed to treat kidney stones. We have successfully utilized this treatment in our office for many patients over several years.

One of the best ways to prevent plantar fasciitis is to stretch your feet, legs, and lower back on a daily basis. In our September 2012 newsletter, we discussed proper stretching techniques and these can be found on our Facebook page here: Progressive Foot Care of White Plains NY, Pomona NY. The important factor for stretching is discipline. It must be performed every day, preferably right after one gets out of bed. The rationale is that while we sleep, our feet tend to fall downward naturally. As this occurs, the ligaments and tendons on the bottom of the foot tighten and shorten. This leads to increased pain upon stepping out of bed.

Unfortunately, simply wearing “good” shoes does not prevent pain. While supportive footwear is beneficial in providing orthopedic support, shock absorption and biomechanical control, it is often not enough. Many times, a custom-made orthotic is necessary to address the concerns of the foot. We prescribe and fabricate these in the office on a regular basis.

As we enjoy more temperate weather, we may choose to jog, walk or run. It is important to stretch out, wear proper footwear, and seek the advice of a podiatrist if foot pain occurs. Many foot issues can be treated conservatively, and if addressed quickly, can be resolved in a relatively short period of time.
Taking care of your feet can be your first step toward good health. Remember, your feet are the foundation for your body.

Dr. Bruce Pinker is a podiatrist with offices in Pomona and White Plains.

3 Comments

  • Gary Scarano Posted August 25, 2013 9:13 am

    Thanks for posting this. As you know, I am now suffering from heal pain and hope it will be healed soon!

  • Gary Scarano Posted August 25, 2013 11:03 am

    Here is the link on Dr. Pinker’s Facebook page to the article about Streching. The link provided above in the article is to the FB page, and you have to scroll quite a ways down to find it
    https://www.facebook.com/permalink.php?story_fbid=466564046741914&id=131355506930287

    PROGRESSIVE FOOT CARE: DR. BRUCE PINKER’S FOOT HEALTH NEWSLETTER JANUARY 2013

    Your Feet May Be Your Future?

    With nearly a full year ahead of us, many may be wondering what the year holds in store for us, or, what we have in store for it. As most of us make new year resolutions which are usually difficult to keep, here’s a suggestion: make a resolution to stretch out every morning. It’s a terrific way to get the mind and body focused on the day that awaits you. Reality is that most individuals never stretch, as I have heard from my patients, but in just 5 minutes one can thoroughly stretch all the major muscle groups (prior to exercising a more detailed stretch and warm-up is required, to be discussed in future issues).

    Our recommended stretch focuses on the lower back, hamstrings, shoulders, neck, lower legs, calves, and feet. The exercise is as follows:

    1. Toe Touches
    The old classic of bending over to touch your toes still holds its value today. Be sure to hold for ten seconds. Do not bounce. Then reverse by arching your back and hold for the same amount.

    2. Wall Pushups
    Stand in front of a wall, arms fully extended forward with palms flat on the wall. Hold hands close together and, while keeping your heels flat on the floor, lean into the wall. Hold for ten seconds as you experience a stretch down the back of your legs and into your heels. Repeat.

    3. Trunk Twists
    While standing with feet shoulder width apart and arms in front of you, twist from your waist to increase mobility to your lower back, hips and spine. Perform 5 – 10 twists at a moderate pace.

    4. Shoulder Rotations
    Extend your right arm up to your side with your thumb pointed down. Tilt head to left. Rotate your hand left and right 5 times to loosen the rotator cuff and shoulder muscles. Switch to left arm with head tilted to right and perform the same. This will reduce stress in the neck and trapezius regions.

    5. Piriformis Stretch
    Sit upright on the floor. Bring right foot over left knee. Hold under left knee with both hands and lift left leg straight up while flexing the left ankle. Roll onto back. Feel the stretch in right lower back. Hold for ten seconds. Perform on opposite side in the same manner.

    This stretching routine can help to realign your body after a night of sleep, especially for those who toss and turn. It can also balance and re-energize you. By aligning your muscles and joints, your body will be in harmony, feet included, providing you with the ultimate support. After practicing this regimen for over 20 years, it has allowed me to remain focused and virtually pain-free.

    Many people neglect their feet until they hurt. However, your feet should not be overlooked as they may become more than just a means of ambulation! According to NBC News, our feet may soon become our password:
    http://www.nbcnews.com/technology/futureoftech/your-feet-may-soon-be-your-password-905968 A company called Autonomous ID combined the physical and behavioral qualities of the foot (shape and gait pattern, for example). Initially a military implication, it can be applicable for detecting early warning signs of diseases such as Parkinson’s and dementia, which can affect how we walk.

    So in this new year, let’s make it the greatest ever! Reach for our goals, achieve our resolutions, and be as healthy as possible in the future. A unique gentleman in NYC has found a new energetic and fun way to walk. He plans to Dance Walk through the year. Please click on this link to see him, and perhaps you’ll join in:

    http://www.youtube.com/watch?v=HSy7h3TPB-M

    A special thanks goes out to all of our 5th Annual Holiday Shoe Drive for the Homeless ambassadors, especially Mr. Scott Bloom of Bloom Real Estate Group, Gloria Smith of Greenburgh Hebrew Center, NYSC Palisades Mall, and Kraft Foods. Together, we collected over two thousand pairs of footwear to help prevent foot diseases and foot amputations in the less fortunate. Thank you all for donating. We look forward to continuing the tradition this coming October.

    Stay tuned for special foot health seminars from Progressive Foot Care in your area. They promise to be very edu-taining (both educational and entertaining)!

    Taking good care of your feet can be your first step towards good health. Remember, your feet are the foundation for your body.

    Yours in good health,
    Dr. Bruce Pinker, DPM, AACFAS, AAPWCA

    Sponsored by an educational grant from New Age Wellness, the Complete Corporate Health & Wellness Specialists. Let us plan your next Health Fair at no charge: New_Age_Wellness@yahoo.com

    Follow us on Twitter: @Docpinker4feet

    Like us on Facebook: http://www.facebook.com/pages/Progressive-Foot-Care-of-White-Plains-NY-Pomona-NY/131355506930287

    Feel Free to Forward to a Friend

    Dr. Bruce Pinker, DPM, AACFAS, AAPWCA
    Associate, American College of Foot & Ankle Surgeons
    Associate, American Professional Wound Care Association
    Specialist, Foot & Ankle Sports Medicine/Diabetic Foot Care
    Professional Health & Wellness Speaker

    P R O G R E S S I V E F O O T C A R E
    http://www.progressivefootcareny.com

    Offices:
    199 Main Street, Suite #608, White Plains, NY 10601 Tel: (914) 328 – 8000 Fax: (914) 328-8003

    978 Route 45, Suite #109, Pomona, NY 10970 Tel: (845) 354-2700 Fax: (845) 354-2809

    “Improving our patients’ lives, one step at a time.”

    Your feet may soon be your password
    http://www.nbcnews.com
    Shoes outfitted with high-tech soles that can confirm a person’s identity in just a few steps may soon serve as our keycards and computer pa…

  • Mike Johnson Posted August 30, 2013 4:07 pm

    There are two common locations of heel pain: underneath the heel and behind the heel. The most common cause of pain beneath the heel is plantar fasciitis, but this pain can also be indicative of a heel spur (a hook-shaped calcium deposit on the bottom of the heel bone) or a stone bruise, which is a short-term soft tissue injury (a bruise) caused by stepping on a small, hard object, like a stone.Add arch supports to their running shoes
    Ice your heel and keep it elevated when you are not on your feet.
    Check the below link
    http://www.footsolutions.com/store/bethesda/problems/plantar-fasciitis

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