Dr. Vincent Coda, D.P.M.
Ligament & Tendon Problems
If your heel moves too much or too little, it can cause other parts of your foot to function incorrectly. Over time, stress from poor foot function can stretch or tear the ligaments or tendons in your heel. In some people, the constant demands of daily use are enough to weaken these tissues. Being overweight may aggravate such problems. Ligament and tendon injuries can also result from a direct blow or a sudden twist. Treatment goals for tissue problems include reducing abnormal pull on the ligaments and tendons.
Plantar Fasciitis
This is an inflammation of the ligament running from your heel to the ball of your foot (plantar fascia). The bottom or inside of your heel may hurt when you stand. The pain usually decreases after you walk a few steps, but it may return with prolonged movement.
If your foot flattens too much, the plantar fascia may overstretch and become inflamed
If your foot doesn't flatten, the plantar fascia may be pulled too tight, eventually causing pain.
Causes of Plantar Fasciitis
Plantar fasciitis is often caused by poor foot mechanics. If your foot flattens too much, the fascia may overstretch and swell. If your foot flattens too little, the fascia may ache from being pulled to tight.
Symptoms
With plantar fasciitis, the bottom of your foot may hurt when you stand, especially first thing in the morning. Pain usually occurs on the inside of the foot, near the spot where your heel and arch meet. Pain may lessen after a few steps, but it comes back after rest or with prolonged movement.
Medical History and Physical Exam
Where and when does your foot hurt? Dr. Coda may first ask about your symptoms. Then he may feel for damaged ligaments, inflamed tendons, and displaced bones or joints. Dr. Coda may also watch you walk to see if your symptoms are caused by incorrect foot movement.
Testing
X-rays of your foot may be taken, or you may have a bone scan to confirm a suspected hell spur or a stress fracture of the heel bone.
Reducing Symptoms
To relieve mild symptoms, try aspirin, ibuprofen, or other medications as directed. Rubbing ice on the affected area may also help.
To reduce sever pain and swelling, Dr. Coda may prescribe pills or injections. Physical therapy, such as ultrasound or stretching exercises, may also be recommended.
To reduce symptoms caused by poor foot mechanics, your foot may be taped. This supports the arch and temporarily controls movement. Night splints may also help by stretching the fascia.
If taping helps, Dr. Coda may then prescribe orthoses, built using a Computer Gait Analysis System to custom fit your feet. These inserts control the way your foot moves. As a result, your symptoms should go away.
If Surgery Is Needed...
Dr. Coda may consider surgery if other types of treatment don't control your pain. During surgery, the plantar fascia is partially cut to release tension. As you heal, fibrous tissue fills the space between the heel bone and the plantar facia.
What can I do?
You can't stay off your feet altogether, but you can reduce overuse and the risks that come with it. Also, be sure to follow Dr. Coda's treatment plan. Take medications as directed, and wear orthoses if you have them, even while at home.
Reduce Overuse - Every time your foot strikes the ground, the plantar fascia is stretched. You can reduce the strain on the plantar fascia and the possibility of overuse by following these suggestions:
- Lose any excess weight.
- Avoid running on hard or uneven ground.
- Wear shoes or house slippers that support your arch.
Tendinitis
Inflammation of a tendon or the tissue surrounding it is called tendinitis. You may feel pain when you move your ankle or when your heel shifts from side to side. The Achilles and peroneal tendons are common sites for tendinitis.
For more information about heel pain, or to discuss treatment options, click here for contact options.