Olympic Gymnast Larisa Iordache Has Heel Pain

Romanian Larisa Iordache joins the long list of Olympic hopefuls who have had foot injuries or complications in the past few weeks. The 16 year old gymnast developed plantar fasciitis in her left heel, making Romania's chance for an Olympic comeback slim.
The Romanian gymnastic team used to dominate the world gymnastic field, but fell a distant third at the Beijing Olympics in 2008 and did not even place at last year's world championships. The team collapsed after Mariana Bitang and Octavian Belu left the team.
During training on Thursday, Iordache practiced on the uneven bars and balance beam and coach Mariana Bitang said there was just a 50% chance Iordache would participate in all four events. "It's very, very difficult. She was the most important piece of the team," Bitang said.
Competition began on Sunday with Iordache qualifying for all-around. Iordache has been called the "new Nadia". She led the Romanians to an upset of the Russians at Europeans, where she won the title on the floor exercise and came in second on beam. Last year she won six medals at the European Youth Olympic Festival, including the all-around title and golds on floor exercise and balance beam.
If you are experiencing heel pain, call our Rocky Hill or Middletown office to make an appointment.
Jeffrey S. Kahn, DPM
Connecticut Foot Care Centers
Heel Pain Doctor in CT
Podiatrist in Rocky Hill and Middletown, CT
Visit our website, follow my tweets on Twitter, and friend or like our page on Facebook.

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• Will I Need Surgery For Plantar Fasciitis?

Will I Need Surgery For Plantar Fasciitis?

95% of people who have heel pain will not need surgery as part of their treatment course. Most conservative treatment options will resolve plantar fasciitis pain. Only if six months of non-surgical treatments have not helped ease your pain and the pain is affecting your daily activities will a doctor consider surgery. Having surgery for plantar fasciitis is not a guarantee that the pain will go away. About 75% have less pain than they did before surgery.
There are several types of surgery for plantar fasciits. One of the most common types of surgery is the plantar fascia release. This surgery involves cutting part of the plantar fascia ligament to release the tendon and relieve inflammation of the ligament. Plantar fascia release can be done either by cutting through the area (open surgery) or by inserting instruments through small incisions (endoscopic surgery).

The surgery is done by making an incision on the foot above the heel pad, where the thicker skin of the sole meets the thinner skin on the back of the heel. If the surgery is done endoscopically, the podiatrist will make a small incision on either side of the heel below the ankle bone. The plantar fascia may be detached from either the heel bone or relieved by making incisions on either side. The bone surface may be smoothed to allow the plantar fascia to heal under less tension. A piece of damaged tissue may be removed as well.
Traditional open surgery will require you to wear a non-weight-bearing cast or brace, such as a CAM walker for 2 to 3 weeks after surgery to allow tissues to heal. If you have endoscopic surgery, you can begin weight-bearing immediately and can begin wearing normal shoes as soon as it is comfortable. Most people return to normal activities 3 to 6 weeks after surgery.
After surgery you will begin a gradual strengthening and flexibility program. You will not be able to run or jump for 3 months after surgery.
Risks of this surgery include: nerve entrapment or tarsal tunnel syndrome, recurring heel pain, neuroma, delayed wound healing, prolonged pain or swelling, delay in return to activities, infection, risks of anesthesia, and the possibility that symptoms will get worse.
To help you decide if surgery is best for you, here are some questions you should ask:
1. My symptoms have improved with the use of medicines, orthotics, or other nonsurgical treatments.
2. Before considering surgery I am willing to try nonsurgical treatments for 6 months to see if my symptoms improve.
3. I have used orthotics, medicines, and other nonsurgical treatments for 6 months and my symptoms are still the same.
4. My heel pain is interfering with my ability to work.
5. My heel pain is interfering with my athletic or exercise program.
6. I would prefer to avoid surgery if at all possible.
7. My heel pain is forcing me to adjust the way I walk, stand, or run.
8. I have heel pain, but neither my work nor my personal life are affected.
If you are experiencing heel pain, call our Rocky Hill or Middletown office to make an appointment.
Jeffrey S. Kahn, DPM
Connecticut Foot Care Centers
Heel Pain Doctor in CT
Podiatrist in Rocky Hill and Middletown, CT
Visit our website, follow my tweets on Twitter, and friend or like our page on Facebook.

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• What Is Plantar Fasciitis?

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• Causes of Heel Pain

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Bursitis and Heel Pain

A bursa is a small fluid-filled sac that forms in areas of extra rubbing and friction. They are usually present with a bone deformity as the bone is pressed against other structures like a tendon or against the ground as you walk. The bursa acts like a shock absorber and is a way for your body to protect you from damage. When this bursa or sac-like structure becomes swollen and inflamed it is called bursitis. The bursa may have an anatomical meaning normally present, or it may be adventitious meaning, only present because of a problem. Many bursa are present and do not cause pain.

Symptoms of bursitis usually occur after rest and relaxation. Upon activity there is usually more intense pain in the area of the bursa. The common areas to have bursitis in the foot are in the bottom of the heel, behind the heel near the attachment of the Achilles tendon as well as along the side of a bunion. A bursa may also form in multiple areas, especially along the metatarsal heads, or "ball" of your foot. You may actually feel the sac-like fluid when rubbing the area of pain.
Causes of bursitis can be any kind of friction between bone and soft tissue. The most common cause is due to abnormal pronation.
Prevention can be accomplished by controlling your foot structure with good supportive shoes or arch supports. Pay attention to early signs of friction like blister formation. This tells you where the areas that are more likely to cause a bursa to form and subsequently bursitis.
Diagnosis is first by clinical suspicion of symptoms. This can be mistaken for gout or infection, especially in the big toe region. A diagnosis of bursitis is usually used in combination of the underlying cause, for instance a bunion deformity, Haglund's Deformity, or Heel Spur Syndrome. Many times the cause needs to be addressed to rid the problem of bursitis.
Podiatric care may include using an anti-inflammatory oral medication or an injection of medication and local anesthetic to reduce the swelling in the bursa. An injection may be used for both the diagnosis and treatment. When you go to your doctor, x-rays are usually required to evaluate the structure of your foot and ankle to ensure no other problems exist in this area. They may advise you on different shoewear or prescribe a custom-made orthotic to try and control the foot structure, especially if you have excessive pronation. Sometimes patients are sent to physical therapy for treatment as well. To aid in relief of pressure points, some simple padding techniques can be utilized. Most all patients respond to these conservative measures once the area of irritation is removed.
Surgery is rarely done strictly for treatment of a bursitis. If any underlying cause is the reason, this may be addressed surgically. During the surgery for other conditions, the bursa may be seen and removed surgically.
If you are having pain because of a bursa or heel pain, and do not currently see a podiatrist, call our Rocky Hill or Middletown office to make an appointment.
Jeffrey S. Kahn, DPM
Connecticut Foot Care Centers
Heel Pain Doctor in CT
Podiatrist in Rocky Hill and Middletown, CT
Visit our website, friend and like our page on Facebook, and follow our tweets on Twitter. 

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• Causes of Heel Pain

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Heel Pain Stretch of the Week: Quad/Hip Flexor Stretch

Stand or lie down with your right leg bent. Holding the right foot with your right hand, gently pull the heel towards your buttocks until you feel a stretch in the front of the leg. Keep your upper body straight; do not lean forward. To increase the stretch, pull with enough pressure so that the right knee passes behind the left knee. Reverse legs and repeat.
Hold 30 seconds. Repeat 5 times for each leg, 1 time a day.
If you are experiencing heel pain, call our Rocky Hill or Middletown office to make an appointment.
Jeffrey S. Kahn, DPM
Connecticut Foot Care Centers
Heel Pain Doctor in CT
Podiatrist in Rocky Hill and Middletown, CT
Visit our website, follow my tweets on Twitter, and friend or like our page on Facebook.

Shoes For Heel Pain Sufferers

I often get asked what shoes are best for those who suffer with heel pain, or plantar fasciitis. Sometimes it's easier to say what to stay away from than what you should look for. Here is a short list of shoes I would recommend to patients suffering with heel pain:
1. ECCO Mobile Shoes

ECCO shoes and boots are perfect for work. This model is a lightweight, flexible leather shoe with an anatomic footbed and moisture wicking lining. They are perfect for times when you are taking a walk during a lunch break. Received the APMA Seal of Acceptance.

2. Kuru Insight
Kuru shoes have an insole that flexes with the heelstrike, providing great cushioning and ergonomics. They work for casual office, school, travel, and walking commuters. There is a generous toe box.
3. Nike Free 5.0

Nike Free shoes replicate you walking barefoot and fit your foot like a glove. There is extreme flexibility in the grooved sole that allows your foot to move as it wants. The shoes come with a recommended breaking in schedule to allow your feet to acclimate to the new freedom in these shoes. These shoes are lightweight and have minimal cushioning. Oprah Winfrey named them as one of her favorite things in winter 2010.

4. Balance Walking Shoe: Dr. Weil Integrative Footwear
This is a lightweight walking shoe that can be worn for everyday walking. It comes with the Orthaheeel tri-planar footbed, which provides arch support and motion control. They also come with a regular footbed as well. The shoe is flexible in the forefoot for optimal walking stride and are flat with a low heel.

5. Tenevis La Jolla Shoes
Tenevia La Jolla shoes are known for their super cushioning and motion control. These shoes have a balance bone/balance chip replaceable heel, which is a separate piece from the sole. La Jollas encourage good posture and proper foot alignment.

6. Z-Coil
Z-Coil shoes have a spring in the heel, cushioning in the forefoot, and a stiff orthotic. They are a popular shoe among nurses, store clerks, and other people who are on their feet all day. However, they are individually fit by a distributor to make sure there is the proper fit. The negatives of these shoes are they look odd and are heavy. There are other styles for comfort walking as well as fitness and trail walking.

7. Earth Shoes
Earth Shoes have KALSO Negative Heel Technology, which claims they promote natural walking.

8. Rockport Walker
These shoes have also won the APMA Seal of Acceptance. Rockports can sometimes be too stiff in the sole to promote proper roll-through of the foot when walking, but they are great for standing and walking.
9. MBT Sport Walkers by Swiss Masai
MBT, Masai Barefoot Technology, mimics the way the Masai tribe walks barefoot. These shoes have a stiff fiberglass in the sole and no heel, which forces you to roll-through from heel to toe with every step and enforces good walking technique. They are a heavy shoe, which will take time to get used to. The designers claim that these shoes will help you feel better from head to toe.
If you are experiencing heel pain, call our Rocky Hill or Middletown office to make an appointment.
Jeffrey S. Kahn, DPM
Connecticut Foot Care Centers
Heel Pain Doctor in CT
Podiatrist in Rocky Hill and Middletown, CT
Visit our website, follow my tweets on Twitter, and friend or like our page on Facebook.

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• Treating Heel Pain

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Barefoot Running and Heel Pain

Barefoot running is not a new fad, but with the advent of people looking to incorporate natural means into their exercising, it has risen in popularity. Some scientists believe that barefoot running can improve the health of your feet, knees, and hips, while reducing injuries like plantar fasciitis, or heel pain.
Barefoot running has existed throughout history for thousands of years and there are several cultures today, like in Haiti and Africa, that still run barefoot. In Haiti, researchers have found that those who wear shoes are more likely to have injuries to their feet and ankles than those who run barefoot.
Those who are proponents of barefoot running say that it allows the foot to operate as it was designed. Barefoot running makes the runner use the foot pads on the ball of the foot when striking the ground, rather than striking with the heel, which increases the shock absorbed by the legs and feet. This changes how you run, which advocates believe leads to a healthier foot and running form, also reducing the weight carried in your foot.

With the change in running form, barefoot runners are less likely to have plantar fasciitis, or heel pain, because they are not continuously striking the ground with their heels. The plantar fascia, the thick fibrous band that runs along the bottom of your feet, is less likely to become inflamed and painful because the excess stress you would experience in traditional running is not there. Plantar fasciitis is also caused by poor foot structure and an irregular arch. It is a common running injury.
When making the transition from shod running to barefoot running, do not jump into it right away. You need to ease into it because running shoes have allowed your foot muscles to relax and become undeveloped. You know how your body feels after a long spell of not exercising? Pretty tired and sore right? That's how your feet would feet from going from shoes to no shoes.
There is not enough evidence to effectively prove that barefoot running is more beneficial than running with shoes. Therefore, there is no evidence that barefoot runners are going to experience less or more heel pain. It is for each runner to discover on their own.
If you are experiencing heel pain from barefoot running, call our Rocky Hill or Middletown office to make an appointment.
Jeffrey S. Kahn, DPM
Connecticut Foot Care Centers
Heel Pain Doctor in CT
Podiatrist in Rocky Hill and Middletown, CT
Visit our website, follow my tweets on Twitter, and friend or like our page on Facebook. 

Dr. Oz and High Heels

In 2009, 1,300 Cirque de Soleil stilt walkers claimed the world's record for sitting on top of their wooden pools at the same time. Well, during rush hour everyday in every major city across the United States, women are doing their own stilt walking, but on stilettos.
Women are flocking to podiatrists in record numbers to have their corns, calluses, heel pain, ingrown toenails, and foot pain taken care of, all the result of wearing shoes that are too high, too small, too narrow, and just don't fit. And when those women get that foot problem fixed, they are STILL cramming their feet into shoes that are just inappropriate.
Dr. Oz and Dr. Roizen have the following recommendations for those who wear high heels:

• If you wear heels over 2 inches high, save them for posing, not walking around. And travel with flats. 
• In love with toe-pinchers, or pointy-toe shoes? Buy them a half or full size larger than usual and add heel liners to take the pressure of your toes. 
• Look for shoes with open toes so your toes can breathe and stretch.
• If you have tingling or pain in your heels or balls of your feet, your arches ache, or have lower-back pain, visit a podiatrist. 

If you are experiencing heel pain, call our Rocky Hill or Middletown office to make an appointment.
Jeffrey S. Kahn, DPM
Connecticut Foot Care Centers
Heel Pain Doctor in CT
Podiatrist in Rocky Hill and Middletown, CT
Visit our website, follow my tweets on Twitter, and friend or like our page on Facebook.

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• If Dr. Oz Says It... Flip-Flops Cause Plantar Fasciitis

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