Risk Factors for Plantar Fasciitis

Plantar fasciitis remains a mysterious condition. Although the connective tissue at the bottom of each foot is subjected to a lot of daily wear, it is unknown why some people develop inflammation and others don’t. However, there are often specific factors that can be identified as increasing the risk of fascia strains. At Integrity Foot & Ankle Associates in Lorain, our podiatrists are specialists in sports medicine and offer comprehensive treatments for plantar fasciitis and other causes of foot pain, but our patients will need to do what they can to mitigate their risk factors.

Plantar fasciitis is common in distance runners, whose feet are subjected to an especially high amount of stress. It’s also seen in people whose jobs require them to be on their feet for most of the day, such as hairdressers, and in people whose shoes don’t allow them enough arch support. But people who are overweight are also at increased risk, as are people who are new to physical activity or who have recently returned to it. Researchers have noticed that people with plantar fasciitis often have tight calf muscles, suggesting that the plantar fascia is being overstretched to compensate for the heel being pulled upwards.

One bit of good news about plantar fasciitis is that it doesn’t usually appear in people who have heel spurs, so it’s probably possible to stretch the plantar fascia and Achilles tendon enough so that a heel spur won’t wear them down too much. The less good news is that plantar fasciitis is common in people with fallen arches. However, it may be possible to reinforce and arch without restoring to surgery, by making use of customized orthotics and physical therapy to strengthen the foot muscles. Patients should also make sure they are stretching their calf muscles before work-outs and giving them enough time to recover afterward.

Doctors David J. Hintz and Michael A. Wenowitz run Integrity Foot & Ankle Associates at 1740 Cooper Foster Park Road #B, Lorain, Ohio, 44053. To schedule an appointment, visit Integrity Foot and Ankle or call 440-282-1221.

 

Causes of Fallen Arches

If you’ve recently felt pain in the sides of your ankles or a bump developing on the bottom of your foot, you may be in the process of developing a flat foot. While that’s hardly good news, we at the Integrity Foot & Ankle Associates of Lorain are experts at treating this condition. But flat feet can be caused by several things and treatment may vary depending on which of them is responsible, so let’s take a closer look at the causes of ankle degeneration and arch collapse.

Our feet are largely shaped by the posterior tibial tendon, so it’s one of the first things we look at when a person’s foot is getting flatter. The posterior tibial tendon stretches from the thigh to the inside of the foot, and when it frays, the arch of the foot may sag. Fraying is usually due to wear-and-tear, but it could have been the result of an acute injury. It’s also possible that a ligament that is more centrally located or in the back of the foot has frayed. Degeneration is more likely to occur when a person is suffering from diabetes, which damages the nerves and makes it difficult for someone to feel pain from injured tissues. Another potential complicating factor is arthritis, in which the cartilage supporting the ankle joints would be worn away, causing the bones to develop spurs that might also compress nerves.

It might not be possible to determine whether you have a serious structural problem with your foot just by looking at it. Some people have more flexible arches than others. But if you are in pain, or you know diabetes might prevent you from feeling pain and you suspect something is wrong, don’t hesitate to schedule an appointment with us. We can devise a minimally invasive plan to restore your foot’s function, but the earlier you get treatment, the easier it will be.

Doctors David J. Hintz and Michael A. Wenowitz run Integrity Foot & Ankle Associates at 1740 Cooper Foster Park Road #B, Lorain, Ohio, 44053. To schedule an appointment, visit Integrity Foot and Ankle or call 440-282-1221.

 

Heel Pain in Children

Children are more vulnerable to some kinds of injuries than adults, including a certain type of foot pain. Sever’s Disease, also known as calcaneal apophysitis, commonly strikes children between the ages of eight and fourteen, especially when they are highly active. Although this can be frightening for them and their parents, we at the Integrity Foot & Ankle Associates in Lorain want to reassure our patients that it is temporary and we are able to help.

In children, the heel bone contains a growth plate from which new tissue develops. Growth plates are weaker than ordinary bone tissue and the Achilles tendon attaches to the pack of the heel, subjecting this particular growth plate to a lot of strong forces. Children who run frequently and play sports such as soccer and basketball, or who are overweight, may suffer overuse injuries including inflammation of the growth plate. This would cause swelling and tenderness or soreness, which would get worse while walking and may be present in one or both feet.

Children suffering from frequent heel pain will need to reduce their activity. Our podiatrists will conduct an examination to determine whether there is a biomechanical problem, such as a tight Achilles tendon, that could be contributing to the growth plate’s inflammation. To return to activity, a patient will need to do stretching exercises to loosen their tendons, and to make sure they warm up before any strenuous activity. Children may also benefit from wearing heel pad shoe inserts and from switching to shoes that provide better arch support. Once the growth plate solidifies, it will not become inflamed again.

Doctors David J. Hintz and Michael A. Wenowitz run Integrity Foot & Ankle Associates at 1740 Cooper Foster Park Road #B, Lorain, Ohio, 44053. To schedule an appointment, visit Integrity Foot and Ankle or call 440-282-1221.

Friction Blisters

Blisters, pockets of pus that form on the skin, can be caused by all sorts of things. But the ones on the feet are most often caused by chafing. As specialists in sports medicine, the podiatrists at the Integrity Foot and Ankle Associates of Lorain are familiar with friction blisters and their treatment, and will work to help patients start moving again comfortably as soon as possible. But blisters are preventable, so it’s helpful to understand more about them.

When the skin is being chafed, it turns red and swells. As the chafing continues to break the skin, a bubble of liquid will form to protect the deeper tissues from mechanical damage and the spread of pathogens. Since the blister is helping the skin to heal, a patient should avoid bursting it unless it is extremely large and debilitating, and even then the skin should not be removed. Instead, patients may try padding the irritated area, which may include cutting a hole in the pad so it can fit around the blister. Usually, a blister will heal within a few weeks.

People are at increased risk of developing friction blisters when there is excessive moisture in their shoes. Runners may be able to prevent them by applying foot powder and by wearing moisture-wicking socks. People with recurring blisters may want to try applying adhesive bandages and checking whether their shoes need to be replaced or their orthotics have slipped out of position. If a blister shows signs of infection or the patient suffers from neuropathy, we can provide antibacterial treatments in our office.

Doctors David J. Hintz and Michael A. Wenowitz run Integrity Foot & Ankle Associates at 1740 Cooper Foster Park Road #B, Lorain, Ohio, 44053. To schedule an appointment, visit Integrity Foot and Ankle or call 440-282-1221.

Common Causes of Heel Pain

As podiatrists who specialize in sports medicine, we at Integrity Foot & Ankle Associates in Lorain want all our patients to continue leading active lifestyles. Keeping the lower limbs strong and flexible will prevent problems later in life, but athletes are at greater risk for overuse injuries. Heel pain is a common problem that can usually be traced to biomechanical defects that worsen over time, so this week’s blog post is about recognizing why they develop.

Most heel pain is caused by a problem with the plantar fascia or the Achilles tendon. The plantar fascia is what connects the heel to the ball of the foot. It can suffer wear when a person has fallen arches or they develop a bone spur on the back of their heel. The Achilles tendon travels down the back of the ankle to the heel and may be inflamed when a person’s shoes are rubbing against it. Inflammation here can also result in the growth of a bone spur.

Although these problems are usually treatable with rest, they are worth examining in case the heel pain is actually being caused by an infection or fracture. People with plantar fasciitis and Achilles tendonitis may benefit from supportive shoe inserts and from doing stretching exercises to loosen up their tissues. We can provide patients with anti-inflammatory medications, and in severe cases, can discuss surgical options such as bone spur removal.

Doctors David J. Hintz and Michael A. Wenowitz run Integrity Foot & Ankle Associates at 1740 Cooper Foster Park Road #B, Lorain, Ohio, 44053. To schedule an appointment, visit Integrity Foot and Ankle or call 440-282-1221.

 

What is Plantar Fasciitis?

Earlier this year, Cleveland Cavaliers center Ante Zizic’s season debut was delayed for a few weeks due to plantar fasciitis in his left foot. This kind of injury is common in older people as well as athletes, and can cause a person a lot of pain and difficulty moving. We at Integrity Foot & Ankle Associates in Lorain frequently treat it, so we want patients to understand what they can expect when they seek help.

The plantar fascia is a shock-absorbing band of connective tissue that runs the length of the bottom of the foot, right under the skin. It stretches tightly under the heel bone, and when it becomes inflamed due to wear-and-tear or an acute injury, a sharp pain in the heel is a common result. The pain is usually worse after the foot has been at rest. It is most common in people between forty and sixty, and people are at particularly high risk if they have tight calf muscles, heel spurs, or are overweight. The impacts from running can also contribute to it.

Treatment for plantar fasciitis starts off converativeley, with therapeutic exercises to loosen the calves and toes. Patients may be given injections of anti-inflammatory medications and shoe orthotics to compensate for their heel’s loss of cushioning. Surgical options to release the fascia may be considered if the patient shows no improvement after several months, and the bone spur may also be removed.

Doctors David J. Hintz and Michael A. Wenowitz run Integrity Foot & Ankle Associates at 1740 Cooper Foster Park Road #B, Lorain, Ohio, 44053. To schedule an appointment, visit Integrity Foot and Ankle or call 440-282-1221.

 

Tarsal Tunnel Syndrome

If you feel a sharp, shooting pain in the sole of your foot when you’re running, you may be suffering from tarsal tunnel syndrome (TTS). Our podiatrists at Integrity Foot and Ankle Associates in Lorain are trusted care providers to people who have suffered sports injuries. While not all instances of TTS are sports-related, it is an overuse injury that we can help people to manage and recover from.

Like the carpal tunnel in each wrist, the tarsal tunnel is a canal in each ankle through which a major nerve travels. The tibial nerve provides feeling to the bottom of the foot and allows us to move most of our toes. The tarsal tunnel is comprised of both bone and soft tissue, and when it is inflamed, the tibial nerve may be compressed. This will cause sharp pains, numbness, or tingling, especially when the patient has been active or standing for a long time. People who make repetitive motions with their legs are especially at risk, but so are people with flat feet, diabetes, or who have suffered injuries in that area before.

Testing for TTS involves imaging and tapping the nerve. Besides RICE, common treatments for TTS include anti-inflammatory injections and the use of a splint to immobilize the foot. Patients are also advised to wear customized orthotics to ensure their tibial nerve isn’t being stretched by fallen arches. In severe cases, we can surgically release the ligament binding the tarsal tunnel, taking pressure off the nerve.

Doctors David J. Hintz and Michael A. Wenowitz run Integrity Foot & Ankle Associates at 1740 Cooper Foster Park Road #B, Lorain, Ohio, 44053. To schedule an appointment, visit Integrity Foot and Ankle or call 440-282-1221.

Big Toe Sprains

Last season, Cleveland Cavaliers forward Kevin Love suffered a toe injury that prevented him from playing in several games. He reportedly underwent cartilage removal and drainage around the big toe on his left foot while slowly recovering. At Integrity Foot & Ankle Associates in Lorain, we take a special interest in helping athletes get back on their feet. We want our patients to understand why sprains in the big toe are a big deal and how patients can expect us to help.

Unlike the other toes, which have three joints, the big toe has two. The one at its base, the metatarsophalangeal joint (MTP), is a complex structure that includes ligaments on either side to prevent it from dislocating collaterally, as well as tissue below it so it doesn’t bend too far. When the MTP joint does hyperextend and rupture its ligaments, we call that “turf toe.” The patient will experience swelling, bruising, and instability.

Surgery is often not necessary for toe sprains if they are caught early. After implementing RICE protocol (rest, ice, compression, elevation) at the scene of the accident, the next treatments may be anti-inflammatory injections and temporary immobilization. However, if the cartilage was damaged or a sliver of bone chipped off, surgical removal of the deformed tissue may be necessary. If the free-floating bones of the big toe are dislocated or fractured, they will have to be put back into place or the foot won’t heal properly. Injured toes are likelier to become permanently stiff without intervention, which is why patients should always see us if a big toe injury is still painful after three days.

Doctors David J. Hintz and Michael A. Wenowitz run Integrity Foot & Ankle Associates at 1740 Cooper Foster Park Road #B, Lorain, Ohio, 44053. To schedule an appointment, visit Integrity Foot and Ankle or call 440-282-1221.

Risks of a Twisted Ankle

Cleveland baseball fans may have been concerned this week when Mike Clevinger twisted his ankle. The pitcher fell down on Monday and is reportedly recovering from what team doctors determined was a minor injury. Baseball players are particularly vulnerable to twisted ankles. As podiatrists who are particularly interested in serving athletes, we at Integrity Foot & Ankle Associates in Lorain want our patients to understand the importance of having ankle injuries assessed.

An ankle sprain is what occurs when a person stretches or tears one of the ankle’s many ligaments by pulling too hard on the outside of the foot. About half of these types of injuries occur during athletic activity. The word “strain” is used to describe tears to muscles and tendons, while “fractures” are small cracks in bones. When tendons are torn, they may trigger the immune system’s inflammatory response, which is described as “tendonitis.” Elevating the foot will help swelling go down faster.

When injuries are mild, they can likely heal on their own and our concern is to provide the patient with pain relief and ensure they are rehabilitated successfully. The ankle will be weak and tender, and the patient may need anti-inflammatory injections or oral medications. But a large break may require surgery and a carefully monitored program of stretching and strength building. Patients with more severe injuries will be fitted for a customized brace to wear when not doing physical therapy. A minor injury is less likely to lead to chronic ankle instability if we are able to intervene quickly, but people who have suffered sprained ankles in the past are at greater risk for repeats. Patients can prevent relapses by wearing properly fitted shoes that are in good condition, keeping their toenails short, and by maintaining the strength of their ankle muscles.

Doctors David J. Hintz and Michael A. Wenowitz run Integrity Foot & Ankle Associates at 1740 Cooper Foster Park Road #B, Lorain, Ohio, 44053. To schedule an appointment, visit Integrity Foot and Ankle or call 440-282-1221.